Nevin Manimala

Front Bioeng Biotechnol. 2026 Jul 27;14:1787510. doi: 10.3389/fbioe.2026.1787510. eCollection 2026.

ABSTRACT

INTRODUCTION: Postural transitions (PTs) are crucial daily movements often impaired in neurological conditions, impacting autonomy and fall risk. Wearable inertial measurement units (IMUs) enable objective assessment of PTs, but robust algorithms for automatic identification remain limited.

METHODS: This pilot study used Dynamic Time Warping (DTW), a time-series alignment method that is robust to temporal variations, to automatically identify PTs in healthy subjects (HS) and subjects with Parkinson’s Disease (SwPD). For this purpose, 10 participants (5 HS and 5 SwPD) performed 5 postural transition tasks (sit-to-stand, stand-to-sit, supine-to-sit, sit-to-supine, and roll) using a sternum-mounted IMU. Reference PT patterns were generated from previously collected acceleration data representing optimally executed transitions. The DTW algorithm classified each detected candidate transition by minimizing its distance from predefined reference patterns. Classification performance indexes were statistically compared between groups.

RESULTS: Within this pilot dataset, the DTW algorithm correctly identified 118/118 postural-transition signals in HS and 136/147 signals in SwPD. Misclassifications in SwPD primarily affected sit-to-stand (31%) and stand-to-sit (19%) transitions.

DISCUSSION: These preliminary findings support the feasibility of a DTW-based approach for postural-transition identification, although larger independent validation studies are required. Future work should prioritize real-time deployment and larger validation cohorts.

PMID:42577388 | PMC:PMC13454294 | DOI:10.3389/fbioe.2026.1787510

Front Public Health. 2026 Jul 27;14:1827949. doi: 10.3389/fpubh.2026.1827949. eCollection 2026.

ABSTRACT

OBJECTIVE: To investigate the prevalence of gastrointestinal symptoms (reflux, nausea, and vomiting) among nurses in COVID-19 isolation wards and identify associated factors, with a specific focus on discomfort caused by personal protective equipment (PPE).

STUDY DESIGN: A cross-sectional survey.

METHODS: In March 2020, 354 of 368 eligible nurses (96.2% response rate) from the COVID-19 isolation wards of a designated hospital in Wenzhou, China, completed the survey. Data were collected using a demographic questionnaire, a self-rated PPE discomfort scale, the Gastroesophageal Reflux Disease Questionnaire (GerdQ), the Pittsburgh Sleep Quality Index (PSQI), and the Symptom Checklist-90 (SCL-90). Statistical assessments included univariate, correlation, and multivariable logistic regression analyses. Firth’s penalized likelihood logistic regression and sensitivity analyses were applied to address sparse data in specific subgroups.

RESULTS: The overall prevalence of gastrointestinal symptoms in the cohort was 23.2% (82/354). Multivariable regression identified several independent factors significantly associated with these symptoms (all P < 0.01): severe PPE-induced discomfort (OR = 3.64, 95% CI: 1.95-6.80), elevated psychological stress (SCL-90 total score: OR = 1.14, 95% CI: 1.09-1.20), and poor sleep quality (PSQI total score: OR = 2.10, 95% CI: 1.51-2.92). Although univariate analyses suggested protective associations for prior intensive care unit (ICU) experience and male gender, these effects lost statistical significance following Firth correction. Temporally, 76.8% of symptomatic cases emerged within the first five days of the shift cycle.

CONCLUSIONS: Gastrointestinal symptoms are prevalent among nurses in COVID-19 isolation wards and are strongly associated with PPE-induced discomfort, psychological stress, and sleep disturbances. Although the cross-sectional design precludes causal inference, these findings underscore an urgent need for the ergonomic optimization of PPE to alleviate heat stress and physical burden. Furthermore, implementing rapid adaptation training programs and integrating psychological and sleep support into routine occupational health surveillance are vital to safeguarding frontline clinicians.

PMID:42577379 | PMC:PMC13454333 | DOI:10.3389/fpubh.2026.1827949

Front Artif Intell. 2026 Jul 27;9:1816796. doi: 10.3389/frai.2026.1816796. eCollection 2026.

ABSTRACT

Face recognition systems are widely used in surveillance, biometric authentication, access control, and digital identity verification; however, supervision sensitivity, evaluation stability, and performance consistency across datasets remain insufficiently understood. This study investigates the behavior of convolutional, transformer-based, and hybrid face recognition architectures under both Softmax and ArcFace supervision using five-fold subject-disjoint cross-validation on the Labeled Faces in the Wild (LFW) and FAGEv2 datasets. ResNet50, MobileNetV3, DeiT-Small, and a Hybrid multi-branch architecture integrating complementary convolutional and transformer feature representations were evaluated using Top-1 identification accuracy, Area Under the ROC Curve (AUC), Equal Error Rate (EER), computational complexity, and fold-level statistical analysis. Experimental results revealed substantial supervision sensitivity across architectures and datasets. On the LFW dataset, Hybrid-Softmax achieved the highest Top-1 identification accuracy (62.4%), while DeiT-Small-Softmax achieved the strongest verification performance with an AUC of 0.905 and EER of 0.159. On the FAGEv2 dataset, Hybrid-Softmax and DeiT-Small-Softmax achieved the highest identification accuracy (38.0%), while Hybrid-Softmax achieved the strongest verification performance with an AUC of 0.825 and EER of 0.251. Fold-level analyses demonstrated that the effect of ArcFace supervision varied across architectures and datasets, with consistent improvements observed for some convolutional architectures but not for transformer-based or hybrid models. Cross-dataset evaluation further revealed changes in model ranking and supervision behavior, indicating that comparative performance is strongly influenced by dataset characteristics and evaluation conditions. The findings demonstrate that additive angular margin supervision does not universally outperform conventional Softmax optimization and highlight the importance of multi-dataset benchmarking, fold-level evaluation, and supervision sensitivity analysis for robust and reproducible face recognition benchmarking.

PMID:42577375 | PMC:PMC13454437 | DOI:10.3389/frai.2026.1816796

Front Pediatr. 2026 Jul 27;14:1826785. doi: 10.3389/fped.2026.1826785. eCollection 2026.

ABSTRACT

PURPOSE: To evaluate choroidal microcirculation using choroidal thickness (CTh) in pediatric patients with surgically treated adamantinomatous craniopharyngioma (CP) and to identify clinical and tumor-related factors associated with CTh.

METHODS: This cross-sectional, prospective, observational study included 60 eyes of 31 children with histopathologically confirmed CP and 78 eyes of 39 age- and sex-matched healthy controls. Comprehensive ophthalmological examination and spectral-domain optical coherence tomography (SD-OCT) were performed in all participants. CTh was manually measured at five locations: subfoveal (SFCTh), 1500 μm superior, inferior, nasal, and temporal to the fovea in both eyes. Tumor characteristics and demographic data were collected and analyzed for associations with CTh.

RESULTS: CTh was significantly thinner in the CP group compared to controls at all locations except 1500 μm superior to the fovea. The mean subfoveal CTh was 333.13 μm in the CP group and 370.13 μm in the control group (p < 0.05). The most pronounced thinning was observed nasally (255.93 vs. 335.06 μm, p < 0.05). At the temporal location, mean CTh was 317.62 μm in the CP group and 360.62 μm in controls (p < 0.05). Inferiorly, it measured 318.88 μm in the CP group vs. 346.04 μm in controls (p < 0.05). Superior CTh was 340.23 μm in the CP group and 358.47 μm in controls, with no statistically significant difference (p = 0.08). In the study group, the thickest CTh was found superiorly, while in the control group, it was SFCTh. In both groups, the thinnest CTh was observed nasally. Children born in the city had a significantly thicker SFCTh than those born outside the city (p < 0.005). Cavernous sinus infiltration was associated with increased nasal CTh and temporal CTh (p < 0.005). No association was found between CTh and tumor location, tumor volume, tumor diameter, morphology, third ventricle invasion, hydrocephalus, Rosenthal fibers or ventriculoperitoneal shunt. Age at examination and gender did not affect CTh.

CONCLUSION: Pediatric patients with CP show significantly reduced CTh in multiple locations. Place of birth, and specific tumor characteristics such as cavernous sinus infiltration were influenced by CTh. These findings highlight the complex interplay between tumor characteristics and ocular microvascular changes in pediatric patients with CP.

PMID:42577367 | PMC:PMC13454242 | DOI:10.3389/fped.2026.1826785

Health Sci Rep. 2026 Aug 9;9(8):e73005. doi: 10.1002/hsr2.73005. eCollection 2026 Aug.

ABSTRACT

BACKGROUND AND AIMS: Epilepsy affects about 50 million people worldwide, with stigma and misconceptions that contribute to social exclusion and psychological distress, sometimes more disabling than the physical symptoms. In Syria, epilepsy awareness among university students remains under-studied, despite their role as future healthcare providers and community leaders. This study assessed epilepsy-related knowledge, attitudes, and first-aid practices among Syrian university students and identified associated factors.

METHODS: A cross-sectional study was conducted including 1005 students from 24 Syrian universities using a structured questionnaire that covered demographics, epilepsy knowledge, first aid, and attitudes. Reliability was assessed using Cronbach’s alpha. Data were analyzed using descriptive statistics, t-tests, ANOVA, and logistic regression, with statistical significance set at p < 0.05.

RESULTS: High epilepsy knowledge was found in 59% of students, but misconceptions persisted. Although 63% showed good first-aid knowledge, harmful practices were common. Attitudes were mixed, with 56% expressing positive views but significant reluctance toward close personal and professional relationships, potentially leading to social isolation, discrimination in employment and education, and reduced opportunities for marriage and community integration.

CONCLUSIONS: Syrian students show moderate knowledge but persistent stigma and unsafe practices. Targeted education and first-aid training are needed to reduce misconceptions and improve support for people with epilepsy.

PMID:42577361 | PMC:PMC13454210 | DOI:10.1002/hsr2.73005

JTCVS Tech. 2026 May 6;38:102402. doi: 10.1016/j.xjtc.2026.102402. eCollection 2026 Aug.

ABSTRACT

OBJECTIVE: Cardiac myxomas are the most common primary benign cardiac tumors, with approximately 75% located in the left atrium (LA). The optimal surgical approach for LA myxoma excision remains controversial. This study aims to compare the uniatrial and biatrial approaches in terms of safety and outcomes.

METHODS: We retrospectively reviewed 157 consecutive patients diagnosed with LA myxoma over a 24-year period. Patients were divided into uniatrial (LA group) and biatrial groups on the basis of the surgical approach to compare outcomes.

RESULTS: There was no statistically significant difference between the 2 groups in mean age (P = .61), gender distribution (P = .72), clinical presentation (P = .071), New York Heart Association classification (P = .97), preoperative and postoperative rhythm (P = .83 and P = .20, respectively), concomitant procedures (P = .63), overall postoperative complications (P = .32), re-exploration for bleeding (P = 1), 30-day mortality (P = 1), in-hospital stay (P = .08), long-term survival (P = .42), and recurrence rate (P = .38). However, the mean cardiopulmonary bypass time and aortic crossclamp time were significantly longer in the biatrial group (cardiopulmonary bypass: 81 vs 72 minutes, P = .05; crossclamp: 55 vs 48 minutes, P = .05). Kaplan-Meier survival analysis showed no significant difference in short-, mid- (5-year), and long-term (>10-year) survival rates. Eight cases initially planned for LA approach were converted to biatrial because of technical difficulty.

CONCLUSIONS: To the best of our knowledge, this is the largest single-center study on this topic. Both uniatrial and biatrial approaches provide safe and effective resection of left atrial myxomas with comparable long-term outcomes. The biatrial approach offers improved exposure but at the expense of longer operative times. These findings support an individualized surgical strategy on the basis of tumor characteristics and intraoperative exposure.

PMID:42577350 | PMC:PMC13453849 | DOI:10.1016/j.xjtc.2026.102402

Front Psychiatry. 2026 Jul 27;17:1843959. doi: 10.3389/fpsyt.2026.1843959. eCollection 2026.

ABSTRACT

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, often-but not always-characterized by inattention, hyperactivity/impulsivity, and deficits in executive functions (EFs); some individuals may also exhibit sensorimotor dysfunction. While SMN dysfunction has been implicated in ADHD, the patterns of SMN functional connectivity (FC) and their relationships with clinical symptoms and EFs remain inconsistent, partly due to methodological heterogeneity.

METHODS: The study included 62 medication-naïve patients with ADHD (aged 6-15 years) and 46 healthy controls matched for age, sex, and IQ. Clinical symptoms and EFs were assessed using CPRS, IVA-CPT, and Stroop tests. Resting-state fMRI data were acquired, and ROIs within SMN, SN, DMN, and FPN were selected from the Dosenbach atlas. FC was analyzed using Network-Based Statistics (NBS). Partial correlations explored FC-behavior relationships in the ADHD group, controlling for age, sex, and IQ.

RESULTS: The ADHD group showed significantly higher CPRS hyperactivity/impulsivity scores and poorer IVA-CPT and Stroop performance. Compared to controls, ADHD showed increased FC within SMN (right posterior insula to left precentral gyrus/parietal lobe), between SMN-DMN (precentral gyrus, dorsal frontal cortex, temporal lobe, angular gyrus, posterior cingulate cortex, and precuneus), and SMN-SN (middle insula, superior parietal lobule, superior temporal gyrus, basal ganglia, and fusiform gyrus). Enhanced intra-SMN FC was negatively correlated with impulsivity/hyperactivity and hyperactivity index scores. Enhanced SMN-DMN FC was negatively correlated with hyperactivity symptoms and positively correlated with control quotients in IVA-CPT. Enhanced SMN-SN FC was negatively correlated with Stroop correct responses and positively correlated with omission errors.

CONCLUSIONS: In this medication-naïve pediatric sample, distinct SMN connectivity patterns differentially related to ADHD symptoms and executive function. However, given the cross-sectional design and modest sample size, these associations cannot establish causality; they require replication in longitudinal studies and larger cohorts to clarify whether they reflect developmental variation, neurobiological subtypes, or epiphenomena.

PMID:42577345 | PMC:PMC13454290 | DOI:10.3389/fpsyt.2026.1843959

Front Immunol. 2026 Jul 27;17:1886428. doi: 10.3389/fimmu.2026.1886428. eCollection 2026.

ABSTRACT

OBJECTIVE: This study aims to investigate the impact of different feeding patterns and Mycoplasma pneumoniae (MP) infection on coronary artery lesions (CAL) in children with Kawasaki disease (KD), particularly analyzing whether breastfeeding retains a protective effect against CAL in patients co-infected with MP.

METHODS: A retrospective cohort study was performed, recruiting 388 children diagnosed with KD between January 2020 and January 2025. The participants were categorized into three groups according to feeding status in the first 6 months of life: exclusive breastfeeding (n = 222), partial breastfeeding (n = 76), and formula feeding (n = 90). Of all 388 patients, 88 were MP-positive, and 56 had echocardiography-confirmed CAL. Clinical characteristics and CAL incidence were compared across feeding subgroups. Multivariate logistic regression was applied to assess interaction effects between feeding patterns and MP infection on the risk of CAL development.

RESULTS: Significant intergroup differences were detected in age, proportion of incomplete KD (iKD), and erythrocyte sedimentation rate (ESR) (P < 0.05). The overall CAL incidence was 14.4% (56/388), with no intergroup difference (P = 0.503). Platelet count was identified as an independent risk factor for CAL development (OR = 1.357, 95% CI 1.082-1.702, P = 0.008, per 100 × 10⁹/L increment). Multivariate logistic regression analysis did not reveal a significant interaction between feeding method and MP infection. Within the MP-positive subgroup (n = 88, 14 CAL events), no statistically significant difference in CAL risk was identified between the combined exclusive and partial breastfeeding and formula feeding groups.

CONCLUSION: Among MP-positive KD children in this cohort, we detected no statistically significant inverse association between breastfeeding and CAL risk (OR = 0.906, 95% CI 0.225-3.649). The wide confidence interval reflects considerable statistical uncertainty attributable to the small number of CAL events in this subgroup; therefore, a clinically meaningful protective effect of breastfeeding cannot be ruled out.

PMID:42577342 | PMC:PMC13454092 | DOI:10.3389/fimmu.2026.1886428

Cureus. 2026 Jul 10;18(7):e112426. doi: 10.7759/cureus.112426. eCollection 2026 Jul.

ABSTRACT

Background Hemorrhoidal disease is one of the most common benign anorectal disorders encountered in surgical practice. Although various surgical modalities are available for grade III and IV hemorrhoids, Milligan-Morgan hemorrhoidectomy remains the gold standard treatment. However, postoperative pain is a major complication associated with this procedure. Therefore, hemorrhoidectomy using the harmonic scalpel (HS) has gained attention because of its potential to reduce tissue injury and postoperative pain. Methods This prospective single-center observational study included 112 patients with grade III and IV hemorrhoids who underwent hemorrhoidectomy using the conventional technique (n = 59) or the harmonic scalpel (n = 53) at a tertiary teaching hospital between December 2024 and May 2026. Approval was obtained from the Institutional Ethics Committee of Sri Ramachandra Institute of Higher Education and Research (approval number: CSP-MED/24/OCT/110/327), and written informed consent was obtained from all the participants. The study aimed to compare the efficacy of hemorrhoidectomy using the harmonic scalpel with the conventional technique in terms of perioperative outcomes. The primary outcomes included intraoperative bleeding, operating time, and postoperative pain, whereas secondary outcomes included the duration of hospital stay and postoperative urinary retention. Statistical analysis was performed, and a p-value of <0.05 was considered statistically significant. Results A significant reduction in operating time (<0.001), intraoperative blood loss (<0.001), postoperative pain (<0.001), postoperative urinary catheterization (0.018), and hospital stay (<0.001) was noted in the group undergoing hemorrhoidectomy using the harmonic scalpel compared with the conventional group. Conclusion Patients undergoing hemorrhoidectomy using the harmonic scalpel demonstrated a significant reduction in intra- and postoperative complications compared with the conventional group, suggesting greater efficacy in the management of grade III and IV hemorrhoids.

PMID:42577337 | PMC:PMC13453973 | DOI:10.7759/cureus.112426

Front Surg. 2026 Jul 27;13:1885360. doi: 10.3389/fsurg.2026.1885360. eCollection 2026.

ABSTRACT

OBJECTIVE: To compare the clinical efficacy of retrograde vs. antegrade intramedullary nailing(RIN vs. AIN)for extra-articular distal tibial fracture.

METHODS: This retrospective matched case-control study included 42 patients treated between April 2020 and April 2024-21 with RIN and 21 with AIN. Patients were matched by age and sex. Perioperative parameters, radiographic reduction quality, malunion rate, time to weight-bearing, functional outcomes (Baird-Jackson and AOFAS scores), and complications were assessed. Pain at the knee and ankle was also recorded. All patients were followed for at least 12 months. A post hoc power analysis was performed based on key outcome variables. Binary outcomes were analyzed using conditional logistic regression accounting for the matched design, with sensitivity analyses adjusting for fracture type and fibular fracture. A post-hoc power analysis based on discordant pairs was performed.

RESULTS: Both groups had comparable baseline characteristics. RIN resulted in significantly lower intraoperative blood loss (34.38 ± 2.27 mL vs.49.38 ± 7.00 mL, P < 0.05), shorter hospital stays (8.00 ± 2.07 days vs.11.00 ± 2.10 days, P < 0.05), earlier weight-bearing (11.86 ± 0.96 days vs.12.76 ± 1.04 days, P < 0.05). The RIN group showed a numerically higher rate of excellent fracture reduction (90.5% vs. 76.2%), though this difference was not statistically significant in the matched-pair analysis (OR = 3.50, 95% CI: 0.73-16.85, P = 0.119). post-hoc power analysis indicated that this non-significant finding likely reflected insufficient power (<10%) due to a limited number of discordant pairs. Functional scores improved significantly over time in both groups, with no inter-group differences at any time point. The incidence of anterior knee pain was significantly lower in the RIN group (9.5% vs. 47.6%, OR = 0.10, 95% CI: 0.01-0.82, P = 0.032), whereas malunion rates and other complications were comparable.

CONCLUSION: Both RIN and AIN provide reliable fixation and satisfactory functional outcomes for extra-articular distal tibial fracture. RIN significantly reduces the incidence of anterior knee pain compared to AIN, a finding supported by adequate statistical power. RIN also reduces intraoperative blood loss and shortens hospital stay. The observed numerical advantage in excellent reduction requires further confirmation in larger, appropriately powered studies. RIN may be the preferred approach in selected patients, especially those with high functional demands or preexisting anterior knee pathology.

PMID:42577333 | PMC:PMC13454167 | DOI:10.3389/fsurg.2026.1885360