Nevin Manimala

Behav Sci Law. 2026 May 27. doi: 10.1002/bsl.70072. Online ahead of print.

ABSTRACT

This study examined and compared the prevalence and expression of psychopathic traits in a Portuguese sample of prisoners and community members, using the abbreviated version of the Self-Report Psychopathy Scale (SRP-SF). The sample consisted of 766 participants (41.5% prisoners, 58.5% community members) of both sexes. Results indicated that prisoners presented significantly higher levels in all four facets of psychopathy. Males presented higher levels in all facets, regardless of context. The interaction between sex and context was statistically significant only in the affective facet: female prisoners presented similar levels to male prisoners, while females in the community presented lower levels. 31.4% of inmates scored high on psychopathy (≥ 70), compared to 2.2% in the community, demonstrating the discriminant validity of the SRP-SF. The results support the dimensional conceptualization of psychopathy and illustrate the utility of the SRP-SF for forensic screening. Practical implications for forensic assessment, prison intervention, and community prevention are discussed.

PMID:42204381 | DOI:10.1002/bsl.70072

Chirality. 2026 Jun;38(6):e70107. doi: 10.1002/chir.70107.

ABSTRACT

The homochirality of life-the exclusive use of L-amino acids and the universal right-handedness of $\alpha$ -helices-stands as one of the most persistent asymmetries in biology. While often attributed to kinetic or energetic biases, the overwhelming statistical dominance of these chiral forms still lacks a fully compelling thermodynamic and geometric explanation. Here, we propose a geometric mechanism for the stabilization and amplification of biomolecular handedness in open, entropy-producing systems. By introducing a local chirality marker based on the sign of a scalar triple product (equivalently, the sign of a determinant built from atomic coordinate differences and the local helical axis), we show that right-handed $\alpha$ -helices can be can be represented as orientation-preserving sectors of the local configuration space in the local configuration space. Under physically admissible continuous backbone moves, chirality inversion requires crossing a degenerate subset where the marker vanishes, which constitutes a lower dimensional region of effectively zero measure in the feasible configuration manifold. Consequently, parity-inverting pathways are dynamically suppressed, and once a chiral sign becomes established, it tends to persist and amplify under irreversible evolution consistent with least-time free-energy dissipation. Our framework reframes biomolecular homochirality not as the consequence of a primordial energetic asymmetry but as an emergent, statistically stabilized standard arising from the interplay between nonequilibrium thermodynamics and the geometry of configuration space.

PMID:42204377 | DOI:10.1002/chir.70107

NPJ Digit Med. 2026 May 27. doi: 10.1038/s41746-026-02721-3. Online ahead of print.

ABSTRACT

Significant executive function deficits mark attention-deficit/hyperactivity disorder (ADHD). Digital therapeutics (DTx) targeting cognitive control offer promising non-pharmacological options but require rigorous validation. We evaluated the efficacy and safety of STAR RUCKUS, an adaptive multitasking DTx designed to strengthen cognitive control in children with ADHD. In this multicenter, randomized, single-blind, sham-controlled trial, 122 children aged 6-12 years with DSM-5/ICD-10-diagnosed ADHD were assigned 1:1 to STAR RUCKUS or a visually matched driving-only sham intervention and completed five daily sessions for 4 weeks. The primary outcome was the change in clinician-rated Korean ADHD rating scale (K-ARS) scores. Of 122 randomized children, 114 completed the trial. At Week 4, STAR RUCKUS produced greater symptom reduction than sham (-7.50 vs. -4.00; p = 0.009), with improvements in inattention (p = 0.024) and hyperactivity/impulsivity (p = 0.015). These findings suggest statistically significant improvements of small-to-moderate magnitude (ηp² = 0.05) in clinician-rated ADHD symptoms, along with favorable adherence and tolerability. Trial registration: ClinicalTrials.gov (NCT07173439).

PMID:42204362 | DOI:10.1038/s41746-026-02721-3

Sci Rep. 2026 May 27. doi: 10.1038/s41598-026-54614-w. Online ahead of print.

ABSTRACT

Hypertension is a chronic condition frequently requiring long-term pharmacotherapy, which may increase the risk of medication-related problems. Comprehensive Medication Management (CMM) has been associated with improvements in health outcomes in patients with hypertension; however, evidence from pragmatic randomized clinical trials in primary care settings remains limited. This study aimed to evaluate the association between pharmacist-led CMM on clinical, anthropometric, humanistic, and cardiovascular risk outcomes among patients with hypertension treated within the public health care network of Alegre, Espírito Santo, Brazil. A pragmatic, single-blind, randomized controlled clinical trial with a 12-month follow-up was conducted. A total of 128 adults with hypertension were randomized in a 1:1 ratio to the intervention group (CMM) or the control group (usual care). No statistically significant between-group differences were observed for clinical, anthropometric, or humanistic parameters; cardiovascular risk was the only outcome showing a statistically significant time × group interaction (p = 0.039; η²p = 0.026), indicating a trend toward a more favorable trajectory in the CMM group. Intention-to-treat analyses showed significant time effects for systolic blood pressure, lipid profile components, quality of life, hypertension-related knowledge, and cardiovascular risk in both groups. In exploratory intragroup analyses, the intervention group showed significant changes in systolic blood pressure (- 9.47 mmHg), total cholesterol, LDL cholesterol, non-HDL cholesterol, and cardiovascular risk, along with improvements in quality of life and hypertension-related knowledge, whereas the control group showed improvements limited to knowledge scores and self-rated quality of life. Per-protocol sensitivity analyses confirmed the consistency of these findings. Although between-group comparisons did not demonstrate clear statistical superiority of CMM over usual care for most outcomes, the results suggest that CMM may contribute to clinically relevant improvements in cardiovascular risk and patient-centered outcomes in real-world practice. These findings should be considered hypothesis-generating, and larger, adequately powered, multicenter pragmatic trials are warranted to confirm the effectiveness of CMM in hypertension management.

PMID:42204303 | DOI:10.1038/s41598-026-54614-w

Sci Rep. 2026 May 28. doi: 10.1038/s41598-026-54404-4. Online ahead of print.

ABSTRACT

We aimed to study the relationship between brain network measures and cognitive performance in this population, focusing on hub regions. A sub-cohort of young stroke survivors (ages 18-49) with confirmed cerebral ischemia from the ODYSSEY study underwent MRI and neuropsychological assessments at baseline (n = 60) and follow-up (n = 46) up to 2 years, the discovery cohort. Additionally, a validation cohort of young stroke survivors with confirmed cerebral ischemia who had baseline standard MRI protocol and neuropsychological assessment (n = 423), as well as follow-up neuropsychological assessment (n = 288), was included for validation analysis. We used diffusion tensor imaging (DTI) based connectivity matrices for graph analysis. Lesion impact scores (combining affected voxel percentage and mean betweenness centrality) and rich club scores (quantifying affected voxels in rich club areas) were calculated using a normative brain atlas derived from DTI data from 23 stroke-free controls. Participants were categorized having no/mild or major vascular cognitive disorder (VCD) and group differences were examined. Among 60 participants (median age: 39.2 years (IQR 27.9-46.2) and 52% women), 20 were classified as having major VCD. The major VCD group exhibited larger lesion volumes (p = 0.01), lower global efficiency (p = 0.03) and local efficiency (p = 0.05) compared to the no/mild VCD group at baseline and follow-up. However, after adjusting for network density in sensitivity analyses, these differences in global and local efficiency were no longer statistically significant. Univariable logistic regression analyses revealed that the Lesion Impact Score were a significant predictor for VCD at follow-up and the Rich Club Score predicted VCD at baseline and follow-up. However, in multivariable logistic regression, both the Lesion Impact Score and the Rich Club Score did not retain predictive significance. Following validation analysis, no predictive values were observed for any of these scores. Our findings indicate a significant association between brain network measures and cognitive function in young stroke survivors, indicating a role of network disruption in post-stroke cognitive impairment. However, our study did not reveal specific associations with hub regions.

PMID:42204300 | DOI:10.1038/s41598-026-54404-4

Sci Rep. 2026 May 27;16(1):16417. doi: 10.1038/s41598-026-54582-1.

NO ABSTRACT

PMID:42204267 | DOI:10.1038/s41598-026-54582-1

Sci Rep. 2026 May 27. doi: 10.1038/s41598-026-55008-8. Online ahead of print.

ABSTRACT

To investigate the frequency of pseudoexfoliation syndrome (PEXS), its ocular and systemic clinical features in patients scheduled for cataract surgery, and to evaluate surgical complications and outcomes. Data from 585 eyes that underwent cataract surgery were included in this retrospective study. Data retrieved from patient files and our hospital’s electronic medical records were reviewed, including the presence of PEXS, pupil dilation, cataract type, nuclear hardness according to Lens Opacities Classification System III, and glaucoma. Additionally, data on clinical characteristics of pre-existing systemic diseases, surgical outcomes, and intraoperative and postoperative complications were also noted. The data were analyzed between two groups: eyes with PEXS and eyes without PEXS. The frequency of PEXS was 10.7%. The most common type of cataracts in the PEXS group was nuclear cataracts. Nuclear cataracts were harder in eyes with PEXS than in eyes without PEXS. Mean intraocular pressure was significantly higher in eyes with PEXS than in eyes without PEXS (p = 0.001). The prevalence of glaucoma was significantly higher in the PEXS group (p = 0.001). There was no statistically significant difference between the two groups in terms of the frequency of intraoperative and postoperative complications. The non-PEXS group showed significantly better best-corrected visual acuity (BCVA) compared to the PEXS group at the first week postoperatively (p = 0.001). However, BCVA was comparable between groups at the one-month postoperative visit. The frequency of PEXS was relatively high in our study. Awareness of the potential risks associated with PEXS in cataract surgery is essential, and appropriate preparations, including necessary surgical tools and techniques, should be made to ensure optimal outcomes. Although no differences were observed in the rates of intraoperative complications between the groups, this finding should be interpreted cautiously and should not be considered as evidence of equivalent surgical risk.

PMID:42204261 | DOI:10.1038/s41598-026-55008-8

Sci Rep. 2026 May 27. doi: 10.1038/s41598-026-53896-4. Online ahead of print.

ABSTRACT

Both frailty and symptomatic knee osteoarthritis (SKOA) are prevalent among older adults, with a greater incidence noted in women. The present study aimed to classify the trajectory types pertaining to the Frailty Index (FI) in postmenopausal women, explore the longitudinal correlational link among different FI trajectory profiles as well as the likelihood of developing SKOA, and evaluate the predictive value of FI trajectories for SKOA along with the robustness of this association. A long-term prospective follow-up investigation was conducted on the basis of the CHARLS cohort of postmenopausal women. Latent Class Growth Modeling (LCGM) was applied to classify the FI trajectory patterns across five waves from 2011 to 2020. Differences in the cumulative incidence risk of SKOA among trajectory subgroups were evaluated using Kaplan-Meier survival curves paired with the log-rank statistical test. The strength of this association was assessed using Cox proportional hazards regression models. Model performance across FI trajectories, as well as baseline frailty, was assessed and contrasted using ROC curves, Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI). E-value estimation, subgroup analyses, and sensitivity analyses were performed to gauge the robustness of this association. For this investigation, data pertaining to 4636 postmenopausal women within the CHARLS study cohort were analyzed, with a systematic comparison of the predictive capacity of FI trajectories and baseline frailty status in assessing SKOA. The results showed that both FI trajectories and baseline frailty status showed statistically significant correlations with SKOA. Specifically, in contrast to the low-baseline slight-increase trajectory subgroup (Class 1), the high-baseline consistently rising trajectory subgroup (Class 3) exhibited the greatest likelihood of developing SKOA (HR: 3.86, 95% CI: 3.19-4.68), followed by the moderate-baseline gentle-increase trajectory group (Class 2) (HR: 3.35, 95% CI: 2.98-3.77). In comparison with baseline frailty, FI trajectories exhibited stronger predictive capability, as evaluated by the ROC curve, NRI, and IDI. Additional analyses, such as E-value calculations, subgroup analyses, and multiple sensitivity analyses, validated the stability of these relationships. The findings from this investigation highlight the significance of frailty and FI trajectories in evaluating SKOA among postmenopausal women.

PMID:42204258 | DOI:10.1038/s41598-026-53896-4

NPJ Digit Med. 2026 May 27. doi: 10.1038/s41746-026-02796-y. Online ahead of print.

ABSTRACT

Gastroesophageal reflux disease (GERD) diagnosis traditionally relies on acid exposure time (AET) obtained from 24-h multichannel intraluminal impedance-pH (MII-pH) monitoring, the gold standard for GERD diagnosis. However, a negative result (AET < 4%) does not always exclude GERD, as the limited 24-h monitoring window may fail to capture reflux events in patients with intermittent or low-frequency reflux. To address this limitation, we proposed a complementary machine learning-based framework targeting exclusively patients with negative MII-pH results (AET < 4%) to identify potential false-negative cases within this cohort, by integrating statistical and waveform-derived features from pH signals to enhance anomaly detection. Using one-class support vector machine and support vector data description models trained on real-world MII-pH datasets, the framework achieved an $F_3$ score of approximately 0.9 and identified potential anomalies undetected by the conventional AET criteria. Explainable AI techniques using Shapley additive explanations showed that features such as kurtosis and peak-to-peak amplitude contributed significantly to the identification of subtle reflux patterns within this cohort. These anomalies may indicate additional candidates for clinical reassessment within the AET-negative cohort. This complementary approach, operating downstream of the conventional MII-pH diagnostic system, could help identify potential false-negative cases among patients with negative MII-pH results, potentially assisting in their proper clinical management.

PMID:42204253 | DOI:10.1038/s41746-026-02796-y

Commun Med (Lond). 2026 May 28. doi: 10.1038/s43856-026-01645-z. Online ahead of print.

ABSTRACT

BACKGROUND: Prostate cancer (PCa) is heterogeneous, making risk stratification essential for clinical care. Although polygenic risk scores (PRSs) with main effects of single-nucleotide polymorphisms (SNPs) can help identify individuals at high risk before biological and clinical onset, a PRS for predicting PCa aggressiveness remains underdeveloped. The KLK3, which encodes prostate-specific antigen (PSA), is linked to PCa aggressiveness. Recent findings on KLK3 SNP-SNP interactions show promise for predicting PCa aggressiveness. The objective of this study is to develop a PRS (PRS-KLK3int) by examining KLK3 SNP-SNP interaction pairs.

METHODS: The PRS-KLK3int was developed based on a discovery set (10,836 PCa patients) and two validation sets with 14,348 and 16,584 patients of European ancestry. A total of 3145 SNP pairs and two published PRSs were evaluated.

RESULTS: This study developed a PRS-KLK3int with 284 SNPs, combining an existing PRS with 270 SNPs and 12 SNP-SNP interaction pairs with 15 SNPs (one overlapped). All these 12 pairs were involved with at least one SNP from KLK3. The PRS-KLK3int outperformed two existing PRSs in predicting PCa aggressiveness (p-values: 3.5×10^-18, 9×10^-14, and 1.7×10^-20 for the three sets). It effectively distinguished high-risk from low-risk groups across all datasets. The top 1% high-risk group had a higher prevalence of PCa aggressiveness than the middle 50% group (45.5% vs. 25.9%, OR = 2.38, p = 2.2×10^-5) in the discovery set, and similar results were observed in validation sets (OR = 2.56, p = 4.3×10^-6; OR = 2.07, p = 2.1×10^-5).

CONCLUSIONS: These findings support PRS-KLK3int as a valuable tool for PCa severity stratification, especially in identifying extremely high-risk PCa patients.

PMID:42204244 | DOI:10.1038/s43856-026-01645-z