Nevin Manimala

Horm Behav. 2026 May 25;182:105950. doi: 10.1016/j.yhbeh.2026.105950. Online ahead of print.

ABSTRACT

Some theories have proposed that children with autism spectrum disorder (ASD) may be exposed to increased levels of androgens during prenatal development, resulting in greater androgenization of testosterone-dependent traits including both peripheral (bodily) and central (brain-related) traits. Empirical support for this hypothesis is scant and inconsistent. In the present work, we studied an ostensible anatomical marker of testosterone exposure (sexually differentiated finger lengths) which develops during the first trimester or early second trimester of gestation. Participants were 25 boys with classic autism, recruited from the clinical practice of a local physician specializing in childhood autism, who met the standardized DSM (Diagnostic and Statistical Manual) criteria for ASD, and 57 normally-developing age- and sex-matched male and female controls (32 males, 25 females); N = 82; M_age = 7.30 yrs., SD = 4.18. Finger length was measured to the nearest 0.5 mm from digital images of the ventral surface of the hands using a validated measurement protocol. Consistent with past reports from adult samples, several of the finger length ratios were confirmed to display sex differences among control children, but the group of boys with ASD showed a female-like finger growth pattern, not the hypermasculine pattern predicted, and were found to differ statistically from the male controls. Boys with ASD thus showed a demasculinized pattern of finger differentiation. Our data do not support theories which suggest that greater fetal testosterone exposure occurs in boys with autism.

PMID:42184479 | DOI:10.1016/j.yhbeh.2026.105950

Neural Netw. 2026 May 19;203:109151. doi: 10.1016/j.neunet.2026.109151. Online ahead of print.

ABSTRACT

Accurate identification of the seizure onset zone (SOZ) is critical for the diagnosis and treatment of drug-resistant epilepsy (DRE). In recent years, although phase-amplitude coupling (PAC) has played an important role in epilepsy-related studies, few investigations have focused on applying PAC methods to SOZ identification. To this end, leveraging the capability of PAC to characterize neural interactions within the brain, this study computes the modulation index (MI) from clinical electrocorticography (ECoG) recordings of DRE patients. Subsequently, a statistical analysis of temporally evolving distributions of MI values across multiple frequency bands is conducted to analyze the differences in MI distribution features between SOZ and non-seizure onset zone (NSOZ) regions. Finally, distribution features of MI values are integrated with machine learning techniques to systematically evaluate the influence of different frequency bands and time windows on SOZ identification performance. The results demonstrate that MI distribution features can achieve accurate SOZ identification, with classification accuracy reaching 90.69%, indicating their potential as biomarkers for SOZ identification.

PMID:42184467 | DOI:10.1016/j.neunet.2026.109151

Neural Netw. 2026 May 19;203:109153. doi: 10.1016/j.neunet.2026.109153. Online ahead of print.

ABSTRACT

In safety-critical domains ranging from medical diagnostics to credit scoring, learning algorithms for set-structured data must satisfy strict theoretical axioms: permutation invariance, monotonicity, and computational scalability. However, deep learning architectures and axiomatic aggregation theory remain poorly connected. Building on recent bounds for sum-decomposable set representations, we formalize and specialize a fundamental efficiency limitation in canonical additive architectures (Deep Sets): for exact representation of basic order-statistics with an injective sum-decomposable encoder, sum-pooling requires linear feature scaling (m=Ω(N)), rendering them dimension-inefficient for winner-take-all logic. Conversely, standard attention mechanisms violate monotonicity via competitive normalization. To bridge this gap, we introduce the Monotone Set Transformer (MoST), a verifiable neuro-fuzzy architecture. MoST utilizes a dual-prong design: (1) a learnable non-competitive gating mechanism based on positive kernels to approximate supermodular synergies, and (2) a semantic anchor based on Ordered Weighted Averaging (OWA) that enables explicit rank-dependent aggregation with O(Nlog N) complexity. We prove that MoST preserves set-inclusion monotonicity by construction. In controlled synthetic settings aligned with the theory, MoST can realize near-exact max aggregation, while supplementary experiments show strong monotonic certification and favorable time/memory scaling versus attention baselines. Across molecular tasks, results highlight a task-dependent trade-off between strict monotonic constraints and unconstrained predictive flexibility.

PMID:42184462 | DOI:10.1016/j.neunet.2026.109153

Microbiol Res. 2026 May 22;310:128560. doi: 10.1016/j.micres.2026.128560. Online ahead of print.

ABSTRACT

Heavy metal (HM) contamination in mining soils threatens ecological security and agricultural sustainability worldwide. Phytoremediation is frequently constrained by low plant accumulation efficiency and poor environmental adaptability of plant growth-promoting bacteria in multi-metal contaminated environments. The microbial mechanisms underlying Paenibacillus polymyxa WZ14 enhances multi-HMs (Cd, Pb, Cu) accumulation in diverse leguminous plants remain unclear. A pot experiment combined with 16S rRNA high-throughput Illumina MiSeq sequencing and multivariate statistical analyses was coupled with investigate the regulatory effects of WZ14 inoculation on strengthening leguminous plant (Robinia pseudoacacia L., Sophora xanthantha, Cajanus cajan L., and Albizia kalkora Roxb) HMs accumulation and the underlying microbial mechanisms. In this study, WZ14 inoculation significantly increased the concentrations and total uptake of Cd, Pb and Cu in four leguminous plants, with the strongest enhancement effect on S. xanthantha (Cd, Pb, and Cu uptake increased by 92.78%, 66.26%, and 117.92%, respectively). This promotion effect exhibited distinct plant species specificity and HM type dependence. Besides, WZ14 reshaped rhizosphere microbial community structure, increased relative abundance of HM-responsive dominant genera (Sphingomonas and Flavobacterium increased by 5.06%-31.03% and 8.64%-73.05%, respectively), enhanced microbial co-occurrence network modularity and cooperative interactions. PLS-PM analysis further clarified that available phosphorus, Sphingomonas and Flavisolibacter were the key factors regulating plant HMs uptake, and confirmed the chain regulatory pathway of soil nutrients-dominant genera-plant HMs uptake. Conclusively, this study clarifies the microbial-mediated regulatory mechanism of HMs uptake between P. polymyxa WZ14 and leguminous plants, providing a reliable and environmentally friendly new strategy for the ecological remediation of multi-HM contaminated soils.

PMID:42184460 | DOI:10.1016/j.micres.2026.128560

Bol Med Hosp Infant Mex. 2026;83(2):94-101. doi: 10.24875/BMHIM.25000020.

ABSTRACT

INTRODUCCIÓN: El síndrome de Down (SD) se caracteriza por dismorfias, retraso psicomotor y afectaciones sistémicas. Su prevalencia es de 1:700 nacidos vivos. Aproximadamente el 80% de los recién nacidos con SD presentan hipotonía, que es la principal causa de retraso motor grueso. El desarrollo motor se considera atípico, dado que se retrasa en comparación con niños de la población general. El objetivo de este trabajo es describir los factores asociados al desarrollo motor en pacientes con SD.

MÉTODOS: Se realizó un estudio observacional, analítico, transversal y ambispectivo en el Servicio de Genética Médica del Hospital General de Zona No. 20, Puebla. Se analizaron: edad, sexo, mecanismo citogenético, prematurez, lactancia materna, nivel socioeconómico, cardiopatía congénita, función tiroidea y rehabilitación para el desarrollo motor. Se realizó análisis estadístico descriptivo e inferencial (chi cuadrada) para identificar las variables asociadas al desarrollo motor de pacientes con SD.

RESULTADOS: Se analizaron 40 pacientes con SD, 22 (55%) de sexo masculino y 18 (45%) femenino; la mediana de edad fue 32.5 meses; 22 individuos (55%) presentaron trisomía 21 libre y 18 (45%) en mosaico; en 37 individuos (92.5%) se retrasó el desarrollo motor y solo 3 (7.5%) alcanzaron los hitos. Se encontró una diferencia estadísticamente significativa entre el presentar o no hipotiroidismo y el logro de los hitos (p = 0.046).

CONCLUSIONES: En este estudio se comprobó que los pacientes con SD presentan retraso del desarrollo motor y que existe una diferencia estadísticamente significativa entre el hipotiroidismo y los hitos motores, destacando que el hipotiroidismo no limitó el desarrollo motor en los pacientes con SD que alcanzaron sus hitos motores.

BACKGROUND: Down syndrome (DS) is characterized by dysmorphia, psychomotor delay, and systemic conditions, with a prevalence of 1:700 live births. Around 80% of newborns with DS exhibit hypotonia, which is the main cause of gross motor delay. In these children, motor milestones are considered atypical because it is delayed compared to children in the general population. The aim is to describe factors associated to motor development in patients with DS.

METHODS: An observational, analytical, cross-sectional, and ambispective study was conducted at the Medical Genetics Service of the General Hospital of Zone No. 20, Puebla. Age, sex, cytogenetic mechanism, prematurity, breastfeeding, socioeconomic level, congenital heart disease, thyroid function, and rehabilitation for motor development were analyzed. Descriptive and inferential statistical analysis was performed with the chi square test to identify variables associated with the motor development of patients with DS.

RESULTS: Forty patients were analyzed, 22 (55%) male and 18 (45%) female, a median age of 32.5 months; 22 individuals (55%) had regular trisomy 21 and 18 (45%) mosaicism; 37 individuals (92.5%) presented developmental motor delay and 3 (7.5%) reached the milestones. A statistically significant difference was found between having or not having hypothyroidism and milestone achievement (p = 0.046).

CONCLUSIONS: This study found that patients with DS have delayed motor development and that there is a statistically significant difference between hypothyroidism and motor milestones, highlighting that hypothyroidism did not limit motor development in patients with DS who reached their motor milestones.

PMID:42184417 | DOI:10.24875/BMHIM.25000020

Cir Cir. 2026;94(2):149-156. doi: 10.24875/CIRU.24000358.

ABSTRACT

OBJECTIVE: To bear the evidence that laparoscopy is the possible new treatment of choice in the management of retroperitoneal disease in patients with testicular cancer. The surgical management of retroperitoneal lymph nodes is a crucial step in the multidisciplinary treatment of testicular germ cell tumors. Laparoscopic retroperitoneal approach poses technical challenges in urologic oncology. This study reports on the safety, efficacy, and short-term oncological outcomes of laparoscopic retroperitoneal lymph node dissection at a tertiary referral hospital.

METHOD: Prospective, observational, descriptive study conducted from 2021 to 2023, including 83 patients who underwent laparoscopic retroperitoneal lymph node dissection.

RESULTS: Eleven cases of primary laparoscopic retroperitoneal lymph node dissection (13.3%), 36 standard (43.3%), 22 salvage (26.5%), 11 desperation (13.3%), and 3 redo cases (3.6%) were performed. In primary cases, 81.9% of patients had positive nodes (pN1-3). The conversion rate to open surgery was 6%. Bleeding, lymph node volume, pre-lymphadenectomy markers, chemotherapy, initial histology, and lymph node histology were not risk factors for conversion = Mean surgical time was 250 minutes. There were no major complications (organ injury, vascular injury) or need for blood transfusion = Mean blood loss was 60 mL. Recurrence rate was 9.6%, with recurrence-free survival of 36.7 months.

CONCLUSIONS: The reported experience demonstrated the safety and efficacy of primary laparoscopic retroperitoneal lymph node dissection, as well as post-chemotherapy cases. Laparoscopic approach allows for early patient recovery without compromising oncological outcomes. It is advisable to perform this surgery in high-volume centers with experienced surgeons in retroperitoneal surgery.

PMID:42184400 | DOI:10.24875/CIRU.24000358

Cir Cir. 2026;94(2):167-178. doi: 10.24875/CIRU.25000390.

ABSTRACT

OBJECTIVES: To assess the clinical and ultrasonographic effectiveness of transfer energy capacitive and resistive (TECAR) therapy in managing lateral epicondylitis (LE).

METHOD: Forty-seven patients with clinically and sonographically confirmed unilateral LE were randomized into two groups. The control group received exercise and LE banding for 3 weeks. The TECAR group received the same treatment, plus TECAR therapy 3 times weekly (nine sessions). Outcomes were evaluated using the patient-rated tennis elbow evaluation (PRTEE) as the primary measure. Secondary outcomes included Visual Analog Scale (VAS) scores, handgrip strength (HGS), common extensor tendon (CET) thickness, and total ultrasonography scale score (TUSS). Assessments were made at baseline and post-treatment.

RESULTS: Both groups demonstrated significant improvements in elbow VAS-rest, VAS-night, VAS for activities of daily living (VAS-ADL), forearm VAS-night, VAS-ADL, arm VAS-ADL, lateral epicondyle tenderness-VAS, HGS, TUSS, hypoechogenicity, and PRTEE scores after treatment compared to baseline. Treatment did not significantly improve either group’s forearm VAS-rest, CET thickness, neovascularity, heterogeneity, or bone abnormality. Change in elbow VAS-ADL was found to be statistically significantly better in the TECAR group.

CONCLUSIONS: TECAR therapy, when combined with conventional treatment, led to greater improvement in ADL-related pain and may be particularly beneficial for active individuals requiring faster symptom relief.

PMID:42184399 | DOI:10.24875/CIRU.25000390

Cir Cir. 2026;94(2):197-204. doi: 10.24875/CIRU.24000319.

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the relationship between kinesiophobia and physical activity levels in patients with end-stage kidney disease (ESKD) undergoing hemodialysis.

METHOD: This cross-sectional study involved 227 ESKD patients undergoing HD treatment. Patients were assessed using the Tampa Scale of Kinesiophobia (TSK), the International Physical Activity Questionnaire-short form, and Beck Depression and Anxiety scales.

RESULTS: Our findings revealed a significant association between kinesiophobia and low physical activity levels in HD patients (r = 0.384, p < 0.001). Patients with high TSK scores were more likely to have reduced physical activity levels. In addition, age (odds ratio [OR] = -31.3, p < 0.001), dialysis duration (OR = -57.2, p = 0.003), and TSK score (OR = 49.9, p < 0.001) emerged as independent predictors of physical activity levels. Notably, older age and longer dialysis duration were associated.

CONCLUSIONS: This study highlights the significant impact of kinesiophobia on physical activity levels in HD patients. More research is needed to figure out how these things work and help doctors decide how to treat ESKD patients so they can be more active.

PMID:42184398 | DOI:10.24875/CIRU.24000319

Cir Cir. 2026;94(2):137-148. doi: 10.24875/CIRU.24000222.

ABSTRACT

OBJECTIVE: This study aimed to investigate the application of MIMICS software in measuring femoral neck fracture (FNF) parameters and its clinical significance.

METHOD: Computed tomography data from 72 patients with FNFs were used to reconstruct three-dimensional (3D) models using MIMICS. The FNFs were divided into valgus and bowing groups based on the coronal femoral head-neck angle. A simulated sphere identified the center of the femoral head, and a 3D coordinate system was established. Statistical analyses were performed.

RESULTS: The valgus group showed more lateral x-axis and upward z-axis displacement (both p < 0.01). The medial x-axis and downward z-axis displacement distances were larger in the bowing group (both p < 0.01). Strong positive correlations were found between the horizontal head tilt angle and head spacing, spatial head-neck angle and y-axis displacement distance (all r_s > 0.89, p < 0.01).

CONCLUSIONS: MIMICS-based FNF parameter measurement accurately describes spatial characteristics post-fracture, providing guidance for FNF treatment and evaluation.

PMID:42184394 | DOI:10.24875/CIRU.24000222

Cir Cir. 2026;94(2):214-224. doi: 10.24875/CIRU.24000480.

ABSTRACT

OBJECTIVE: We implemented and evaluated a novel score called the blunt thoracic trauma score (BTTS) for the triage of chest wall injury (CWI) patients to optimize utilization of the intensive care unit (ICU).

METHOD: Patients who sustained rib fractures after a traumatic injury (2014-2020) were identified in our trauma registry. Demographics and clinical characteristics were summarized by cohorts pre- and post-BTTS implementation in 2017 and BTTS > 6 versus BTTS < 6 using median or frequency. Wilcoxon rank-sum test was used to compare continuous variables, and χ² or Fisher’s exact test for categorical variables. Logistic/negative binomial regression models were used to find predictors for ICU admission and length of stay (LOS).

RESULTS: Six hundred thirty-three patients were included; 407 pre-BTTS/226 post-BTTS. Pre-BTTShigher median ISS (p < 0.001), more rib fractures (p < 0.001). Post-BTTS older (p < 0.001), more comorbidities (coronary artery disease [p = 0.028], hyperlipidemia [p = 0.004], pulmonary disease [p = 0.038]). Post-BTTS cohort had lower rates of ICU admission (p = 0.008), shorter ICU-LOS (p < 0.001), and Hospital-LOS (p < 0.001). Post-BTTS cohort was associated with shorter Hospital-LOS after adjusting for other factors (p = 0.004).

CONCLUSIONS: Implementation of a novel BTTS for triage of CWI was associated with decreased ICU admission rates and shorter ICU-LOS and Hospital-LOS. The decreased Hospital-LOS persisted even after controlling for other factors.

PMID:42184391 | DOI:10.24875/CIRU.24000480