Nevin Manimala

Front Med (Lausanne). 2026 May 15;13:1807805. doi: 10.3389/fmed.2026.1807805. eCollection 2026.

ABSTRACT

BACKGROUND: Vascular calcification (VC), characterized by calcium deposition in arterial walls, is a major risk factor for cardiovascular morbidity and mortality. While genome-wide association studies (GWAS) have identified susceptibility loci for specific vascular beds, such as coronary artery calcification (CAC) and abdominal aortic calcification (AAC), single-phenotype studies may overlook pleiotropic variants. This study aims to elucidate the shared genetic architecture of CAC and AAC and translate these findings into biological insights and potential therapeutic targets.

METHODS: We performed a multivariate genome-wide analysis integrating summary statistics for CAC and AAC from individuals of European ancestry. To prioritize candidate genes, we applied four complementary mapping strategies, including positional mapping, multivariate set-based association test, transcriptome-wide association study, and multi-marker analysis of genomic annotation. Findings were further characterized using tissue-specific expression profiling, Gene Ontology enrichment, and cell-type specificity analysis. Therapeutic potential and safety were subsequently evaluated using OpenTargets for druggability assessment and phenome-wide association studies (PheWAS) to assess horizontal pleiotropy. Finally, experimental validation was conducted to verify the genetic findings.

RESULTS: The multivariate analysis identified seven genome-wide significant loci. Cross-referencing the four gene-mapping strategies highlighted a consensus set of robust candidate genes, with CDKN2B supported by all methods, and strong multi-method support for ADAMTS7, PHACTR1, and MORF4L1. Pathway analysis identified lipid homeostasis and cell cycle regulation as key functional modules. Cell-type specificity analysis demonstrated that candidate genes were enriched in endothelial cells. Druggability assessments identified HDAC9 as a target for approved drugs potentially repurposed for VC, while PheWAS results suggested a predicted lack of severe genetic pleiotropy for most candidates, with the notable exception of CDKN2A, which showed associations with neoplasms. Quantitative real-time PCR confirmed significantly altered expression of most candidate genes, including ADAMTS7, CDKN2A, CDKN2B, CXCL12, FHL5, HDAC9, MORF4L1, PDGFD, and PHACTR1, in the experimental group.

CONCLUSION: This study demonstrates that CAC and AAC share a substantial genetic basis, reinforcing the concept of VC as a systemic pathological process driven by common mechanisms. By rigorously prioritizing candidate genes and mapping them to specific cell types, we provide a comprehensive genetic map of VC and highlight potentially safe targets for future therapeutic development.

PMID:42221083 | PMC:PMC13218890 | DOI:10.3389/fmed.2026.1807805

Front Med (Lausanne). 2026 May 15;13:1793058. doi: 10.3389/fmed.2026.1793058. eCollection 2026.

ABSTRACT

INTRODUCTION: The clinical-epidemiological profile of Chagas disease (CD) has changed over the past decades, leading to decreased levels of physical activity (PA), which may be associated with changes in markers of subclinical atherosclerosis. This study aimed to investigate the association between PA levels and carotid intima-media thickness (CIMT), the presence of carotid atherosclerotic plaque (CAP), and the amount of epicardial adipose tissue (EAT) in patients with chronic CD.

METHODS: This cross-sectional study included patients with chronic CD. The PA level was determined using the short version of the International Physical Activity Questionnaire (IPAQ-short). CIMT and CAP were assessed using Doppler ultrasound of the carotid arteries. The amount of EAT was assessed using transthoracic echocardiography. Linear and binomial logistic regression models were used.

RESULTS: The median age of the 349 participants was 62 years (54.0-69.0), 56.5% were women, and 79.5% were non-white, with 67.6% having <9 years of schooling. The most common clinical form of CD was the cardiac form without heart failure (HF) (53.9%). Median CIMT values were 0.65 mm (left) and 0.66 mm (right). CAP was present in 46.4% of participants, and the median EAT was 5.0 mm. No statistically significant association was observed between PA levels and CIMT, the presence of CAP, or the amount of EAT.

CONCLUSION: PA levels were not associated with the markers of subclinical atherosclerosis in individuals with chronic CD.

PMID:42221074 | PMC:PMC13219020 | DOI:10.3389/fmed.2026.1793058

Front Med (Lausanne). 2026 May 14;13:1786137. doi: 10.3389/fmed.2026.1786137. eCollection 2026.

ABSTRACT

OBJECTIVE: Fentanyl-induced cough (FIC) is a common adverse event during anesthesia induction with a high incidence and may result in serious clinical complications. Although our clinical observations suggest that oliceridine attenuates FIC, the available evidence remains limited. This study was designed to assess the prophylactic efficacy of oliceridine against FIC and to characterize its peri-induction safety profile.

METHODS: A total of 168 adult surgical patients with American Society of Anesthesiologists physical status I-III scheduled for general anesthesia were randomized to receive either oliceridine 2 mg (OF group) or normal saline (SF group) prior to fentanyl administration. The primary outcome was the incidence of cough within 1 min following fentanyl injection. Secondary outcomes included cough severity, vital sign changes, and the incidence of adverse events.

RESULTS: No patients in the OF group experienced FIC, compared to 58.33% in the SF group (p < 0.001). Cough severity in the SF group was classified as mild (17.86%), moderate (20.24%), and severe (20.24%). Vital signs did not show statistically significant changes from before to after oliceridine injection within each group, and no significant between-group differences were identified. The incidence of adverse events was low in both groups, with no significant between-group differences.

CONCLUSION: Pretreatment with 2 mg oliceridine effectively reduces the incidence of FIC without increasing significant additional risks, providing a rationale and safe approach for anesthetic induction.

CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=272947, identifier ChiCTR2500105221.

PMID:42221070 | PMC:PMC13215988 | DOI:10.3389/fmed.2026.1786137

Front Med (Lausanne). 2026 May 14;13:1829842. doi: 10.3389/fmed.2026.1829842. eCollection 2026.

ABSTRACT

INTRODUCTION: The comparative impact of Minimally Invasive Cardiac Surgery versus median sternotomy on the interplay between peripheral muscle strength, kinesiophobia, and functional capacity remains unclear. This study compared these parameters in the early postoperative period.

METHODS: Forty-six patients (30 Sternotomy, 16 Minimally Invasive Cardiac Surgery) were included in this prospective study. Peripheral muscle strength (handgrip and knee extension), functional capacity (30-Second Sit-to-Stand test), and kinesiophobia (Tampa Kinesiophobia Scale) were assessed preoperatively and on the postoperative 5th day.

RESULTS: Both groups experienced a significant decline in postoperative muscle strength from baseline; however, there was no statistically significant difference between the groups regarding the magnitude of this decline (e.g., right handgrip p = 0.366, right knee extension p = 0.294). However, the Minimally Invasive Cardiac Surgery group demonstrated superior functional performance in the 30-Second Sit-to-Stand test (p = 0.008) and significantly lower increases in kinesiophobia scores compared to the sternotomy group (p = 0.008). A significant negative correlation was found between kinesiophobia and functional capacity (r = -0.311, p = 0.035).

CONCLUSION: Although Minimally Invasive Cardiac Surgery does not mitigate surgery-associated muscle strength decline, it offers a distinct advantage in preserving functional capacity by minimizing kinesiophobia. Functional limitations after sternotomy appear driven more by movement-related fear than muscle weakness. Consequently, rehabilitation strategies should integrate kinesiophobia management to optimize early mobilization and functional independence.

CLINICAL TRAIL REGISTRATION: ClinicalTrials.gov, identifier (NCT07172529).

PMID:42221065 | PMC:PMC13216003 | DOI:10.3389/fmed.2026.1829842

Front Big Data. 2026 May 15;9:1799073. doi: 10.3389/fdata.2026.1799073. eCollection 2026.

ABSTRACT

Inventory management is a critical business process that affects the operational efficiency and competitiveness of manufacturing companies. Inaccurate inventory decisions can result in significant financial losses for companies. Demand variability poses a challenge in determining inventory levels, requiring more sophisticated, flexible forecasting methods. This study was conducted to examine the roles of statistical methods and Artificial Intelligence (AI) in inventory decision-making in the manufacturing industry, analyze the conditions under which each method is suitable, and evaluate the potential of a hybrid approach integrating statistical methods and AI. This study uses the Systematic Literature Review method with the PRISMA 2020 framework to ensure research transparency and accuracy. This study identifies articles from reputable databases indexed in Scopus. The findings show a significant shift in inventory management research. In the last decade, AI technology has dominated the literature at 62.5%, while statistical methods account for 25%, and hybrid methods have begun to emerge but remain limited to 12.5%. Based on the review of selected papers, statistical methods have proven to remain effective for consistent historical data and stable demand patterns. Conversely, in dynamic operational environments with large-scale data and complex nonlinear patterns, AI technology is superior. This study also found that the hybrid approach has great potential to balance accuracy, interpretability, and decision support, although the relevant literature remains limited. The implementation of technology in the manufacturing industry faces several obstacles, including limited data quality, a skills gap in technology, and the black-box nature of complex AI. This review provides a systematic and critical synthesis of methodological patterns and operational fit in the use of statistical, AI, and hybrid methods for manufacturing inventory management. Future research is recommended to focus on the development of interpretable AI, modular hybrid frameworks, and the use of real industry data to ensure that academic innovations can be applied in the manufacturing industry.

PMID:42221062 | PMC:PMC13218985 | DOI:10.3389/fdata.2026.1799073

J Med Educ Curric Dev. 2026 May 29;13:23821205261450082. doi: 10.1177/23821205261450082. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: Clear communication and cohesive teamwork are critical for ensuring safe, high-quality patient care, especially within the demanding environment of the labor ward. Pakistan faces some of the worst pregnancy outcomes globally. The TeamSTEPPS® is a validated curriculum for teaching interprofessional communication to healthcare professionals. Given the unique contexts of maternity care in Pakistan, there is a need to test the effectiveness of the TeamSTEPPS® program in interprofessional team involved in provision of care.

METHODS: This quasi experimental study was conducted at Services Institute Medical Sciences/Services hospital Lahore, Pakistan. All the nursing students, pharmacist, obstetric, anesthesia and pediatric residents posted in labour room for two months were included. A core team of faculty taught the participants using TeamSTEPPS® framework. Participants knowledge, perceptions and attitudes were checked pre-training, one week and one month post-training using TeamSTEPPS® questionnaire of Teamwork Attitudes Questionnaire, Teamwork Perceptions Questionnaire and learning benchmarks. Team performance using Team Performance Observation Tool was also assessed after a month by simulation scenarios. Data were entered and analyzed using SPSS version 25. Descriptive statistics were used to summarize demographic characteristics and Chi-square test was applied to evaluate the association between pre- and post-intervention scores related to attitude, perception, benchmark and team performance. P-value of less than 0.05 was considered statistically significant.

RESULTS: Total of 25 participants were imparted training. Significant improvements in team knowledge were seen in understanding the role of a team leader, shared mental model identifying the best method for conflict resolution at one week and one month post training (P<0.05). Changes in attitudes was observed in Team Structure, leadership and communication after one month (p<0.05). The intervention was effective in enhancing perceptions of team structure, situation monitoring, mutual support, and communication (p<0.05). The team performance assessment showed that all teams scored from acceptable to excellent implying that training had positive impact on their ability to work as interprofessional team.

CONCLUSION: The study demonstrated improvements in knowledge, attitudes, perceptions, and observed behaviors of healthcare professionals, affirming the relevance and effectiveness of structured teamwork training in a maternity care setting. This advocates for integration of TeamSTEPPS® into medical curricula, institutional policy, and national health programs.

PMID:42221058 | PMC:PMC13221585 | DOI:10.1177/23821205261450082

Tob Induc Dis. 2026 May 28;24. doi: 10.18332/tid/219364. eCollection 2026.

ABSTRACT

INTRODUCTION: Previous studies have established a link between marital relationship quality and smoking cessation behavior, but the mediating role of nicotine dependence has not been fully explored. The purpose of this study was to explore the association between marital satisfaction and willingness to quit smoking, and to test the mediating role of nicotine dependence in this association.

METHODS: This study was conducted among students in grades 1 to 5 at 17 pilot elementary schools in Qingdao, China. It is a cross-sectional analysis study that collected data in July 2022. The sample consisted of families in which the father smoked and the mother did not. Researchers underwent standardized training before data collection. Parents were screened, and both spouses completed corresponding questionnaires, ultimately yielding 950 valid matched questionnaires. Structural equation modeling using AMOS was employed to test the mediating effect of nicotine dependence.

RESULTS: Path analysis revealed that marital satisfaction was negatively associated with nicotine dependence (β= -0.091; 95% CI: -0.172 – -0.014). Willingness to quit smoking was positively related to marital satisfaction (β=0.063; 95% CI: 0.001-0.129) and negatively associated with nicotine dependence (β= -0.394; 95% CI: -0.469 – -0.314). Moreover, the indirect effect of willingness to quit smoking on marital satisfaction via nicotine dependence was positive and statistically significant (β=0.036; 95% CI: 0.006-0.072). Bootstrap mediation tests revealed statistically significant direct and mediating effects, with the mediating effect accounting for 36.36% of the variance.

CONCLUSIONS: The results supported that nicotine dependence had a mediating effect between marital satisfaction and willingness to quit smoking.

PMID:42221057 | PMC:PMC13218405 | DOI:10.18332/tid/219364

Tob Induc Dis. 2026 May 28;24. doi: 10.18332/tid/220358. eCollection 2026.

ABSTRACT

INTRODUCTION: Although smoking is not an effective coping mechanism, it is a common behavior among university students experiencing psychological distress, but limited research has examined its psychological determinants in multicultural university settings. This mixed-methods study investigated the relationship between smoking behavior and the mental toughness scale.

METHODS: A convergent mixed-methods cross-sectional study design was conducted between March and June 2025 among 280 immigrant students at the University of Bologna. Eligible participants were students aged 18-30 years, currently enrolled in a study program, able to communicate in English or Italian, and without chronic conditions affecting smoking behavior. Quantitative data assessed demographic characteristics, smoking patterns, and mental toughness, assessed using the Mental Toughness Questionnaire (MTQ-18), which evaluates control, commitment, challenge, self-confidence, and underlying psychological and migration-related stressors. Qualitative data were obtained through semi-structured interviews exploring emotional coping, cultural adaptation, and smoking motivations. Data were analyzed separately and integrated during interpretation.

RESULTS: Among the 280 participants, 42.86% were smokers and 57.14% were nonsmokers. No statistically significant associations were found between smoking status and demographic variables, including gender (χ²=0.66, p=0.417), age (χ²=6.70, p=0.152), parental smoking (χ²=0.00, p=1.000), and sibling smoking (χ²=0.07, p=0.789). Most smokers reported low to moderate cigarette consumption (1-10 cigarettes per day). Across all mental toughness dimensions, smokers demonstrated lower mean scores compared to non-smokers. For instance, overall mental toughness scores were lower among smokers (males: 2.57; females: 2.31) compared to non-smokers (males: 3.84; females: 3.74). Qualitative findings highlighted key psychological stressors, including identity disruption, anxiety, academic pressure, and social isolation, which contributed to smoking behavior as a perceived means of emotional regulation.

CONCLUSIONS: Smoking behavior among immigrant students is shaped primarily by psychological vulnerability and migration-related stress rather than demographic characteristics. Integrating mental health support, stress-management resources, and culturally responsive interventions into smoking prevention programs may be essential for reducing smoking in immigrant student populations.

PMID:42221056 | PMC:PMC13218404 | DOI:10.18332/tid/220358

Intractable Rare Dis Res. 2026 May 31;15(2):194-199. doi: 10.5582/irdr.2026.01011.

ABSTRACT

There is controversial evidence that some selected congenital anomalies (CA) are associated with sex, maternal age, urban-rural residence, or socioeconomic status among the Hispanic population. This study aimed to assess the prevalence and maternal-child clinical and socioeconomic factors across a wide range of CA in a hospital-based setting from northwest Mexico. From January to December 2023, a cross-sectional study for CA and live births at Durango General Hospital was performed. Hospital-based prevalence was calculated for all CA subtypes and grouped anatomical system defects. Associations with CA and subgroup analysis were conducted to assess newborn sex, maternal age, residence, and socioeconomic factors on CA prevalence, using Pearson’s chi-squared test and Fisher’s exact test. Probability of CA was estimated based on logistic regression analysis along with odds ratio (OR) and its 95% confidence interval. All tests were two-sided with p values < 0.05 considered statistically significant. A total of 6,784 newborns and 306 CA were assessed (hospital-based prevalence 4.5%). Males, maternal age < 20 and ≥ 35 years, urban residence, and lowest socioeconomic status were associated with CA (all OR > 1.0 and p < 0.05). Subgroup analysis indicated associations between males and cardiovascular and genitourinary defects; maternal age < 20 years and craniofacial and abdominal defects; maternal age ≥ 35 years and digestive and chromosomal abnormalities; mother’s urban residence and craniofacial, cardiovascular, genitourinary, and abdominal defects; socioeconomic levels D-E and craniofacial and cardiovascular defects (all OR > 1.0 and p < 0.05). These findings reflect noticeable components associated with several CA and might be relevant for prevention and maternal-child health.

PMID:42221043 | PMC:PMC13220133 | DOI:10.5582/irdr.2026.01011

Clin Ophthalmol. 2026 May 25;20:593122. doi: 10.2147/OPTH.S593122. eCollection 2026.

ABSTRACT

PURPOSE: To compare the effect of surgical sequence during combined excisional KDB goniotomy using the Kahook Dual Blade (KDB) and phacoemulsification.

METHODS: In this prospective comparative randomized cohort we included patients that underwent combined phacoemulsification and excisional KDB goniotomy with KDB. Eye were randomized into 2 groups: group PG underwent phacoemulsification followed by KDB goniotomy and GP KDB followed by phacoemulsification.

RESULTS: A total of 47 patients (59 eyes) were included: 27 eyes (46%) in group PG and 32 eyes (54%) in GP. Post-operative efficacy outcomes were comparable for IOP, number of medications, decrease in IOP at all the follow-up periods regardless of surgical sequence. Post-operative IOP and number of medications significantly decreased in both groups. Surgical success was achieved in 82% and 73% of eyes at 6- and 12-month follow-up respectively. Postoperative hyphema at day 1 was more frequent in group PG (52% vs. 19%, p=0.008). This difference did not reach statistical significance at day 7 (26% vs. 13%, p=0.16).

CONCLUSION: Combined Phacoemulsification-KDB KDB goniotomy has a good safety and efficacy profile. If KDB goniotomy is performed before phacoemulsification, the occurrence of early postoperative hyphema is significantly lower without affecting surgical success in terms of IOP decrease and reduction in glaucoma medication.

PMID:42221037 | PMC:PMC13220826 | DOI:10.2147/OPTH.S593122