Nevin Manimala

Gastroenterol Res Pract. 2026 Jun 10;2026:9920130. doi: 10.1155/grp/9920130. eCollection 2026.

ABSTRACT

INTRODUCTION: Effects of aging on the relationship of striated esophagus (StEso) motor function with pharyngeal deglutitive biomechanics has not been systematically studied.

OBJECTIVE: The aim of this study is to characterize the effects of aging on the correlation of deglutitive StEso with pharyngeal function.

MATERIALS AND METHODS: We studied 33 healthy subjects. Fifteen elderly (age: 75 ± 7 years, 8 female) and 18 nonelderly (age: 50 ± 14 years, 9 F) were evaluated using high resolution manometry/impedance. Nine elderly (73 ± 7 years, 5 F) and eight young (24 ± 3 years, 4 F) were further evaluated by digital videofluoroscopy.

RESULTS AND DISCUSSION: Duration of StEso excursion averaged 2.56 ± 0.65 s in elderly and 2.33 ± 0.41 in young. We identified four periods in StEso motor function during deglutitive excursion: (a) anterosuperior ascent without bolus/peristaltic activity, (b) nonperistaltic bolus receiving function at apogee of StEso excursion during UES opening and pharyngeal peristalsis, (c) peristaltic bolus transport as StEso descends, (d) continued peristalsis in resting position. Apart from the final period described, the periods are significantly different in the elderly compared with the young subjects (p < 0.04). Furthermore, the interaction of striated esophageal flow dynamics and peristaltic contractile vigor showed that a significant correlation (r = -0.71, p = 0.0009) was found when comparing the average bolus injection length to the average SECI in young subjects. This correlation was muted in the elderly and did not reach statistical significance (r = -0.41, p = 0.13).

CONCLUSIONS: Sequencing of StEso/pharyngeal deglutitive motor function is preserved in the elderly. The differences observed in early stages of spatiotemporal mapping of StEso deglutitive motor function when comparing healthy elderly to young populations may be due to age-related suprahyoid muscle weakness since the affected periods are those associated with the active StEso ascent and descent. Like young individuals, elderly pressure signatures currently attributed to the StEso deglutitive motor activity do not represent the entirety of StEso peristalsis.

PMID:42282916 | PMC:PMC13250628 | DOI:10.1155/grp/9920130

Cancer Commun (Lond). 2026 Jun 10;46:0034. doi: 10.34133/cancomm.0034. eCollection 2026.

ABSTRACT

Background: ASTRUM-002 met the primary endpoint of progression-free survival (PFS) with the combination of serplulimab plus HLX04 (bevacizumab biosimilar) and chemotherapy at interim analysis. Here, we report the results of the final survival analysis. Methods: A total of 636 patients with treatment-naïve, locally advanced or metastatic nonsquamous non-small cell lung cancer (nsq-NSCLC) without epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK)/ROS proto-oncogene 1 receptor tyrosine kinase (ROS1) genetic alterations were randomized 1:1:1 to receive serplulimab plus HLX04 and chemotherapy (group A), serplulimab plus HLX04 placebo and chemotherapy (group B), or double placebo plus chemotherapy (group C). Patients and the investigators were blinded to the group assignments. The primary endpoint was blinded independent central review-assessed PFS. Overall survival (OS) was the key secondary endpoint. Results: At the final analysis, median OS was 23.7 (95% confidence interval [CI] 20.5 to 27.5) months, 26.8 (95% CI 21.2 to 30.9) months, and 20.3 (95% CI 16.2 to 24.6) months in groups A (n = 212), B (n = 214), and C (n = 210), respectively. A significant reduction in risk of death for group B compared to group C was observed (hazard ratio [HR] = 0.66, 95% CI 0.52 to 0.83; P < 0.001). A total of 79 (37.6%) patients in group C had crossed over to serplulimab plus HLX04 treatment. Median OS in group C adjusted by the 2-stage model was 14.2 months (95% CI 11.9 to 17.0), corresponding to an adjusted HR of 0.53 (95% CI 0.42 to 0.68; P < 0.001) for group B versus group C. Using the rank-preserving structural failure time model, the adjusted median OS in group C was 17.9 months (95% CI 14.2 to 20.3), with a corresponding adjusted HR of 0.65 (95% CI 0.51 to 0.83; P < 0.001). No statistical difference in median OS for group A compared to group B (HR = 1.12, 95% CI 0.88 to 1.42; P = 0.363) was found. Conclusions: Serplulimab plus chemotherapy significantly prolonged OS and maintained PFS benefit compared to chemotherapy; however, the addition of bevacizumab biosimilar HLX04 did not yield further improvement for the first-line treatment of nsq-NSCLC without EGFR or ALK/ROS1 genetic alterations. Trial registration: This trial was registered at ClinicalTrials.gov (NCT03952403, date of registration: 2019 May 14).

PMID:42282892 | PMC:PMC13250280 | DOI:10.34133/cancomm.0034

Work. 2026 Jun 11:10519815261449929. doi: 10.1177/10519815261449929. Online ahead of print.

ABSTRACT

BackgroundHealthcare workers face challenges such as intense work tempo, irregular working hours and high patient expectations. This situation may affect the happiness and performance of employees, as well as the quality of health services.ObjectiveThe aim of this study is to reveal the relationship between organizational health perceptions, happiness and job performance of health personnel working in a university hospital.MethodThe data were collected from 350 healthcare workers between December 2023 and January 2024 by face-to-face survey method. Organizational Health Scale, Oxford Happiness Scale and Employee Performance Scale were used as measurement tools. Data were analyzed with SPSS 22.0 and AMOS 26.0 programs; descriptive statistics, correlation analysis and Structural Equation Modeling (SEM) were applied.ResultsAccording to the correlation analysis, there was a positive and low level relationship between organizational health and happiness (r = .359) and a very weak but significant relationship with performance (r = .136). A moderately significant relationship was found between happiness and performance (r = .252). According to SEM findings, organizational health significantly predicted happiness (β = 0.98, p < .001), while happiness predicted performance (β = 0.14, p = .002). The direct effect of organizational health on performance was not significant (β = 0.23, p = .077). In subgroup analyses, differences were observed according to occupational groups and length of experience.ConclusionsOrganizational health is a determinant of employee happiness, and happiness increases job performance. Therefore, it is recommended that healthcare organizations develop strategies that focus on employee well-being.

PMID:42277563 | DOI:10.1177/10519815261449929

Eur Arch Paediatr Dent. 2026 Jun 11. doi: 10.1007/s40368-026-01240-9. Online ahead of print.

ABSTRACT

PURPOSE: The present study aimed to assess parental knowledge of paediatric oral health among parents and guardians of children aged 2-12 years in Valencia, Spain, and to analyse its association with key sociodemographic variables.

METHODS: A cross-sectional study was conducted with 208 parents and guardians of children attending a university dental clinic in Spain. A validated self-administered 20-item questionnaire was used to evaluate oral health knowledge. Descriptive statistics and one-way ANOVA with Tukey post hoc tests were applied to compare mean knowledge scores across sociodemographic groups. The significance level was set at p < 0.05.

RESULTS: Parental education level was significantly associated with oral health knowledge. Parents with university education (17.01 ± 1.86) and vocational training (16.71 ± 2.09) scored higher than those with secondary school (15.78 ± 2.34), basic education (13.09 ± 2.77), or no education (13.30 ± 2.41). No significant difference was observed by gender (p = 0.394). Age group was also associated with knowledge (F(2,195) = 7.55, p = 0.001), with the highest scores observed among parents aged 41-50 years (17.45 ± 1.97).

CONCLUSIONS: Parental oral health knowledge was associated with educational attainment and age, while no gender differences were observed. These results suggest the value of developing targeted educational approaches for younger parents and those with lower education levels.

PMID:42277547 | DOI:10.1007/s40368-026-01240-9

J Imaging Inform Med. 2026 Jun 11. doi: 10.1007/s10278-026-02044-5. Online ahead of print.

ABSTRACT

As a low-dose portable imaging technology, chest X-ray (CXR) is widely used for the screening of lung diseases, including COVID-19. However, existing deep learning methods for CXR-based COVID-19 detection and common pneumonia recognition still face the challenge of limited discrimination, partly because it is difficult to effectively integrate fine-grained local lesion information with global spatial context. To address this problem, we propose a triple neural network framework based on Mixture of Experts (TriNet-MoE) for CXR-based COVID-19 detection. Specifically, TriNet-MoE integrates ResNet34 for basic local features, ResNet50 for higher-order local semantics, and a Vision Transformer for global context to form a mixture-of-experts model. Then, a three-stage cross-attention mechanism, Cross-Attention Synergy (CA-Synergy), is designed to enable hierarchical feature interaction among experts, including complementary local feature mining between the ResNet dual branches and bidirectional information exchange with the ViT, aiming to obtain more discriminative fusion features. In addition, a dynamic decision mechanism, MoE-Intelligent Linked Feature Collaborator (MoE-ILFC), is introduced to adaptively fuse expert features based on the input content. Experiments on the DLAI3 and COVIDx datasets show that TriNet-MoE achieves accuracies of 98.73% and 98.78%, respectively, consistently outperforming representative baselines under the same experimental settings. Additional statistical evaluations across multiple runs demonstrate stable performance improvements, while cross-dataset experiments further validate the generalization capability of the proposed framework under domain shifts. Visualization analyses, including Grad-CAM activation maps and gating weight distributions, provide qualitative insights into how TriNet-MoE for robust COVID-19 detection.

PMID:42277544 | DOI:10.1007/s10278-026-02044-5

Child Psychiatry Hum Dev. 2026 Jun 12. doi: 10.1007/s10578-026-02040-4. Online ahead of print.

ABSTRACT

To assess the efficacy and acceptability of non-pharmacological therapies, novel pharmaceuticals, and their combination for autism and explore the preferred treatment options for autism. A thorough search was conducted across PubMed, Web of Science, The Cochrane Library, Embase, PsycINFO, China National Knowledge Infrastructure, and Medline databases to collect all studies associated with randomized controlled trials on non-pharmacological or new pharmacological interventions for autism, up to October 2024. Two researchers will independently conduct literature screening, data extraction, and quality assessment. The primary outcome will be assessed by the severity of core autistic symptoms using validated scales and standardized mean differences (SMDs). In contrast, the secondary outcome will focus on the acceptability of the treatment. We performed a network meta-analysis within a frequentist framework, utilizing the network package in statistical software Stata 18. 106 RCTs were involved, including 5986 patients, and data from 21 interventions were analyzed. Compared with placebo, the following interventions improved the core symptoms of autism: exercise (SMD = -1.05, 95%CI: -1.55 to -0.55), acupuncture and moxibustion (SMD = -0.87, 95%CI: -1.13 to -0.60), tDCS (SMD = -0.86, 95%CI: -1.58 to -0.13) and bumetanide (SMD = -0.57, 95%CI: -1.12 to -0.01). The cannabinoids group has a lower acceptance rate than most of the other groups. Exercise, acupuncture, non-invasive brain stimulation, and bumetanide can improve the core symptoms of autism and can be used as an alternative or adjunct to autism treatment, but more clinical trials are still needed to support this outcome.

PMID:42277537 | DOI:10.1007/s10578-026-02040-4

J Ultrasound Med. 2026 Jun 11. doi: 10.1002/jum.70331. Online ahead of print.

NO ABSTRACT

PMID:42277487 | DOI:10.1002/jum.70331

Doc Ophthalmol. 2026 Jun 12. doi: 10.1007/s10633-026-10117-7. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the impact of pharmacologic pupil dilation (PD) on biometric measurements and intraocular lens (IOL) power calculation using different generation formulas in patients undergoing cataract surgery.

METHODS: This prospective study included 126 eyes from 75 patients. Biometric data were obtained before and after pharmacologic dilation using the Anterion Swept-Source OCT biometer (Heidelberg Engineering). Parameters recorded included axial length (AL), mean keratometry (Km), anterior chamber depth (ACD), lens thickness (LT), and white-to-white (WTW) distance. IOL power was calculated using six formulas: SRK/T, Haigis, Barrett Universal II (BUII), Kane, Hoffer QST, and Okulix. Statistical comparisons of biometric values and predicted IOL power before and after dilation were conducted using mixed-effects models.

RESULTS: No significant changes were observed in AL, CCT, LT or Km after dilation. However, ACD, WTW distance and PD showed statistically significant increases (both p < 0.01). IOL power estimations based on SRK/T, Haigis, Hoffer QST, BUII and Kane were not significantly affected after dilation. In contrast, Okulix formulas demonstrated statistically significant variations in calculated IOL power post-dilation (p < 0.0001).

CONCLUSIONS: Pharmacologic pupil dilation induces changes in ACD and WTW measurements obtained using the Anterion Swept-Source biometer, thereby influencing IOL power estimation in formulas incorporating these parameters. Ray-tracing Okulix formula is more sensitive to dilation, whereas third-generation formulas remain more stable. Consistency in pupil status during biometry acquisition is essential to ensure refractive predictability.

PMID:42277479 | DOI:10.1007/s10633-026-10117-7

Langenbecks Arch Surg. 2026 Jun 11. doi: 10.1007/s00423-026-04102-6. Online ahead of print.

ABSTRACT

PURPOSE: Patients with primary unilateral indirect inguinal hernias and large internal inguinal rings have a higher incidence of seroma formation following laparoscopic transabdominal preperitoneal (TAPP) hernia repair. This study aims to investigate the clinical efficacy of suturing and closing the internal inguinal ring during the TAPP procedure to reduce the postoperative seroma rate.

METHODS: A retrospective analysis was conducted on the clinical data of 162 patients with primary unilateral indirect inguinal hernias and an internal ring defect diameter of ≥ 3.0 cm, who were treated at Kunshan First People’s Hospital from December 2023 to November 2024. All patients underwent the TAPP procedure with hernia sac transection. Based on whether the internal inguinal ring was sutured closed intraoperatively, patients were divided into two groups: an experimental group (internal ring closure, n = 81) and a control group (no internal ring closure, n = 81).The study compared the incidence of postoperative seromas, perioperative indicators (operative time, incision size, blood loss, length of hospital stay, etc.), and other related complications (postoperative pain, sensory abnormalities, infection, urinary retention, testicular edema, etc.) between the two groups, as well as short-term recurrence rates.

RESULTS: There were no statistically significant differences in the baseline characteristics between the two groups, and all surgeries were completed successfully. The incidence of seroma in the experimental group at 7 days and 1 month postoperatively was significantly lower than in the control group [8.64% (7/81) vs. 28.40% (23/81), P = 0.002; and 2.47% (2/81) vs. 13.58% (11/81), P = 0.018, respectively]. Regarding severity (Morales-Conde classification), the experimental group recorded 5 Grade I and 2 Grade II cases, with zero Grade III events; whereas the control group observed 12 Grade I, 8 Grade II, and 3 Grade III events. There were no significant differences in seroma incidence between the two groups at 3 months and 6 months postoperatively (P > 0.05). The operative time for the experimental group [(63.67 ± 9.26) min] was slightly longer than that of the control group [(60.21 ± 10.23) min] (t = 2.255, P = 0.025). There were no statistically significant differences in other perioperative indicators, other related complications, or short-term recurrence rates between the two groups (P > 0.05).

CONCLUSION: For primary unilateral indirect inguinal hernias with an internal ring defect diameter of ≥ 3.0 cm, suturing and closing the internal ring defect during the TAPP procedure was associated with a lower rate of seroma formation.

PMID:42277471 | DOI:10.1007/s00423-026-04102-6

Support Care Cancer. 2026 Jun 11;34(7):644. doi: 10.1007/s00520-026-10841-5.

ABSTRACT

BACKGROUND: Chemotherapy-induced neutropenia (CIN) is the most common type of myelosuppression in patients undergoing chemotherapy. It can lead to chemotherapy dose reduction, treatment delays, diminished antitumor efficacy, reduced quality of life, and increased healthcare burden. Although various guidelines have been established domestically and internationally to standardize the management of CIN, their effectiveness in controlling its incidence remains limited.

PURPOSE: This study aimed to evaluate the role of a standardized management pathway in the management of CIN and its impact on chemotherapy-related adverse events and satisfaction among gynecological cancer patients.

METHODS: A total of 230 patients receiving conventional management from July to December 2024 were selected as the control group, while 230 patients managed under the CIN standardized pathway from January to June 2025 were enrolled as the intervention group. The CIN standardized management pathway integrated functions such as febrile neutropenia (FN) risk calculation, visual risk stratification alerts, intelligent decision support for prophylactic medication, multi-approach health education, and cloud-based follow-up. Comparisons were made between the two groups regarding hematological toxicity markers (ANC, WBC), incidence of chemotherapy-related adverse events (FN, chemotherapy delay, and dose reduction), FN risk assessment compliance rate, and patient satisfaction.

RESULTS: After three chemotherapy cycles, unadjusted comparisons showed more favorable ANC and WBC distributions in the intervention group than in the control group (all P < 0.001). However, adjusted analyses did not show statistically significant associations with grade 3-4 ANC reduction or grade 3-4 WBC reduction. The FN risk-assessment compliance rate reached 100% in the intervention group, higher than the 54.6% observed in the control group (P < 0.001). The observed incidence of FN was lower in the intervention group than in the control group (1.4% vs. 8.3%; P = 0.002), although FN was analyzed descriptively. The intervention was associated with lower adjusted odds of chemotherapy delay and dose reduction and with higher adjusted patient satisfaction scores.

CONCLUSION: The standardized CIN management pathway was associated with favorable changes in hematologic toxicity indicators, chemotherapy-related adverse events, and patient satisfaction. Further multicenter randomized or cluster-randomized studies are needed to confirm these findings.

PMID:42277458 | DOI:10.1007/s00520-026-10841-5