Nevin Manimala

Folia Morphol (Warsz). 2026;85:e01726095. doi: 10.5603/fm.112025.

ABSTRACT

BACKGROUND: Accurate characterization of fetal thoracic development is essential for improving prenatal assessment and early detection of structural abnormalities. The aim of this study was to evaluate the morphometric and proportional characteristics of the fetal thoracic cavity during mid and late gestational periods.

MATERIALS AND METHODS: A total of 32 fetal specimens (16 mid gestation, 16 late-gestation) were included. Crown-rump length (CRL), transverse diameter (TD), anteroposterior diameter (AP), and thoracic circumference (TC) were measured and analyzed using descriptive statistics, between-group comparisons, correlation, and regression methods.

RESULTS: All parameters increased significantly from mid to late gestation (p < 0.001). The greatest relative growth was observed in TD (≈55%), indicating that transverse expansion represents the dominant pattern of thoracic development. Regression analysis demonstrated that in mid gestation, TC could be reliably predicted by TD alone, whereas in late gestation the inclusion of AP improved predictive accuracy, reflecting increasing structural complexity. Minimal clinically important difference (MCID) analysis confirmed that these changes were not only statistically significant but also clinically meaningful.

CONCLUSIONS: Fetal thoracic development follows stage-specific growth patterns with important clinical implications. The findings provide preliminary data that may support improved prenatal evaluation, the establishment of population-specific normative data, and enhanced prediction of fetal respiratory system maturity.

PMID:42160706 | DOI:10.5603/fm.112025

Folia Morphol (Warsz). 2026;85:e01726096. doi: 10.5603/fm.111811.

ABSTRACT

BACKGROUND: Failure of inferior alveolar nerve block may be attributable to anatomical variations in the location of the mandibular foramen. This study aimed to determine the 3D location of the mandibular foramen (MF) using cone-beam computed tomography (CBCT) and compare the measurements across different sagittal facial types in Asians.

MATERIALS AND METHODS: CBCT scans of 60 mandibles (10 retrognathic, 10 normal, 10 prognathic per gender) were analyzed. The injection pathway was simulated as a line through MF and contralateral lower premolar (MF-cL4). The distances from MF to ramus borders and the angles between MF-cL4 and the mid-sagittal plane (MSP), the mandibular plane (MP) and the lower occlusal plane (LOP) were measured. Data analysis was conducted using descriptive statistics and two-way ANOVA.

RESULTS: Distances from MF to the ramus borders were significantly greater in males than in females (p < 0.05). The distance between MF and the sigmoid notch of prognathic mandibles was greater than in normal/retrognathic types (p < 0.05). Angle MF-cL4-MSP was highly stable at 50.9° ± 2.9°, whereas angle MF-cL4-LOP exhibited significant individual variation with a coefficient of variation (CV) of 63.9%.

CONCLUSIONS: In Asians, MF was consistently located within the upper posterior quadrant of the ramus. Its anteroposterior position remains stable when referenced to MSP and cL4. In prognathic mandibles, MF positioned inferiorly relative to normal and retrognathic mandibles.

PMID:42160705 | DOI:10.5603/fm.111811

J Trop Pediatr. 2026 Apr 11;72(3):fmag031. doi: 10.1093/tropej/fmag031.

ABSTRACT

Preterm birth remains a leading cause of neonatal mortality, disproportionately affecting low-and middle-income countries (LMICs). Surfactant replacement therapy (SRT) is a key intervention for neonatal respiratory distress syndrome (RDS). However, due to cost and differing guidelines there are likely differences in SRT in different parts of the world. This study compared surfactant use, timing of administration, and associated neonatal outcomes in very low birth weight (VLBW) infants born in high-income countries (HICs) versus middle-income countries (MICs), with further analysis of public and private centers within MICs. This secondary analysis of prospectively collected data using the Vermont Oxford Network database included 271 826 inborn VLBW infants from 2018 to 23. Data were stratified by country income classification and ownership (public center vs. private center) in MICs. Surfactant use was highest in private MIC centers (64.1%), followed by HICs (55.3%), and public MIC centers (43.5%). Median time to first surfactant dose was shortest in private MIC centers (60 min) and longest in public MIC centers (120 min). Infants in HICs were more likely to receive delivery room continuous positive airway pressure and earlier surfactant. Survival post-SRT was highest in HICs (88.1%) and lowest in public MIC centers (69.5%) with sepsis being a particular problem in MICs. Disparities in the proportion of infants receiving SRT, the timing of doses, and neonatal outcomes such as mortality and sepsis rates persist between HICs and MICs, and between public and private sectors in MICs.

PMID:42160703 | DOI:10.1093/tropej/fmag031

JCO Glob Oncol. 2026 May;12(5):e2500317. doi: 10.1200/GO-25-00317. Epub 2026 May 20.

ABSTRACT

PURPOSE: The combination of venetoclax (VEN) and a hypomethylating agent (HMA) is a standard of care for patients with AML and higher-risk myelodysplastic syndromes (MDS). However, real-world outcomes data from low- and middle-income countries are scarce, where constraints in advanced diagnostics, financial resources, and supportive care infrastructure present unique challenges. This study evaluates the efficacy and safety of this regimen in a resource-limited setting.

MATERIALS AND METHODS: We conducted a retrospective analysis of 96 patients (AML, n = 54; MDS, n = 42) treated with HMA + VEN at a single center between January 2020 and December 2024. Key outcomes included overall survival (OS), disease-free survival (DFS), and response rates, assessed per standard criteria.

RESULTS: The median age was 52 years for patients with AML and 51 years for patients with MDS. In the AML cohort, OS was 77.4% and DFS was 52.8% at 2 years. The overall response rate (ORR) reached 66.6% at end of treatment (EOT), with 55.5% achieving complete remission. In the MDS cohort, 2-year OS was 59.5% and DFS was 44.4%. The most common major toxicity was febrile neutropenia (AML: 66.7%; MDS: 54.8%), although no related mortality occurred. A minority of patients underwent consolidative transplant (AML: 12.9%; MDS: 21.4%). Statistical analysis identified EOT ORR and VEN maintenance as significant for AML OS, while relapse was a critical factor for MDS OS.

CONCLUSION: The HMA-VEN combination is a highly effective and feasible treatment for AML and MDS, even within a resource-limited setting. The findings underscore the critical need for improved supportive care measures, expanded access to molecular diagnostics for risk stratification, and the development of individualized treatment strategies to optimize patient outcomes.

PMID:42160693 | DOI:10.1200/GO-25-00317

J Chem Inf Model. 2026 May 20. doi: 10.1021/acs.jcim.6c00885. Online ahead of print.

ABSTRACT

Genotoxicity assessment is crucial for drug development and chemical safety evaluation. However, traditional experimental approaches are time-consuming, resource-intensive, and raise ethical concerns related to animal testing. Although computational models offer efficient alternatives, most existing approaches treat all data points equally, disregarding the heterogeneous quality of public database records and rarely addressing predictive uncertainty. We present a reliability-aware framework for genotoxicity prediction using a curated data set of 8,389 compounds annotated with experimental reliability tiers reflecting protocol quality, reproducibility, and review status. A two-step hierarchical learning strategy is employed. First, a message-passing neural network trained on high- and medium-reliability data is used to evaluate low-reliability samples and assign adaptive weights. These weights are then incorporated into conventional machine learning models, including random forest, support vector machine (SVM), and logistic regression, using molecular fingerprints. To address predictive uncertainty, we integrate conformal prediction, which provides distribution-free, finite-sample coverage guarantees for individual predictions. Random forest and RBF-kernel SVM achieved AUC values of 0.8613 and 0.8582, respectively, with Brier scores of 0.1523 and 0.1530. Conformal prediction attained 90.7% empirical coverage at α = 0.1 and identified 35.8% of test compounds as ambiguous. By incorporating data reliability and uncertainty quantification, the proposed framework provides a more transparent and uncertainty-aware approach.

PMID:42160670 | DOI:10.1021/acs.jcim.6c00885

ACS Nano. 2026 May 20. doi: 10.1021/acsnano.6c05258. Online ahead of print.

ABSTRACT

The chiral-induced spin selectivity (CISS) effect presents a promising avenue for enhancing electrocatalytic processes through spin-polarized electron transfers. However, a comprehensive understanding of how nanoscale chirality influences catalytic activity has remained elusive. In this study, we employ scanning electrochemical cell microscopy (SECCM) to directly investigate the oxygen evolution reaction (OER) at individual chiral Au nanocrystals featuring precisely tunable helicoidal morphologies. Such a single-chiral-particle measurement allows the decoupling of the CISS effect from other influencing factors on the intrinsic OER activity. Our finding reveals that chiral D- and L-Au nanocrystals exhibit a 70% increase in OER activity compared to their achiral counterparts. Furthermore, the increasing OER activities of chiral nanocrystals with different helicities were statistically significant (p < 0.001, ANOVA), leading to a positive correlation between spin polarization and chiral-enhanced activity. This single-chiral nanoparticle electrochemical measurement not only provides mechanistic insight into CISS-mediated electrocatalysis but also establishes a design principle for the development of highly efficient spin-selective catalytic nanomaterials.

PMID:42160667 | DOI:10.1021/acsnano.6c05258

J Urol. 2026 May 20:101097JU0000000000005127. doi: 10.1097/JU.0000000000005127. Online ahead of print.

ABSTRACT

PURPOSE: MRI membranous urethral length is associated with post-prostatectomy continence. Nevertheless, it is not routinely used for patient counseling because predictive models haven’t been externally validated. The objective of this study was to assess the performance of membranous urethral length continence model on an external cohort.

METHODS: A continence prediction model was applied to a prospective cohort of patients with a pre-prostatectomy MRI and validated assessment of post-operative continence between 2015-2023. Patients from multiple surgeons underwent open or robotic prostatectomy. Membranous urethral length was retrospectively measured by two reviewers. The model included: age, nerve spare plan, prostate volume, surgical approach, and membranous urethral length. Continence definitions were: 0 pads/24hours and 0-1 pad/24 hours. Model performance was assessed using c-statistics, calibration curves, and decision curve analyses.

RESULTS: Among 500 patients, median membranous urethral length was 11 mm (IQR 8.1, 14). One-year post-prostatectomy continence (defined as 0 pads/24h) occurred in 312 (62%) patients. The c-statistic was 0.64 (95% CI 0.59, 0.69). The calibration was poor. The decision curve analysis showed no net-benefit of using the model. Continence defined as 0-1 pad/24h was achieved in 450 (90%) patients. The c-statistic was 0.69 (95%CI 0.61, 0.76) and the calibration was moderate. Decision curves showed a net-benefit of using the model over a range of clinically relevant continence risk thresholds.

CONCLUSION: This recalibrated prediction model incorporating MRI derived membranous urethral length provides net-benefit for predicting continence defined as 0-1 pad/24h. However, the model was not useful for predicting 0 pad use.

PMID:42160664 | DOI:10.1097/JU.0000000000005127

Lab Med. 2026 Apr 3;57(3):lmag025. doi: 10.1093/labmed/lmag025.

ABSTRACT

INTRODUCTION: ATP2B1 and STK39 loci influence blood pressure in genome-wide association studies. We tested whether ATP2B1 rs2681472 and STK39 rs35929607 are associated with essential hypertension and blood pressure.

METHODS: We studied 194 untreated hypertensive adults and 191 normotensive control individuals. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. Logistic regression evaluated hypertension risk, and linear regression assessed systolic and diastolic blood pressure (BP) under genotypic, dominant, and additive models, with adjustment for clinical covariates; the false discovery rate was controlled.

RESULTS: The STK39 rs35929607 G allele was associated with hypertension (adjusted odds ratio [OR], 1.97 [95% CI, 1.21-3.21]; P = .007) and higher systolic BP (+8.02 mm Hg per G allele, 95% CI, 2.18-13.87; P = .007). Effects on diastolic BP were weaker (additive P = .10; dominant P = .06). ATP2B1 rs2681472 showed no statistically significant associations (hypertension per T allele OR, 1.18 [95% CI, 0.74-1.87]; P = .49). In sex-stratified analyses, STK39 associations were evident in men (hypertension OR, 3.22 [95% CI, 1.42-7.31]; P = .005; systolic BP, +15.88 mm Hg [95% CI, 5.95-25.80]; P = .002) but not in women.

DISCUSSION: In our study cohort, STK39 rs35929607 is associated with essential hypertension and higher systolic BP, with possible sex-specific effects. ATP2B1 rs2681472 is not associated with hypertension or BP traits.

PMID:42160625 | DOI:10.1093/labmed/lmag025

J Pak Med Assoc. 2026 Apr;76(4):567-570. doi: 10.47391/JPMA.20901.

ABSTRACT

OBJECTIVE: To evaluate adherence to the guidelines for the management of gallstones in a tertiary care setting.

METHODS: The clinical audit was conducted at the General Surgical Unit VI, Civil Hospital, Karachi, and comprised data of laparoscopic cholecystectomy from October 1 to November 1, 2023. Management practices were assessed using the guidelines published by the National Institute of Health and Care Excellence. The audit conformed to the Standards for Quality Improvement Reporting Excellence 2.0 guidelines for quality improvement projects. Data was analysed using SPSS 20.

RESULTS: Of the 62 patients, 49(79%) were females, 12(21%) were males, 18(29%) were aged 40-50 years and 17(27.4%) were aged 30-49 years. All the 62(100%) patients underwent liver function tests and an ultrasound of the abdomen. There were 26(41.9%) patients with acute cholecystitis, and 6(23%) underwent surgery within a week of diagnosis as recommended. There were 48(77.4%) symptomatic patients, and the recommended day-care admission was employed for 15(31,3%).

CONCLUSION: The delay in surgical intervention for acute cholecystitis warranted attention. Balancing this with resource limitations underscored the need for effective adaptive strategies to optimise patient care.

PMID:42160558 | DOI:10.47391/JPMA.20901

J Neuropathol Exp Neurol. 2026 May 20:nlag032. doi: 10.1093/jnen/nlag032. Online ahead of print.

ABSTRACT

Astrocytes play essential roles in various functions including ionic homeostasis, energy metabolism, neurotransmission, and regulation of the blood-brain barrier. Researchers have reported that hyperphosphorylated tau in astrocytes can be identified in postmortem, particularly in individuals over the age of 60 years. Astrocytic p-tau has also been reported in association with chronic traumatic encephalopathy neuropathologic change (CTE-NC). This study investigates possible association between subpial aging-related tau astrogliopathy (ARTAG) and a history of playing high school American-style football. Postmortem brain tissue samples were obtained from 176 men (median age at death = 65 years; range = 50-96) from the Lieber Institute for Brain Development. There were 128 with no known history of participating in contact or collision sports and 48 (27.3%) who participated in football. Subpial ARTAG was identified in 23 cases (13.1%). Those who participated in football had a higher percentage with subpial ARTAG than those who did not participate in football (20.8% vs 10.2%), although this difference was not statistically significant (P =.061). The 2 groups did not differ in the percentages who had subpial ARTAG in a sulcal depth (10.4% of former football players and 7.8% of controls). More research is needed to understand possible associations between subpial ARTAG, aging, and CTE-NC.

PMID:42160102 | DOI:10.1093/jnen/nlag032