Tag: nevin manimala

Eur J Dent Educ. 2026 Jun 8. doi: 10.1111/eje.70208. Online ahead of print.

ABSTRACT

BACKGROUND: Modern higher education requires a redefinition of pedagogical objectives to meet the evolving cognitive and perceptual demands of contemporary students. One such emerging objective is the cultivation of visual perceptions. Generational differences suggest that current students possess distinct cognitive profiles and learning preferences compared to previous cohorts. These differences necessitate updated educational strategies that address the unique ways newer generations process and engage with information.

METHOD: This longitudinal comparative study involved a 12-week developmental course, designed and led by a single art educator and implemented with dental student volunteers. The course integrated one phase focused on drawing and two phases involving wax carving, all structured around a self-assessment framework to encourage reflective practice. To evaluate changes in motor performance, the Purdue Pegboard Test was administered at two intervals: prior to and following the course.

RESULTS: Participants demonstrated statistically significant improvements in motor performance across all academic levels. Notably, students who experienced educational disruption due to the COVID-19 pandemic exhibited greater gains, despite the lack of skill development traditionally expected within the dental curriculum. These findings suggest that the course provided compensatory cognitive and motor training during a period of limited practical instruction.

CONCLUSION: The developmental course was associated with improvements in motor coordination and visual perception among student participants. The observed improvements, particularly in the context of pandemic-related educational challenges, underscore the value of integrating manual dexterity training into university curricula. This approach may address both generational learning differences and gaps in skill acquisition resulting from disrupted educational pathways.

PMID:42260328 | DOI:10.1111/eje.70208

Nurs Open. 2026 Jun;13(6):e70633. doi: 10.1002/nop2.70633.

ABSTRACT

BACKGROUND: Work engagement is essential for nurses’ motivation, retention and quality of care. However, the mechanisms linking organizational resources to engagement remain insufficiently understood. Grounded in the Job Demands-Resources (JD-R) model, this study examined whether decent work is statistically associated with the relationship between work capital (WC) and work engagement among nurses.

METHODS: A cross-sectional survey was conducted among 535 nurses from multiple hospitals in Zhejiang Province, China. Standardized instruments were used to assess WC, Decent Work (DW), and Work Engagement (UWES). Data were analysed using confirmatory factor analysis and mediation analysis (PROCESS Model 4, 5000 bootstrap samples).

RESULTS: Work Capital was positively associated with decent work (B = 0.74, p < 0.001) and work engagement (B = 0.19, p < 0.001). Decent work was positively associated with work engagement (B = 0.85, p < 0.001). Mediation analysis indicated a significant indirect association (indirect effect = 0.67, 95% CI [0.56, 0.79]), accounting for 76.1% of the total association. Subscale comparisons, based on standardized mean scores, suggested relatively higher dedication and lower absorption levels.

CONCLUSION: Decent work may function as a potential explanatory pathway linking work capital and work engagement. These findings highlight the importance of considering both resource availability and perceived work quality when examining engagement in nursing contexts.

IMPACT: This study extends the JD-R framework by examining decent work as a potential mediating mechanism between work capital and work engagement in nurses.

REPORTING METHOD: This study followed the STROBE guidelines for cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:42260327 | DOI:10.1002/nop2.70633

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2026 Jun 8:1-10. doi: 10.3724/zdxbyxb-2025-0965. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the diagnostic performance of cerebrospinal fluid (CSF) metagenomic next generation sequencing (mNGS) for neonatal intracranial infections and its impact on clinical decision making.

METHODS: A retrospective observational study was conducted. Neonates admitted to the Children’s Hospital, Zhejiang University School of Medicine from 2020 to 2025 with suspected intracranial infection who underwent CSF mNGS were enrolled. The sensitivity of mNGS and its concordance with CSF culture and PCR were calculated. Clinical impact was assessed using predefined criteria, and samples were categorized into positive impact and no impact groups to identify independent factors influencing the clinical utility of mNGS.

RESULTS: Among 61 neonates with suspected intracranial infection, 48 were confirmed. Pathogens were identified in 18 cases, of which 9 were detected exclusively by mNGS, accounting for 50% of etiological diagnoses. The sensitivity of mNGS was 31.3% (95% CI: 18.7%-46.3%), higher than that of culture PCR (18.8%, 95% CI: 8.9%-32.6%), but the difference was not statistically significant (P=0.15). The positive and negative concordance rates between mNGS and culture PCR were 66.7% (95% CI: 29.9%-92.5%) and 76.9% (95% CI: 60.7%-88.9%), respectively. mNGS positively influenced clinical decisions in 37.7% (23/61) of patients: 12 cases with positive results guided etiological diagnosis and treatment adjustment, and 11 cases with negative results led to antibiotic de escalation or discontinuation. Multivariate analysis identified a positive mNGS result as an independent factor associated with positive clinical impact (OR = 22.127, P<0.01).

CONCLUSIONS: CSF mNGS provides valuable support in etiological diagnosis and clinical decision making for neonatal intracranial infections.

PMID:42260308 | DOI:10.3724/zdxbyxb-2025-0965

NPJ Syst Biol Appl. 2026 Jun 9. doi: 10.1038/s41540-026-00752-w. Online ahead of print.

ABSTRACT

Pathway enrichment analysis (PEA) of omics data identifies significant pathway-molecule associations, yet delivers results as tabular lists in which complex systems-biology insights remain inaccessible. Hyperpathway is an open-access network-based webtool that addresses this limitation through three original innovations: (1) conversion of a PEA results table into a pathway-molecule bipartite network; (2) a minimal artificial linking strategy to resolve structural disconnections; (3) a leaf removal and post-hoc reinsertion pipeline that accelerates coalescent embedding without any loss of geometric fidelity. The resulting network is visualized in a two-dimensional hyperbolic disk with flexible coloring schemes encoding hierarchical relevance, connectivity similarity, statistical significance, or user-defined annotations; revealing latent functional modules that are invisible in conventional tabular outputs. Validated on genomic, metabolomic, and lipidomic datasets, Hyperpathway enables a deeper, systems-level understanding of the interplay between pathways and their molecular components, providing insights that go beyond p-value-based significance testing. Beyond PEA, Hyperpathway can be used as a general-purpose open webtool for fast hyperbolic embedding and interactive visualization of any bipartite network.

PMID:42260283 | DOI:10.1038/s41540-026-00752-w

Sci Rep. 2026 Jun 8. doi: 10.1038/s41598-026-53777-w. Online ahead of print.

ABSTRACT

Spontaneous abortion is one of the most common adverse pregnancy outcomes, with an incidence of approximately 15-25% in clinically recognized pregnancies. Chromosomal abnormalities are recognized as a primary genetic etiology, yet the specific underlying molecular mechanisms and pathways remain incompletely understood. Embryonic tissue samples from 1585 patients with spontaneous abortion were collected from January 2019 to June 2025. Chromosomal microarray analysis (CMA) was used for whole-genome detection of chromosomal abnormalities, including aneuploidy and copy number variations (CNVs). Functional enrichment analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were conducted on CNV-related genes. 34 cases with negative CMA results and a history of recurrent pregnancy loss (≥ 2 episodes) were randomly selected to undergo whole-exome sequencing (WES) for the screening of monogenic variants. Statistical analysis included chi-square tests for inter-group comparisons, restricted cubic splines (RCS), and multivariate logistic regression for assessing risk factors. The detection rate of chromosomal abnormalities was 54.44%, mainly numerical abnormalities, with trisomy 16 and X monosomy being the most common subtypes. Structural variants include CNVs, loss of heterozygosity (LOH) and Runs of homozygosity(ROH). The results of the GO enrichment analysis indicated that genes associated with CNVs are primarily involved in hemostasis regulation and monocyte migration; KEGG enrichment analysis indicated that the Toll-like receptor signaling pathway and the neuroactive ligand-receptor interaction pathway may play a significant role in the pathogenesis of miscarriage. Multivariate Logistic regression analysis revealed that a mother’s age of ≥ 35 years was an independent risk factor (OR = 1.72, 95%CI: 1.31-2.26), while a gestational age of ≥ 12 weeks had a protective effect (OR = 0.27, 95%CI: 0.21-0.34). The RCS model revealed a U-shaped relationship between maternal age and the risk of chromosomal abnormalities. The risk was lowest at ages 28-29 (OR = 0.99) and increased gradually after age 30; the risk of chromosomal abnormalities peaked between 8 and 10 weeks of gestation. The diagnostic yield of WES in recurrent miscarriage cases with normal CMA results reached 26.47%. This approach identified a variant in the MOS gene associated with oocyte maturation defects, along with clinically significant variants in possible miscarriage-implicated genes such as TTC7A. Chromosomal abnormalities, particularly trisomy 16 and monosomy X, along with dysregulation of hemostatic and immune pathways, are central to spontaneous abortion etiology. Advanced maternal age, defined as 30 years or older, and early gestational loss are key risk factors, challenging the conventional threshold of 35 years. The use of a combined CMA and WES strategy has effectively improved the genetic diagnosis rate, demonstrating the complementary value and advantages of combining chromosomal and single-gene testing technologies in diagnosing the causes of miscarriage.

PMID:42260280 | DOI:10.1038/s41598-026-53777-w

J Imaging Inform Med. 2026 Jun 8. doi: 10.1007/s10278-025-01751-9. Online ahead of print.

ABSTRACT

To investigate the feasibility of time-resolved maximum intensity projection computed tomography angiography (tMIP-CTA) in assessing below-the-knee arterial lesions in diabetic patients. A prospective study enrolled 79 patients (53 males, 26 females; mean age 71.6 ± 10.2 years) with diabetic foot and lower extremity vascular disease between June 2023 and May 2024. Standard lower extremity arterial CTA was performed, followed by a low-dose dynamic CTA scan after a 5-min delay. tMIP images were generated by fusing data points from the time when the maximum CT value was reached during the enhancement process. Patients were divided into three groups: Group A (D-CTA, optimal phase of dynamic CTA), Group B (tMIP-CTA, full-phase maximum intensity projection CTA), and Group C (S-CTA, standard CTA). Regions of interest (ROIs) were selected in the popliteal, anterior tibial, peroneal, posterior tibial, and tibiofibular trunk arteries. Arterial vessel CT values and image noise (IN) were measured, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. A 5-point scale was used for subjective scoring of each segment of the below-the-knee arteries. Statistical analyses were performed to compare objective indicators and subjective scores. Differences in below-the-knee arterial stenosis severity, collateral vessels, distal foot artery visualization, and lower extremity venous contamination were also compared. Group B exhibited significantly lower IN, higher muscle CT values, SNR, and CNR compared to groups A and C, with statistically significant differences (p < 0.05). The diagnosability rate of below-the-knee arteries was significantly higher in group B than in group C (p < 0.01). There were no significant differences in subjective scores for stenosis severity among the three groups for bilateral below-the-knee arteries. Strong inter-observer agreement was observed in subjective scoring of below-the-knee arterial image quality (weighted kappa values of 0.919, 0.957, and 0.960, respectively). Compared to group C, group B showed significantly reduced lower extremity venous contamination (p < 0.05) and a significantly higher number of visualized foot arteries (p < 0.05). The number of visualized collateral vessels was higher in group B than in group C, although the difference was not statistically significant. The tMIP-CTA technique significantly improves image quality in below-the-knee arterial imaging for patients with diabetic foot and lower extremity vascular disease. It offers higher reliability in assessing arterial stenosis and enhances the visualization of foot arteries and small collateral vessels.

PMID:42260260 | DOI:10.1007/s10278-025-01751-9

Obes Surg. 2026 Jun 8. doi: 10.1007/s11695-026-08790-3. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) provides durable, stable weight loss and ameliorates renal dysfunction, hyperuricemia (HUA), and other obesity-related metabolic disorders. Renal function is tightly linked to serum uric acid (SUA) metabolism, but conventional estimated glomerular filtration rate (eGFR) equations have well-documented substantial bias in individuals with obesity.

METHODS: We retrospectively collected clinical data from 202 patients who underwent LSG, with assessments performed at baseline and 1, 3, and 6 months postoperatively. Patients were stratified into the renal hyperfiltration (HF, 1n = 147) and normal filtration (NF, n = 55) groups using a baseline eGFR cutoff of 125 mL/min/1.73 m². 1:1 propensity score matching (PSM) was conducted using 7 covariates to balance baseline between-group heterogeneity.

RESULTS: The main effect of time on SUA levels was marginally significant pre-PSM (P = 0.054), but reached statistical significance post-PSM (P = 0.034). A significant main effect of group was observed at both stages (pre-PSM P = 0.008; post-PSM P = 0.037), with consistently higher SUA levels in the NF group. No significant time-by-group interaction effect was detected in either pre- or post-PSM analyses (both P > 0.05). Bonferroni-adjusted post hoc pairwise comparisons revealed significant SUA reductions at 3 and 6 months postoperatively relative to baseline in the pre-PSM HF group, with no significant temporal changes in the pre-PSM NF group; no significant pairwise differences across time points were seen in the matched cohort.

CONCLUSION: Temporal changes in SUA levels after LSG are not significantly associated with baseline renal filtration status.

KEY POINTS: • The time-by-group interaction effect was not significant in either pre- or post-PSM analyses, meaning the temporal trends of SUA levels after LSG did not differ significantly by baseline renal filtration status (HF vs. NF). • Both before and after PSM, SUA levels were consistently lower in the HF group than in the NF group; therefore, a longer duration of SUA monitoring may be necessary for the NF group.

PMID:42260255 | DOI:10.1007/s11695-026-08790-3

Spine Deform. 2026 Jun 8. doi: 10.1007/s43390-026-01464-1. Online ahead of print.

ABSTRACT

PURPOSE: To determine how often physician-ordered limited CTs in pediatric spine patients are not followed, and if this leads to excess radiation.

METHODS: Single-center retrospective review of a tertiary pediatric spine practice.

INCLUSION: CT scans ordered for specific vertebrae (e.g., L4-5) Exclusion: generalized regions (cervical, thoracic, lumbar). Demographics, CT orders and scans, and radiation data were obtained from electronic records. A vertebra was considered imaged only if the entire vertebral body was imaged. Analyses used descriptive statistics, chi-square tests, and one-way ANOVA with Tukey-adjusted post-hoc pairwise comparison.

RESULTS: 93 patients (mean age 16.1 ± 3.4) with 121 CT scans met criteria. In 53 (44%) CTs, more vertebrae were imaged than ordered, yielding a mean of 2.1 times more radiation. Scans occurred at 30 sites. A tertiary medical center with a new limited CT protocol performed 61 (50.4%) scans, with 49.2% scanning additional vertebrae. A private network of 3 outpatient imaging centers with established imaging protocols performed 26 scans, with 3.8% scanning additional vertebrae. The remaining 34 scans were performed at 23 external sites, with 64.7% scanning additional. The imaging center was significantly associated with additional vertebrae imaging frequency (X² = 23.6, P = 0.0002).

CONCLUSION: 44% of patients with limited CT scans of the spine had additional vertebrae scanned compared to what was ordered. This corresponded to an estimated mean of twice the intended radiation dose. Limited CTs at centers with established imaging protocols do not image additional vertebrae in > 96% of patients. Pediatric spine centers should look to develop specific limited CT protocols to help decrease radiation exposure.

PMID:42260251 | DOI:10.1007/s43390-026-01464-1

CVIR Endovasc. 2026 Jun 9;9(1):66. doi: 10.1186/s42155-026-00715-6.

ABSTRACT

BACKGROUND: Type II endoleak after endovascular aneurysm repair is the most common endoleak type. Identifying pre-operative anatomical features that could signal higher risk will improve surveillance post-procedure. This systematic review and meta-analysis evaluated the association between inferior mesenteric artery (IMA) diameter and type II endoleak.

METHODS: MEDLINE and EMBASE were searched via OVID (1946/1974 respectively to January 2025), in line with the PRISMA statement, for adult patients undergoing endovascular aneurysm repair for infrarenal abdominal aortic aneurysm with reported pre-operative inferior mesenteric artery diameter and post-operative type II endoleak outcomes. Both retrospective and prospective observational studies were eligible. Meta-analysis via a random-effects model evaluated the pooled mean IMA diameter among patients with type II endoleak and the mean difference in IMA diameter between patients with and without endoleak. The risk of bias was assessed using the Newcastle-Ottawa scale.

RESULTS: Twenty studies met inclusion criteria; ten provided extractable quantitative data for pooling (2176 patients; 532 type II endoleaks). Assessment with the Newcastle-Ottawa scale demonstrated that the studies had scores between 6 and 8 out of 9. The pooled mean inferior mesenteric artery diameter among cases with endoleak was 2.95 mm (95% CI 2.64-3.26 mm; p < 0.01; I² = 95%). The pooled mean difference in diameter between patients with and without endoleak was 0.50 mm (95% CI 0.36-0.64 mm; p < 0.01; I² = 62%), indicating larger arteries in those who developed type II endoleak. Substantial heterogeneity reflected differences in endoleak definitions, imaging protocols, and measurement methods. Subsequent sac expansion and the need for reintervention were not reported uniformly across all studies, and when reported, insufficient data were available regarding these outcomes and their relation to IMA diameter.

CONCLUSION: Larger pre-operative inferior mesenteric artery diameter was associated with an increased likelihood of type II endoleak after endovascular aneurysm repair. However, the clinical relevance of a 0.5 mm difference remains uncertain, particularly in view of potential inter-observer measurement variability. Multicentre randomised controlled trials are needed to define actionable thresholds for treatment, considering confounding factors and clinical significance of the endoleak.

PMID:42260250 | DOI:10.1186/s42155-026-00715-6

EJNMMI Rep. 2026 Jun 9;10(1):22. doi: 10.1186/s41824-026-00305-8.

ABSTRACT

PURPOSE: Despite the approval of 177Lu-PSMA-617 as standard treatment for patients with mCRPC, at least 50% of patients do not respond to the therapy, especially those with visceral disease. This study analyzes real-world outcomes of 177Lu-PSMA-I&T used in heavily pretreated patients in Brazil.

METHODS: Retrospective analysis of patients with mCRPC previously treated with at least one androgen receptor pathway inhibitor (ARPI) who underwent 177Lu-PSMA-I&T between 2020 and 2025 in two large oncology centers. Our primary endpoint was prostate-specific antigen (PSA) response rate of 50% or more (PSA50). Secondary endpoints included overall survival (OS) and time to next sequential therapies (TNST). Statistical analyses were performed in JAMOVI and RStudio.

RESULTS: Forty-three patients were included, with median age 74 years and median baseline PSA 41 ng/mL. Prior to 177Lu-PSMA-I&T, 86% received more than one ARPI line and 23.3% underwent more than one taxane-based chemotherapy. Visceral disease was present in 41.9%. The overall PSA50 response for all patients was 44.2% and for patients with visceral disease was 33.3%. Median OS was 13.9 months [95% confidence interval (CI) 10.9-19.2] and 12-month survival was 55.5% [95% CI 42.1%-73.3%]. Out of the 24 patients who received subsequent therapies, median TNST was 2.9 months [95% CI 1.6-5.4].

CONCLUSIONS: Our results showed that 177Lu-PSMA-I&T achieved a PSA response comparable to those treated with 177Lu-PSMA-617 in randomized trials, despite our heavily treated patients’ characteristics. A significant number of patients had visceral disease with expected lower PSA response, highlighting the need for more active combinations in this subgroup.

PMID:42260246 | DOI:10.1186/s41824-026-00305-8