Tag: nevin manimala

Am J Speech Lang Pathol. 2026 Jun 5:1-12. doi: 10.1044/2026_AJSLP-25-00622. Online ahead of print.

ABSTRACT

PURPOSE: Nasopharyngoscopy is an imaging method used to visualize the velopharyngeal mechanism. To quantify the movement of the mechanism during speech, an international working group recommended standardized rating guidelines. While these guidelines are widely cited in research, the extent to which cleft teams apply them in a clinical setting is unclear.

METHOD: This cross-sectional study examined clinical nasopharyngoscopy reports from 11 cleft teams in North America. Descriptive statistics were used to summarize the proportion of reports that included ratings for the extent of velar movement, left and right lateral pharyngeal wall movement, gap size, and a surgical recommendation. Fisher’s exact and chi-square tests were used to assess differences in reporting by cleft team and whether the inclusion of quantitative ratings was associated with a surgical recommendation being included.

RESULTS: A total of 188 nasopharyngoscopy reports were included. The extent of velar movement was reported in 68% (n = 127) of reports, the left and right lateral pharyngeal wall movement was reported in 38% (n = 71), and the size of the gap was reported in 70% (n = 132). Only 34% (n = 63) of reports included all three quantitative ratings. Inclusion of all three quantitative ratings varied significantly (p < .001) across teams. Teams either never included all the ratings (n = 4/11) or inconsistently included all ratings (n = 7/11).

CONCLUSIONS: Findings suggest that what is documented clinically in nasopharyngoscopy reports varies both within and across teams. To achieve more consistent reporting within individual teams, providers may consider implementing standardized clinical templates. To achieve consistency across teams, these findings suggest a need for renewed efforts at developing consensus on the nasopharyngoscopy elements important to clinicians.

PMID:42247245 | DOI:10.1044/2026_AJSLP-25-00622

Anal Chem. 2026 Jun 5. doi: 10.1021/acs.analchem.6c01767. Online ahead of print.

ABSTRACT

Ulcerative colitis is a chronic inflammatory condition of the gastrointestinal tract with a rising global prevalence that underscores the urgent need for noninvasive approaches to monitor disease progression and treatment response. Recent evidence links metabolic alterations in colitis to disease severity, suggesting that metabolic profiling is a promising biomarker strategy. Here, we employed Raman spectroscopy (RS) as a sensitive, label-free approach to profiling serum and tissue metabolomes in murine and canine models of colitis. We identified 16 statistically significant metabolites in the murine sera that distinguished healthy from colitis mice with an area under the curve receiver operating characteristic (AUC-ROC) value of 0.98. Both serum and tissue metabolites showed moderate to strong correlations with proinflammatory cytokines, disease activity index, bodyweight, and histology scores of colon. This approach was extended to canine sera, differentiating colitic dogs treated with a synbiotic-IgY supplement from placebo controls with an AUC of 0.81, highlighting Raman features broadly associated with sugars and amino acids as key discriminative metabolites. Our analysis revealed that metabolic changes in placebo-treated dogs were diet-driven, whereas synbiotic supplementation modulated lipid and fatty acid profiles associated with the gut microbiota activity. Proteomic analysis validated RS findings and showed significant alterations in pathways associated with lipid transport and also demonstrated that synbiotic supplementation reduced inflammatory pathways while promoting extracellular matrix remodeling and gut healing. Collectively, these results indicate that metabolic profiling offers an impactful strategy for the diagnosis of UC and prediction of therapeutic response, laying the groundwork for personalized medicine in inflammatory diseases.

PMID:42247239 | DOI:10.1021/acs.analchem.6c01767

JAMA Health Forum. 2026 Jun 1;7(6):e261295. doi: 10.1001/jamahealthforum.2026.1295.

ABSTRACT

IMPORTANCE: Current pregnancy surveillance efforts in the US face substantial challenges in providing timely and accurate data on prenatal care use. Electronic health record (EHR) networks have the potential to enhance existing surveillance systems by providing near real-time, clinically documented data.

OBJECTIVE: To assess whether EHR network data could be used to define valid and reliable surveillance metrics of prenatal care use.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study included US adults (age ≥18 years) who received prenatal care and delivered a live birth from January 1, 2023, to December 31, 2024, at a facility that used the Epic Cosmos EHR network.

EXPOSURE: Live birth at a facility that used the selected EHR network.

MAIN OUTCOMES AND MEASURES: Prenatal care use was calculated as the proportions of patients who initiated care by the 13th week of pregnancy (early care) and who received adequate or better prenatal care (adequate care). Raking weights were applied to adjust the EHR sample to match the marginal distributions for US residents with live births by age, race and ethnicity, insurance, pregnancy risk factors, and geographic region. Electronic health records-based metrics were externally validated against published natality data estimates from National Center for Health Statistics (NCHS) using the two 1-sided test of equivalence. Patterns by demographics, state, and year were examined.

RESULTS: In total, 1 963 496 patients (mean [SD] age, 29.5 [5.7] years; 100% women) had a live birth and evidence of prenatal care at a facility using the selected EHR network during the study period. Compared with all US birthing people (n = 7 224 951), patients who gave birth at a facility using the selected EHR network had lower Medicaid coverage (40.5% vs 21.1%) and a higher prevalence of pregnancy risk factors (eg, prior preterm birth: 4.0% vs 8.8%). After weighting to the national population, EHR-based estimates of early care were consistently lower than those from NCHS data (68.0% [95% CI, 67.9%-68.2%] vs 76.1% [95% CI, 76.1%-76.1%]). However, adequacy estimates were equivalent to NCHS-based estimates (76.0% [95% CI, 75.9%-76.2%] vs 75.2% [95% CI, 75.1%-75.2%]; P < .001 at 0.01 equivalence bound), aligned with expected demographic patterns, and were stable across place and time.

CONCLUSIONS AND RELEVANCE: In this cohort study, EHR network data reliably informed surveillance of prenatal care adequacy after adjusting for nonrepresentativeness of the patient population. These findings suggest that near real-time availability of EHR data has the potential to improve the timeliness of population-level pregnancy surveillance to better inform policy, public health, and clinical efforts aimed at enhancing prenatal care access and use among individuals receiving inadequate care.

PMID:42247225 | DOI:10.1001/jamahealthforum.2026.1295

Environ Toxicol Chem. 2026 Jun 5:vgag125. doi: 10.1093/etojnl/vgag125. Online ahead of print.

ABSTRACT

Microplastics are complex contaminants, potentially posing both a physical and chemical risk to aquatic organisms. To better understand the physical and chemical impacts of microplastics, we conducted a large in situ pelagic mesocosm experiment in a freshwater boreal lake at the International Institute for Sustainable Development-Experimental Lakes Area. An equal mixture of polyethylene, polystyrene, and polyethylene terephthalate fragments with and without chemical additives were added to mesocosms as a single pulse and were contrasted with a control treatment with no added microplastics. Plankton communities were monitored for 62 days following microplastic additions. Total phytoplankton biomass was not affected by either microplastic treatment; however, a shift in phytoplankton community composition was detected in the microplastic treatment without additives on Day 62. Total zooplankton and cladoceran abundance marginally increased over time in both microplastic treated mesocosms, and diversity was lower in the additive treatment. There was a negative impact on Tropocyclops extensus egg production in microplastic treatments with and without additives, and the abundance of early-instar Chaoborus was temporarily higher in mesocosms containing microplastics without additives. Overall, the impacts of microplastics were relatively small, irrespective of the presence or absence of chemical additives, on natural pelagic phytoplankton or zooplankton communities over the 62-day exposure.

PMID:42247215 | DOI:10.1093/etojnl/vgag125

Ann Med. 2026 Dec;58(1):2677997. doi: 10.1080/07853890.2026.2677997. Epub 2026 Jun 5.

ABSTRACT

PURPOSE: Pneumocystis jirovecii pneumonia (PJP) is a potentially life-threatening opportunistic infection. Recent studies have demonstrated a poor prognosis and higher mortality rate in non-human immunodeficiency virus (HIV) patients, with associated risk factors including cytomegalovirus (CMV) co-infection. We aimed to investigate the outcomes of concomitant PJP and CMV infection in non-HIV mechanically ventilated critically ill patients.

PATIENTS AND METHODS: We retrospectively enrolled adult patients admitted to an intensive care unit (ICU) and diagnosed with PJP infection from January 2017 to December 2022. Data were retrieved from the Chang Gung Research Database, including clinical manifestations, comorbidities and mortality.

RESULTS: A total of 132 adult patients without HIV infection received mechanical ventilation in the ICU, underwent bronchoalveolar lavage and diagnosed with PJP were enrolled, of whom 26 patients had concomitant CMV infection and 106 did not. The PJP and concomitant CMV infection group had a significantly lower PaO2/FiO2 ratio (73.5 vs. 95.6, p = 0.04) and higher procalcitonin level (2.2 ng/ml vs. 0.4 ng/ml, p = 0.004). While CMV co-infection was associated with higher ICU mortality in the univariate analysis (33.3% vs. 11.1%, p = 0.002), multivariate analysis revealed that systemic CMV co-infection was not an independent predictor of mortality. Instead, the extended model demonstrated that mortality was significantly associated with acute respiratory distress syndrome (ARDS) (HR 4.281, 95% CI:1.178-15.565, p = 0.027) and the duration of PJP treatment (HR: 0.892, 95% CI: 0.803-0.990, p = 0.006).

CONCLUSION: Concomitant CMV infection was about one-fifth in the non-HIV critically ill patients with PJP infection but does not independently increase mortality risk. Clinical management should prioritize early, sustained anti-pneumocystis therapy and lung-protective strategies for ARDS.

PMID:42247214 | DOI:10.1080/07853890.2026.2677997

Arch Osteoporos. 2026 Jun 5;21(1):87. doi: 10.1007/s11657-026-01721-w.

ABSTRACT

Osteoporotic fractures are underrepresented in administrative data. In the present study, only 1 of 94 admissions for osteoporotic fracture was coded correctly, mostly due to inadequate clinical documentation. Following education of junior doctors, 36% of osteoporotic fractures were coded correctly, with coding of femur fractures particularly amenable to improvement.

PURPOSE: Osteoporotic fractures are underrepresented in hospital administrative data. This study analysed the accuracy of clinical coding of osteoporotic fractures and prospectively evaluated the effectiveness of an educational intervention for junior medical officers (JMO) to improve documentation and coding accuracy.

METHODS: Coding accuracy was measured in 279 consecutive inpatients deemed to have suffered an osteoporotic fracture based on predetermined criteria. Subsequently, an education programme for JMO was delivered, focusing on osteoporotic fracture criteria and clinical coding requirements. A 10-week post-intervention analysis was conducted to determine improvement in coding accuracy using baseline data as a historical control.

RESULTS: At baseline, 1 of 94 (1.1%) admissions meeting the criteria for osteoporotic fracture received the correct ICD-10 M80 primary diagnosis code. Post-intervention, coding accuracy improved markedly, with 14 out of 39 (36%) osteoporotic fracture admissions coded correctly. However, this improvement varied by site, with 77% of femur fractures, but only 10% of radius and 13% of humerus fractures receiving the correct primary clinical code. Coding accuracy decreased with time, from 42% in the first 5 weeks post-education to 27% in the subsequent 5 weeks.

CONCLUSION: Osteoporotic fractures are severely underrepresented in hospital administrative data due to inadequate documentation leading to inaccurate coding. Whilst education programmes can improve coding accuracy, long-term efficacy is limited by multiple factors. Since clinical coding forms an important part of public health resource allocation, automated system-based solutions are required to ensure accurate statistical capture of the true burden of osteoporosis and associated fractures.

PMID:42247205 | DOI:10.1007/s11657-026-01721-w

Biotechnol Lett. 2026 Jun 5;48(4):78. doi: 10.1007/s10529-026-03748-y.

ABSTRACT

The mortality rate of Acute Lymphoblastic Leukemia (ALL) has reduced after the incorporation of L-asparaginase (L-ASNase) in therapeutic regimes, which function via selective starvation of the cancer cells, sparing the rest. However, challenges persist due to the immunogenic nature of the enzyme and the co-glutaminase activity. This study investigates the L-ASNase coded for by the ansB gene from Serratia marcescens MTCC 97. An initial study led to a titer of 1.6 U/mL of L-ASNase in a semi synthetic media. However, due to the opportunistic pathogenic nature of the strain and lower yield of the enzyme, a robust eukaryotic host, and the Pichia pastoris GlycoSwitch® SuperMan₅ (pep4^–prb1^–) strain was selected for the expression. The gene was codon optimized to further enhance the yield. The recombinant strain produced 16.6 U/mL of L-ASNase in a complex BMMY medium. Process and parameter optimization were done via statistical design using the Taguchi orthogonal array, leading to a final yield of 22.3 U/mL of L-ASNase, obtained at 37 °C, at a strictly neutral pH, when 1% inoculum was used to initiate the fermentation, with 0.5% v/v methanol induction. Batch bioreactor cultivation further enhanced the L-ASNase titer to 31.75 U/mL. However, the L-ASNase was also found to have a glutaminase activity, for which in-silico characterization of the enzyme was done for an elevated understanding of the intricate structure and active sites. Through modelling and simulation studies, possible mutations were explored with an aim to reduce the glutaminase activity, and thereby reduce the secondary function of the L-ASNase.

PMID:42247194 | DOI:10.1007/s10529-026-03748-y

Environ Sci Pollut Res Int. 2026 Jun 5. doi: 10.1007/s11356-026-37902-w. Online ahead of print.

ABSTRACT

Harmful algal blooms (HABs) pose water quality risks, including the depletion of dissolved oxygen and human health impacts. Remote sensing is a proven tool for monitoring HABs, yet knowledge is limited about its effectiveness in pond-sized waterbodies, whose size and shape may preclude multi-spectral platforms with large spatial resolutions and increase the probability of mixed pixels. This comparative limnology case study evaluates whether optical remote sensing is a viable tool to monitor HABs in pond-sized waterbodies. We use Sentinel-2 imagery with previously studied chlorophyll-a and cyanobacteria detection algorithms and performed targeted in situ sampling in four small waterbodies in Boulder, CO, USA, from June to August 2021 to validate the algorithms and better understand underlying biogeochemical processes. The chlorophyll-a algorithm indicated persistent algal growth occurred in all waterbodies, yet only Sombrero Marsh chlorophyll-a expressed a statistically significant relationship with the remote sensing output (p < 0.0005, r² = 0.80). Meanwhile, the cyanobacteria algorithm resulted in false negatives, only showing potential cyanobacteria at Sombrero Marsh despite in situ samples from all waterbodies indicating cyanobacteria were present. Samples from Sombrero Marsh had the highest chlorophyll-a (average = 132.5 µg/L) and percent cyanobacteria (average = 43.5%). These findings suggest that there is uncertainty in relying on remote sensing for monitoring HABs in small waterbodies unless a high concentration of algae is present on the water surface. However, in a resource- and time-limited system, remote sensing can be a useful tool as an initial assessment for monitoring algal blooms.

PMID:42247175 | DOI:10.1007/s11356-026-37902-w

Diabetologia. 2026 Jun 5. doi: 10.1007/s00125-026-06758-7. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: The aim of this study was to determine whether overall and time-specific patterns of hyperglycaemia, particularly soon after diagnosis, are associated with incident cancer in adults with newly diagnosed type 2 diabetes.

METHODS: We retrospectively analysed a territory-wide cohort of 52,926 Hong Kong Chinese people with newly diagnosed type 2 diabetes. We examined cancer risk across groups of individuals classified according to their time-weighted mean HbA_1c over the entire follow-up period (n=49,978) or during specific early exposure periods (n=39,185). A weighted cumulative exposure model was used to determine the role of historical HbA_1c exposures in cancer development (n=49,966).

RESULTS: Among 49,978 individuals with newly diagnosed type 2 diabetes, 1758 cancer events occurred. Each 11 mmol/mol (1%) increase in time-weighted mean HbA_1c was associated with a 27% relative higher risk of cancer at any site (HR 1.27; 95% CI 1.20, 1.33). Within the first 2 years after diagnosis, a time-weighted mean HbA_1c ≥53 mmol/mol (≥7.0%) vs <53 mmol/mol (<7.0%) was associated with a 30-75% relative higher risk of cancer at any site, depending on the specific HbA_1c category, even after adjusting for subsequent HbA_1c. Longer durations of early exposure were associated with higher risk, reaching 51-213% in the first 5 years of exposure. Earlier high HbA_1c exposures contributed more strongly to cancer risk than later exposures. A 11 mmol/mol (1%) HbA_1c reduction at 1-2 years was associated with a 6% relative lower cancer risk over a hypothetical 10 year window (HR 0.94; 95% CI 0.91, 0.98), whereas reductions after 5 years showed no significant risk differences.

CONCLUSIONS/INTERPRETATION: Overall, hyperglycaemic exposure was associated with an elevated long-term cancer risk in type 2 diabetes. Notably, individuals who showed better glycaemic management soon after diagnosis exhibited a lower cancer risk than those whose glycaemic management improved later, despite comparable overall glycaemic burdens.

PMID:42247170 | DOI:10.1007/s00125-026-06758-7

Graefes Arch Clin Exp Ophthalmol. 2026 Jun 5. doi: 10.1007/s00417-026-07293-2. Online ahead of print.

ABSTRACT

BACKGROUND: To conduct a comparative analysis of the efficacy and safety profiles of Tofacitinib (Tofa) and Adalimumab (ADA) in individuals diagnosed with refractory Behçet’s uveitis.

METHODS: A retrospective analysis was conducted on the medical records of 64 patients who received Tofa (n = 30) or ADA (n = 34) in routine clinical practice. Treatment allocation was not randomized. The analysis focused on drug response rate, central macular thickness, ocular inflammation parameters, and best-corrected visual acuity at 3, 6, 12, and 24 months after treatment initiation.

RESULTS: A total of 23 patients in the Tofa group (76.6%) and 24 patients in the ADA group (70.5%) achieved remission. Both groups exhibited improvements in mean best-corrected visual acuity (BCVA, Snellen chart, from baseline 0.33 ± 0.31 to 0.54 ± 0.27 in the ADA group, and from baseline 0.31 ± 0.27 to 0.57 ± 0.31 in the Tofa group), central macular thickness (CMT, from baseline 354.53 ± 101 μm to 199.71 ± 57 μm in the ADA group and from baseline 366.77 ± 120 μm to 203.67 ± 71 μm in the Tofa group), anterior chamber cell counts, and vitreous haze. No statistically significant differences were observed between the two groups in these overall outcomes. In an exploratory subgroup analysis, Tofa showed a lower response rate in patients with central occlusive retinal vasculitis, with 1/7 patients responding, whereas 6/8 patients responded in the ADA group (P = 0.041).

CONCLUSIONS: Both ADA and Tofa demonstrated favorable efficacy in treating refractory Behçet’s uveitis in this retrospective real-world study. The observed differences according to vasculitis phenotype should be interpreted cautiously and require confirmation in larger prospective studies.

PMID:42247158 | DOI:10.1007/s00417-026-07293-2