Tag: nevin manimala

Arthroplasty. 2026 May 4;8(1):32. doi: 10.1186/s42836-026-00382-x.

ABSTRACT

BACKGROUND: Pain in knee osteoarthritis (KOA) often shows a limited correlation with radiographic severity, complicating clinical assessment and highlighting the relevance of central pain mechanisms. Functional magnetic resonance imaging (fMRI) enables the investigation of brain regions such as the amygdala and nucleus accumbens, which are increasingly recognized as key components of the affective-motivational dimension of chronic pain and may show differential activation across clinical treatment contexts. This study is part of the HOLOA Project (Clinical and virtual examination of patients for holistic and objective description of the osteoarthritis progression mechanisms).

METHODS: We conducted a cross-sectional observational study nested within the HOLOA cohort. Thirty-one patients with KOA (20 managed conservatively [CM] and 11 observed in the surgical treatment context) with Kellgren Lawrence (KL) grades 2-3 were included. Participants underwent two fMRI paradigms involving pressure stimulation (Knee Interline and Tibial Surface tests). Clinical assessment included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Numeric Rating Scale (NRS). Group comparisons and correlation analyses were performed to examine associations between clinical measures and brain activation patterns.

RESULTS: Groups were broadly comparable with no statistically significant differences in demographic or radiographic severity measures. These patients showed higher WOMAC and PCS scores, indicating greater functional impairment and pain catastrophizing. Across the whole cohort, painful stimulation elicited robust activation of classical pain-processing regions, while no significant amygdala or nucleus accumbens activation was observed at the group level. However, nucleus accumbens activity was positively associated with PCS scores. In between-group analyses, patients observed in the surgical treatment context exhibited significant bilateral amygdala activation during Tibial Surface stimulation, which was absent in the conservatively managed group, and reported higher post-test NRS scores.

CONCLUSION: Limbic system activation and pain catastrophizing were associated with the surgical treatment context in patients with knee osteoarthritis within a similar range of radiographic severity. The observed involvement of the amygdala and nucleus accumbens underscores the relevance of affective-motivational and cognitive processes in chronic KOA pain. These findings support the value of integrating clinical, psychological, and neurobiological perspectives when interpreting symptom burden and treatment context in knee osteoarthritis.

PMID:42071267 | DOI:10.1186/s42836-026-00382-x

J Act Sedentary Sleep Behav. 2026 May 3. doi: 10.1186/s44167-026-00103-4. Online ahead of print.

ABSTRACT

BACKGROUND: Early childhood is a critical period for establishing healthy movement behaviours, including physical activity, sedentary behaviour, screen time, and sleep. Childcare represents a key setting for shaping these behaviours, as many young children spend a substantial proportion of their waking hours in these environments. This study provides a national overview of movement behaviour policies in Canadian childcare facilities and examines associations with facility characteristics and provincial/territorial legislation.

METHODS: A cross-sectional online survey was completed by directors/owners of childcare facilities across Canada (n = 1,340). Respondents reported on the presence and characteristics of written policies across physical activity, sedentary behaviour/screen time, and sleep domains, along with facility characteristics. Descriptive statistics summarized policy prevalence, and thematic analysis was conducted on open-ended responses. Logistic regression models examined associations between facility characteristics (urbanicity, childcare type, enrolment size, daily fees) and the presence of written movement behaviour policies, as well as associations with explicit mention of these behaviours in provincial/territorial legislation.

RESULTS: Written policies were reported by 50.0% of facilities for overall physical activity, 61.1% for providing no screen time, and 68.7% for outdoor physical activity; fewer reported policies limiting prolonged seated time (17.0%) or ensuring age-appropriate nap durations (46.6%). Policies addressing educator professional development and family education were uncommon (< 21% and < 12%, respectively). Facilities in jurisdictions without explicit movement behaviour legislation were significantly less likely to report written policies for overall physical activity, prolonged seated time, and nap duration (p < .01). Urbanicity (p = .044) and enrolment size (p = .027) were associated with the presence of physical activity and nap duration policies, respectively, while family-/home-based childcare facilities had substantially lower odds of reporting a no screen time policy (OR = 0.22, p < .001) and higher odds of reporting a policy for prolonged seated time (OR = 1.94, p = .033) compared to centre-based facilities.

CONCLUSION: Movement behaviour policies in Canadian childcare settings are inconsistent and strongly shaped by governance and childcare context. While policies for physical activity and outdoor play are common, formal guidance for sedentary behaviour, screen time, sleep, and educator and family education remain limited. Greater coordination, implementation supports, and investment in professional learning may promote more equitable movement opportunities for young children in Canada.

PMID:42071266 | DOI:10.1186/s44167-026-00103-4

Br J Nutr. 2026 May 4:1-28. doi: 10.1017/S0007114526107326. Online ahead of print.

ABSTRACT

Flavanones represent a significant subgroup of flavonoids and offer various advantages for the human body, such as aiding in metabolic regulation and providing antioxidant properties. The objective of this research was to investigate the relationship between dietary flavanones and the prevalence of kidney stones among adults in the United States. Flavanones, including eriodictyol, hesperetin, and naringenin, were sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007-2010 and 2017-2018, utilizing two 24-hour dietary recall interviews. The definition of kidney stones was established through a self-administered questionnaire. To evaluate the relationships between dietary flavanones and kidney stones, a variety of statistical methods were utilized, such as multivariable regression analysis, restricted cubic splines (RCS), and subgroup analysis. Data from 9,790 participants were included in this analysis, with 9.67% of them indicating that they had experienced kidney stones. After adjusting for potential confounding factors, it was found that kidney stones exhibited a negative correlation with total flavanones and naringenin, with odds ratios (OR) of 0.96 (95% CI: 0.93, 1.00) and 0.89 (95% CI: 0.80, 0.99) for the highest intake group compared to the lowest intake group. The RCS plot revealed a notable negative linear association between the consumption levels of total dietary flavanones and the risk of kidney stones, including naringenin. The results of the subgroup analysis indicated that no significant interactions were observed in each subgroup. Our research indicated that a higher intake of flavanones correlates with a lowered prevalence of kidney stones in adults.

PMID:42071263 | DOI:10.1017/S0007114526107326

BMC Nutr. 2026 May 4. doi: 10.1186/s40795-026-01344-x. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescence presents an opportunity for nutritional intervention especially among girls whose physical and cognitive development during this period has lifelong implications. In this cross-sectional study, the interrelationship between dietary diversity, nutritional status, anaemia and cognitive performance among 181 adolescent girls in public schools in Southern Ghana were examined.

METHODS: The study employed structured questionnaires to collect sociodemographic data, anthropometric measurements to assess nutritional status, haemoglobin testing to determine anaemia status and Raven’s Coloured Progressive Matrices to evaluate cognitive performance. Data analysis was conducted using R version 4.4.2 to explore the relationship between food quality, nutritional markers and cognitive outcomes.

RESULTS: The mean dietary diversity score was 5.7 ± 1.9, and nearly one in three participants was either underweight or overweight, indicating a double burden of malnutrition. Anaemia affected 18.4% of the participants, primarily in mild or moderate forms, while 14% demonstrated poor cognitive performance. A consistent and significant inverse relationship was observed between dietary diversity and poor cognition. Though not statistically significant, each unit increase in dietary diversity was associated with a 19% reduction in the odds of poor cognitive performance (OR = 0.81, 95% CI: 0.65-1.01, p = 0.056). Mid-adolescents (14-16 years) were significantly less likely to be malnourished compared to early adolescents (10-13 years) (OR = 0.43, 95% CI: 0.21-0.86, p = 0.017). Normal BMI-for-age z-scores (OR = 0.62, 95% CI: 0.23-1.66, p = 0.329) and higher hemoglobin levels (OR = 0.70, 95% CI: 0.46-1.07, p = 0.081) were associated with reduced odds of poor cognitive performance; however, these associations were not statistically significant.

CONCLUSIONS: In contexts where nutrition insecurity and educational inequalities converge, school-based interventions that promote diverse diets and screen for anaemia could improve adolescent health and academic outcomes.

PMID:42071247 | DOI:10.1186/s40795-026-01344-x

J Orthop Surg Res. 2026 May 3. doi: 10.1186/s13018-026-06911-3. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effects of zoledronic acid combined with simvastatin on postoperative functional recovery in elderly patients with osteoporotic intertrochanteric femoral fractures.

METHODS: This retrospective study included 150 elderly patients with osteoporotic intertrochanteric femoral fractures who underwent proximal femoral nail antirotation (PFNA) fixation between May 2022 and May 2024. According to postoperative pharmacological regimens, patients were assigned to a conventional group (n = 79), receiving zoledronic acid alone, or a combination group (n = 71), receiving zoledronic acid plus oral simvastatin.Harris Hip Score (HHS), visual analogue scale(VAS)for pain, and serum bone metabolism markers, includingβ-C-terminal telopeptide of type I collagen (β-CTX), procollagen type I N-terminal propeptide (PINP), 25-hydroxyvitamin D[25(OH)D], and osteocalcin, were assessed preoperatively and at 3 and 6 months after surgery. The occurrence of internal fixation failure and refracture was also recorded. Statistical analyses were performed using R software.

RESULTS: HHS scores increased progressively at postoperative assessment time points in both groups, whereas VAS scores showed a gradual decline. At 3 and 6 months after surgery, the combination group exhibited higher HHS scores than the conventional group (P < 0.05). 3 months after surgery, the VAS score in the combined group was lower than that in the conventional group (P < 0.05). With respect to bone metabolism, postoperative levels ofβ-CTX, PINP, and osteocalcin decreased over time in both groups, while 25 (OH) D levels increased.Differences in several bone metabolism indicators were observed between groups at postoperative time points. The proportions of internal fixation failure and refracture were lower in the combination group; however, the between-group differences were not statistically significant (P > 0.05).

CONCLUSION: In elderly patients with osteoporotic intertrochanteric femoral fractures treated with PFNA, postoperative administration of zoledronic acid combined with simvastatin was associated with better hip function, favorable changes in bone metabolism and greater short-term improvement in postoperative pain compared with zoledronic acid alonebone metabolism.

PMID:42071246 | DOI:10.1186/s13018-026-06911-3

Child Adolesc Psychiatry Ment Health. 2026 May 3. doi: 10.1186/s13034-026-01083-8. Online ahead of print.

ABSTRACT

BACKGROUND: Internet Gaming Disorder (IGD) has emerged as a significant behavioral concern among youth, yet global prevalence estimates remain inconsistent due to methodological variability. This systematic review and meta-analysis aimed to determine the global pooled prevalence of IGD in children and adolescents.

METHODS: Following PRISMA 2020 guidelines and prospective registration in PROSPERO (CRD420251156483) prior to data extraction and analysis, comprehensive searches were conducted in PubMed, Scopus, Web of Science, Embase, and PsycINFO up to September 2025. Eligible observational studies assessed IGD prevalence in individuals aged 6-18 years using standardized diagnostic instruments based on DSM-5 or ICD-11 criteria. A random-effects meta-analysis (DerSimonian and Laird method) with Freeman-Tukey double arcsine transformation was used to pool prevalence estimates. Between-study heterogeneity was quantified using the I² statistic, and publication bias was assessed using funnel plot asymmetry and Egger’s regression test.

RESULTS: Nineteen studies involving 251,037 participants and 26,868 IGD cases met the inclusion criteria. The pooled global prevalence of IGD among children and adolescents was 10% (95% CI: 6-15%). Individual study estimates ranged from approximately 1% in some European populations to over 25% in studies conducted in Middle Eastern and Latin American settings. Heterogeneity was extreme (I² = 99.7%), and smaller studies tended to report higher prevalence.

CONCLUSIONS: Approximately one in ten children and adolescents worldwide meet criteria for IGD, underscoring its growing significance as a global mental health concern. Given the substantial heterogeneity observed, the pooled estimate should be interpreted as an average across diverse contexts rather than a uniform global rate. These findings highlight the need for standardized diagnostic criteria, culturally sensitive preventive interventions, and early identification strategies to mitigate long-term psychosocial impact.

PMID:42071239 | DOI:10.1186/s13034-026-01083-8

J Orthop Surg Res. 2026 May 3. doi: 10.1186/s13018-026-06910-4. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate specific radiological risk factors in patients with patellar dislocation accompanied by inferomedial patellar margin avulsion fractures and provide evidence for clinical treatment strategy selection, this study conducted comparative analysis of radiographic measurements and clinical function between patients with patellar dislocation with and without such avulsion fractures.

METHODS: A total of 73 patients with patellar dislocation who underwent medial patellofemoral ligament (MPFL) reconstruction at the Affiliated Hospital of Chengde Medical University were included. Basic patient data, affected side, injury mechanism, and type of patellar dislocation were collected. The subjects were subsequently divided into an experimental group and a control group based on the presence or absence of a concomitant inferomedial patellar marginal avulsion fracture. Imaging evaluations, including MRI, CT, and X-ray examinations, were comprehensively performed for comparative analysis. MRI was used to assess the height of the vastus medialis obliquus (VMO); CT was used to measure patellar thickness, patellar width, lateral patellar facet angle, Wiberg angle, Wiberg index, the length ratio of lateral to medial patellar facets, trochlear depth index, sulcus angle, lateral trochlear inclination, tibial tubercle-trochlear groove (TT-TG) distance, the cross-sectional area ratio of VMO to vastus lateralis muscle (VLM), medial-lateral width of the femoral condyle, and the length of different regions of the femoral condyle, as well as to classify the patella and trochlea. The Caton-Deschamps index was measured on X-ray. Additionally, clinical function was evaluated and compared using Lysholm score, IKDC score, Tegner score, and VAS score preoperatively and at 6 months postoperatively.

RESULTS: Statistically significant differences were observed between the experimental and control groups regarding injury mechanism, type of patellar dislocation, the ratio of lateral to medial patella facet length, and Wiberg scores (P < 0.05).

CONCLUSION: Injury mechanism, types of patellar dislocation, the Wiberg angle, and the length ratio of the lateral to medial patellar facets have significant predictive value for the occurrence of avulsion fractures of the inferomedial patellar margin following patellar dislocation. Furthermore, patients with patellar dislocation, whether accompanied by avulsion fractures of the inferomedial patellar margin or not, undergoing isolated medial patellofemoral ligament reconstruction show no difference in postoperative clinical function.

PMID:42071233 | DOI:10.1186/s13018-026-06910-4

Nutr Metab (Lond). 2026 May 3. doi: 10.1186/s12986-026-01122-3. Online ahead of print.

ABSTRACT

BACKGROUND: Oyster mushrooms (Pleurotus ostreatus, PO) are rich in β-glucans and other ingredients with cholesterol-lowering potential. While human intervention studies suggest that PO intake may reduce total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides, current evidence remains limited due to methodological limitations of the studies. Thus, this study investigated whether regular intake of PO powder affects LDL-C concentrations in adults with moderately elevated LDL-C (primary aim). Moreover, the study explored the effect on other lipids (TC, high-density lipoprotein cholesterol, triglycerides), on apolipoproteins A1 and B and possible underlying mechanisms of action (secondary aims).

METHODS: In a double-blind, randomized controlled trial, 46 adults (37 female, 9 male) with moderately elevated LDL-C (116-190 mg/dL) consumed a beverage containing 8.4 g PO powder providing 3 g of β-glucans or a beverage without PO daily over 4 weeks. Plasma concentrations of LDL-C, other lipids and apolipoproteins were measured before and after intervention. The concentrations of noncholesterol sterols in serum, normalized to cholesterol, were determined as validated surrogate markers for cholesterol absorption (sitosterol, campesterol, and 5α-cholestanol), cholesterol synthesis (lathosterol), and bile-acid synthesis (7α-hydroxycholesterol), along with ergosterol, a fungal-specific sterol. Expression of selected target genes involved in cholesterol metabolism was analyzed in blood. Statistical analysis included comparisons of the changes between the groups (treatment effect) and linear modeling.

RESULTS: PO treatment did not modulate LDL-C; no treatment effect was observed for other lipids, apolipoproteins or gene expression (P ≥ 0.05 for all). However, after adjustment for sex, linear model analysis showed a reduction in markers of cholesterol absorption, especially in females (P < 0.05 for all). No effects were observed on markers of cholesterol and bile-acid synthesis (P ≥ 0.05 for all). Ergosterol was detectable in all serum samples after PO intake, confirming high compliance with PO treatment.

CONCLUSIONS: Daily consumption of 8.4 g of PO powder over 4 weeks has no impact on LDL-C concentrations in adults with moderately elevated LDL-C concentrations. However, post-hoc analysis indicates a sex-dependent reduction in cholesterol absorption by PO consumption, especially in females, suggesting that PO may have the potential to beneficially modulate cholesterol metabolism.

TRIAL REGISTRATION: Registration at German Clinical Trials Register; DRKS-ID: DRKS00033943; registration date: 21/03/2024. https://drks.de/search/de/trial/DRKS00033943.

PMID:42071226 | DOI:10.1186/s12986-026-01122-3

Cardiovasc Diabetol. 2026 May 3. doi: 10.1186/s12933-026-03191-3. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiometabolic multimorbidity (CMM) poses a growing global health burden, yet few studies have combined the Triglyceride-Glucose (TyG) index, which reflects metabolic dysfunction, with the Frailty Index (FI), which captures physiological reserve and aging-related vulnerability, to assess CMM risk. Given their complementary biological information, this study examines whether a composite TyG-FI index is associated with incident CMM and whether it improves risk stratification beyond established factors.

METHODS: This prospective cohort study analyzed data from Chinese adults aged ≥ 45 years in the 2011-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). To assess the association between the TyG-FI index and incident CMM, we used Kaplan-Meier survival curves and multivariable Cox proportional-hazards models adjusted for potential confounders; restricted cubic spline analyses were employed to explore non-linear relationships. Predictive performance was evaluated using eight machine-learning algorithms: CatBoost, Extra Trees, Random Forest (RANGER), XGBoost, Recursive Partitioning (RPART), k-Nearest Neighbors (KKNN), Neural Network (NNET), and Support Vector Machine (SVM). Subgroup and sensitivity analyses were conducted to test the robustness of the results across population subgroups and modeling choices.

RESULTS: The analytic cohort comprised 2961 adults. Kaplan-Meier curves showed a graded, significant increase in cumulative CMM incidence across TyG‑FI quartiles (log‑rank P < 0.001). In multivariable Cox models, each unit increase in TyG‑FI was associated with a 1.80-fold higher CMM risk (HR = 1.80, 95% CI 1.57-2.05; P < 0.001); participants in the highest quartile had markedly elevated risk versus the lowest (Q4 vs. Q1 HR = 7.86, 95% CI 4.16-14.86). Restricted cubic spline analyses revealed significant non-linear relationships (P for non-linearity < 0.001), showing a J-shaped association between TyG-FI and CMM with threshold effects at TyG-FI ≈ 0.7 and cumulative TyG-FI ≈ 2.7. Subgroup analyses indicated stronger associations in participants < 60 years and in normotensive individuals. TyG-FI demonstrated better predictive performance for CMM than TyG index or FI alone, with improved C-statistic, Integrated Discrimination Improvement (IDI), and Net Reclassification Improvement (NRI). Among machine-learning models, RANGER performed best (AUC ≈ 0.81), and SHAP analysis identified cumulative and baseline TyG-FI as the primary predictors. Findings were robust in sensitivity analyses.

CONCLUSIONS: TyG-FI exhibits non‑linear, threshold-defined associations with incident CMM and age‑dependent effect modification. Machine‑learning models incorporating TyG-FI show strong predictive performance. TyG-FI assessment may facilitate cost‑effective risk stratification for CMM and guide targeted prevention.

PMID:42071205 | DOI:10.1186/s12933-026-03191-3

BMC Infect Dis. 2026 May 3. doi: 10.1186/s12879-026-13413-4. Online ahead of print.

ABSTRACT

BACKGROUND: To explore whether preoperative CD4⁺ T-cell count is associated with postoperative infectious outcomes after endoscopic lithotripsy for upper urinary tract calculi in human immunodeficiency virus (HIV)-infected patients.

METHODS: The HIV-infected patients who underwent endoscopic lithotripsy for upper urinary tract stones at Shanghai Public Health Clinical Center from May 2019 to May 2025 were enrolled for this study. The exposure of interest was the preoperative peripheral blood CD4⁺ T-cell count. The primary endpoint was urosepsis. Secondary outcomes included postoperative fever, systemic inflammatory response syndrome (SIRS), and other postoperative complications.

RESULTS: A total of 120 patients were enrolled in this study, including 20 patients with a CD4⁺ T-cell count < 200 cells/µL and 100 patients with a CD4⁺ T-cell count ≥ 200 cells/µL. None of the patients developed urosepsis or SIRS postoperatively. The overall rate of postoperative fever was 17.5% (21/120). Fever was observed in 15.0% of the patients with a CD4⁺ T-cell count < 200 cells/µL, compared with 18.0% of those with a CD4⁺ T-cell count ≥ 200 cells/µL, and there was no statistically significant difference (P > 0.05). Logistic regression analysis further showed that CD4⁺ T-cell count was not significantly associated with fever (OR = 1.001, 95% CI: 0.998-1.003, P = 0.586), whereas urine white blood cell count, stone density, and surgical approach were independently associated with fever. Sensitivity analyses using propensity score matching and inverse probability of treatment weighting showed similar results.

CONCLUSION: In this retrospective single-center cohort, preoperative CD4⁺ T-cell count was not significantly associated with postoperative fever after endoscopic lithotripsy in HIV-infected patients. However, because no urosepsis events occurred and the sample size, particularly in the CD4⁺ T-cell count < 200 cells/µL subgroup, was limited, the study could not adequately evaluate the primary endpoint. These findings should therefore be considered exploratory and require confirmation in larger studies incorporating HIV viral load and procedure-specific analyses.

PMID:42071191 | DOI:10.1186/s12879-026-13413-4