Tag: nevin manimala

Front Oncol. 2026 Aug 7;16:1848585. doi: 10.3389/fonc.2026.1848585. eCollection 2026.

ABSTRACT

OBJECTIVE: This study aims to compare the expression of p53, PTEN, and p16 among three groups: endometrial polyps of breast cancer patients receiving endocrine therapy, common sporadic endometrial polyps, and endometrial carcinoma (type I). This study also analyzes the correlation between the immunohistochemical expression of these markers and the clinical characteristics of breast cancer patients receiving endocrine therapy.

METHODS: From 1 December 2022, to 31 December 2023, we retrospectively enrolled 93 breast cancer patients receiving endocrine therapy with endometrial polyps, 60 patients with common sporadic endometrial polyps, and 48 patients with endometrial carcinoma (type I) (all cases were retrieved from our hospital). The expression of p53, PTEN, and p16 was detected using immunohistochemistry. Spearman’s correlation analysis was conducted to explore factors associated with p16 and PTEN expression in the endocrine therapy cohort.

RESULTS: No statistically significant difference in the p53 expression distribution was observed among the tamoxifen (TAM), toremifene (TOR), endometrial polyps (EP), and endometrial carcinoma (EC) groups regardless of menopausal status. In premenopausal patients, the semi-quantitative immunohistochemical (IHC) scores of p16 and PTEN in the TAM and TOR groups were intermediate between those of EP and EC groups (Holm-adjusted P < 0.05). This specific pattern was not observed in the postmenopausal group. In the endocrine therapy-treated cohort, Spearman’s correlation analysis revealed that the semi-quantitative IHC score of p16 was positively correlated with age, blood lipids, and BMI; negatively correlated with abnormal uterine bleeding and endometrial thickness (P < 0.05); the semi-quantitative IHC score of PTEN was negatively correlated with menopausal status and diabetes mellitus (P < 0.05).

CONCLUSIONS: In this retrospective immunohistochemical analysis of premenopausal women, p16 and PTEN expression in the TAM/TOR group was intermediate between those of EP and EC groups. This pattern may suggest a hyperproliferative polyp phenotype, but remains speculative without confirmatory proliferation biomarkers and molecular validation. Long-term surveillance may be considered for this population, though prospective cohort data are needed to confirm its clinical utility. p16 was positively associated with age, blood lipids, and BMI, and negatively associated with abnormal uterine bleeding and endometrial thickness; PTEN was negatively associated with menopausal status and diabetes mellitus. These preliminary associations provide exploratory clues for endometrial follow-up biomarker research.

PMID:42630187 | PMC:PMC13493233 | DOI:10.3389/fonc.2026.1848585

Front Oncol. 2026 Aug 7;16:1866026. doi: 10.3389/fonc.2026.1866026. eCollection 2026.

ABSTRACT

BACKGROUND: Neoadjuvant therapy combined with immunotherapy has emerged as a promising strategy for rectal cancer (RC), but its efficacy in anal sphincter preservation, clinical outcomes, and safety profile remains to be systematically validated. This meta-analysis aims to comprehensively evaluate the anal sphincter preservation rate, clinical efficacy, and safety of neoadjuvant therapy combined with immunotherapy in rectal cancer patients, providing evidence-based support for clinical decision-making.

OBJECTIVE: To assess the anal sphincter preservation rate, key clinical efficacy indicators (including pathological complete response rate, R0 resection rate, and tumor regression grade), and safety indicators (adverse events and postoperative complications) of neoadjuvant therapy combined with immunotherapy in rectal cancer patients. We systematically synthesize the absolute sphincter-preservation, pathological-response, and safety proportions of neoadjuvant immunotherapy in rectal cancer patients, with any comparison to historical data of conventional regimens presented as indirect and exploratory only.

METHODS: This study was prospectively registered in PROSPERO (registration number: CRD420251159170) and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodological quality of this systematic review was evaluated using the AMSTAR 2 tool. A comprehensive electronic search was performed across eight databases (PubMed, Embase, Cochrane Library, Web of Science, Sinomed, CNKI, WanFang, and VIP) up to February 2, 2026. Eligible studies included randomized controlled trials (RCTs), single-arm trials, and observational studies (cohort studies, case-control studies) investigating neoadjuvant therapy combined with immunotherapy for rectal cancer. Data extraction was independently performed by two authors, and risk of bias was assessed using the ROBINS-I tool (for non-randomized studies) and the Cochrane Collaboration risk of bias tool (for RCTs). The GRADE approach was used to evaluate the certainty of evidence. Statistical analysis was conducted with R Studio 4.3.2 software, employing random-effects or fixed-effects models based on heterogeneity (assessed by I² statistic and chi-squared test). This meta-analysis does not include controlled comparative trials and that all analyses are single-arm proportion pooling without direct between-group comparisons.

RESULTS: A total of 16 studies involving 540 rectal cancer patients were included. The pooled anal sphincter preservation rate was 0.90 (95% CI: 0.87-0.93) with moderate heterogeneity (I²=37.4%, P = 0.0716). The R0 resection rate was 0.98 (95% CI: 0.96-1.00) (I²=51.4%, P = 0.0361), and the pathological complete response (pCR) rate was 0.34 (95% CI: 0.29-0.38) (I²=71.8%, P < 0.0001). The overall complete response (CR) rate was 0.49 (95% CI: 0.44-0.54) (I²=66.0%, P = 0.0007), and the tumor regression grade (TRG) 0-1 rate was 0.55 (95% CI: 0.49-0.62) (I²=78.6%, P < 0.0001). Regarding safety, the incidence of grade 1-2 adverse events was 0.80 (95% CI: 0.71-0.89) (I²=0.0%, P = 0.8159), grade ≥3 adverse events was 0.17 (95% CI: 0.13-0.21) (I²=97.4%, P < 0.0001), and postoperative complications rate was 0.24 (95% CI: 0.18-0.30) (I²=92.4%, P<0.0001). Pooled estimates within clinically defined subgroups were generally consistent and are reported descriptively only.

CONCLUSIONS: Neoadjuvant therapy combined with immunotherapy was associated with favorable pooled proportions of sphincter preservation and R0 resection in the included studies, although these estimates are derived predominantly from single-arm studies. This regimen warrants further investigation for organ preservation strategies, but confirmatory evidence from high-quality RCTs is needed. Given that the current evidence is predominantly of low-to-moderate certainty, high-quality, large-scale RCTs with long-term follow-up are needed to further validate these findings and optimize treatment regimens.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=CRD420251159170, identifier CRD420251159170.

PMID:42630182 | PMC:PMC13493273 | DOI:10.3389/fonc.2026.1866026

Front Endocrinol (Lausanne). 2026 Aug 7;17:1910192. doi: 10.3389/fendo.2026.1910192. eCollection 2026.

ABSTRACT

INTRODUCTION: Diabetes self-management in older adults with type 1 diabetes (T1D) presents a unique clinical challenge, since maintaining tight glycemic control must be carefully weighed against age-related vulnerabilities. This study aimed to analyze glycemic control through the effects of customized algorithm settings in a cohort of older adults with T1D using an automated insulin delivery (AID) system.

METHODS: This retrospective real-world data analysis included users of the MiniMed™ 780G AID system, aged ≥60 years. Continuous glucose monitoring (CGM) data including time in range (TIR; 70-180 mg/dL; 3.9-10.0 mmol/L), time in tight range (TITR; 70-140 mg/dL; 3.9-7.8 mmol/L), time below range (TBR; <70 mg/dL; <3.9 mmol/L), level 2 TBR (<54 mg/dL; <3.0 mmol/L) and time above range (TAR; >180 mg/dL; >10.0 mmol/L) were analyzed alongside algorithm settings and daily insulin use. Group comparisons utilized standard parametric and non-parametric statistical tests. A multivariable logistic regression model identified independent clinical predictors of high glycemic performance (TITR ≥50%).

RESULTS: The cohort comprised 97 AID users (70.1% female, mean age 67.9 ± 6.7; range 60-90 years). Overall glycemic control was good, with mean TIR 76.1%, TITR 51.1% and TBR 1.1%. Fourteen participants (14.4%) used the manufacturer’s recommended optimal settings (ROS); i.e., target glucose of 5.5 mmol/L and active insulin time of 2 hours. CGM metrics did not differ between ROS and non-ROS users for TIR, TITR and TBR. When stratifying the cohort by glycemic performance, 55 participants (56.7%) reached TITR ≥50%; however, the adoption of ROS in high (≥50%) TITR and lower (<50%) TITR subgroups was similar (16.4% vs 11.9%; Fisher p=0.58). When compared to the lower TITR subgroup, participants in the high TITR subgroup delivered less auto-correction insulin (14.2% vs 20.6%, p<0.001) and a higher proportion of manual bolus insulin (46.1% vs 35.2%, p<0.001), which remained a significant predictor of high TITR after multivariable adjustment. TBR was significantly higher in the high (≥50%) TITR subgroup, although it remained low in absolute terms (1.5% vs. 0.8%; p=0.017).

CONCLUSION: While the MiniMed™ 780G AID system use is associated with low CGM-derived hypoglycemia exposure and highly effective glycemic control, regardless of customized settings, superior glycemic control is associated with a higher proportion of user-initiated manual boluses. The algorithm supports, but cannot replace, user engagement.

PMID:42630180 | PMC:PMC13493288 | DOI:10.3389/fendo.2026.1910192

Front Public Health. 2026 Aug 7;14:1858931. doi: 10.3389/fpubh.2026.1858931. eCollection 2026.

ABSTRACT

BACKGROUND: Family relationships are an important psychosocial determinant of mental health in older adults. Their perception of family functioning may differ from that of other household members and influence the presence of depressive symptoms.

OBJECTIVE: To characterize older adults’ perception of family relationships in Loja, Ecuador, and examine its association with depressive symptoms.

METHODS: An observational, analytical, cross-sectional study was conducted among 171 older adults and one cohabiting family member attending primary healthcare centers in Loja, Ecuador, between January and December 2024. Validated instruments assessed cognitive function (Mini-Mental State Examination), depressive symptoms (Geriatric Depression Scale-15), functional capacity (Barthel Index and Lawton and Brody Index), older adults’ perception of family relationships (PRF), and family functioning reported by relatives (FF-SIL). Descriptive analyses, Spearman correlation, and multivariate binary logistic regression were performed. Crude and adjusted odds ratios (OR and aOR) with 95% confidence intervals (95% CI) were estimated, considering p < 0.05 as statistically significant.

RESULTS: Participants had a mean age of 75.1 years (SD = 8.3), and 70.2% were women. Most older adults (59.6%) perceived their family relationships as disharmonious, whereas 74.3% of family members reported adequate family functioning. Agreement between both perspectives was moderate (ρ = 0.315; p < 0.001). Older adults reporting disharmonious family relationships had significantly higher odds of depressive symptoms in the crude analysis (OR = 3.00; 95% CI: 1.40-6.42). This association remained significant after adjustment for sociodemographic variables (aOR = 2.41; 95% CI: 1.07-5.39) and after additional adjustment for clinical confounders (aOR = 2.35; 95% CI: 1.04-5.28). Per capita income below the unified basic salary was also independently associated with depressive symptoms (aOR = 3.67; 95% CI: 1.65-8.17).

CONCLUSION: Older adults’ perception of family relationships is independently associated with depressive symptoms, even after controlling for sociodemographic and clinical factors. These findings highlight the importance of incorporating older adults’ own perspectives into the assessment of family dynamics and strengthening family-centered mental health promotion and prevention strategies within primary healthcare.

PMID:42630176 | PMC:PMC13493223 | DOI:10.3389/fpubh.2026.1858931

Front Netw Physiol. 2026 Aug 7;6:1908460. doi: 10.3389/fnetp.2026.1908460. eCollection 2026.

ABSTRACT

BACKGROUND: Optic nerve sheath diameter (ONSD) measured by ultrasound provides a non-invasive surrogate of intracranial pressure. Although lower body negative pressure (LBNP) is widely used to simulate central hypovolemia, the dose-response relationship between graded LBNP and ONSD, and possible sex differences therein, are incompletely characterized.

METHODS: Forty-four healthy young adults (22 female, 22 male) underwent graded LBNP ( – 10 to – 40 mmHg) in the supine position; valid ONSD data were available in 37 participants (18 female, 19 male) who constituted the analytical sample. ONSD was measured from transbulbar B-mode ultrasound images 3 mm posterior to the globe, with three representative frames averaged per condition. Relative changes from individual supine baseline were analyzed using a linear mixed-effects model with state, sex, and their interaction as fixed effects.

RESULTS: A progressive and statistically significant reduction in ONSD was observed at every LBNP level in both sexes. Female participants showed reductions of approximately – 4.4 % (LBNP10, p = 0.001), – 9.1 % (LBNP20, p < 0.001), – 13.2 % (LBNP30, p < 0.001) and – 15.9 % (LBNP40, p < 0.001) relative to supine baseline. Male-specific contrasts showed comparable reductions (LBNP10: – 3.0 % , p = 0.022; LBNP20: – 7.9 % , p < 0.001; LBNP30: – 10.1 % , p < 0.001; LBNP40: – 13.4 % , p < 0.001). The main effect of sex was not significant (p = 1.00), and no state × sex interaction reached significance (all p > 0.1). ONSD returned to baseline during recovery (female: p = 0.173; male: p = 0.059).

CONCLUSION: Graded LBNP induces a progressive, dose-dependent reduction in ONSD that is detectable already at mild LBNP ( – 10 mmHg) and reaches approximately – 15 % at – 40 mmHg. No statistically significant sex-related differences in the ONSD response to graded LBNP were detected in the present study. These findings support the use of transbulbar ONSD ultrasound as a sensitive non-invasive marker consistent with intracranial-pressure reductions during simulated central hypovolemia. By linking a systemic cardiovascular perturbation to a cerebro-ocular pressure readout, the study offers a network-physiology view of central-hypovolemia responses relevant to spaceflight and orthostatic-stress research.

PMID:42630170 | PMC:PMC13493247 | DOI:10.3389/fnetp.2026.1908460

Front Cardiovasc Med. 2026 Aug 7;13:1853767. doi: 10.3389/fcvm.2026.1853767. eCollection 2026.

ABSTRACT

BACKGROUND: In multiple countries, clinical guidelines recommend proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors for lowering low-density lipoprotein cholesterol (LDL-C) in individuals with atherosclerotic cardiovascular disease (ASCVD). Comprehensive comparisons of the efficacy, safety, and cost-effectiveness across different PCSK9 inhibitors remain limited, and current evidence requires updating. To address this gap, this study applies a health technology assessment framework to systematically evaluate the use of PCSK9 inhibitors in patients with ASCVD.

METHODS: A systematic search of PubMed, EMBASE, and the Cochrane Library was conducted from database inception to February 28, 2026 to identify randomized controlled trials (RCTs) comparing PCSK9 inhibitors with standard care (statins with or without ezetimibe) in patients with ASCVD. Both pairwise and network meta-analyses were applied to synthesize direct and indirect evidence. Trial sequential analysis (TSA) was performed to evaluate the sufficiency of the accumulated data. In addition, a Markov model was developed from the perspective of the Chinese healthcare system to assess the cost-effectiveness of PCSK9 inhibitors in ASCVD patients.

RESULTS: In total, 24 RCTs comprising 63,328 participants were included. The results of TSA and network meta-analysis showed that, compared with SOC, all three PCSK9 inhibitors significantly reduced LDL-C levels. No statistically significant differences were found for stroke outcomes. However, both alirocumab and evolocumab significantly reduced the risk of non-fatal myocardial infarction. None of the three PCSK9 inhibitors was associated with an increased risk of serious adverse events. Using the meta-analysis findings and data from the Chinese healthcare system, the incremental cost-effectiveness ratios (ICERs) for alirocumab, evolocumab, and inclisiran versus standard care were estimated at USD 12,791.07/QALY, USD 11,646.38/QALY, and USD 31,730.14/QALY, respectively. In a scenario analysis incorporating a 72.1% reduction in the price of inclisiran, its ICER decreased to USD 9,686.31/QALY. The one-way sensitivity analysis showed that the discount rate exerted the greatest influence on model outcomes. In the price-reduction scenario, probabilistic sensitivity analysis indicated that inclisiran had a 96.6% probability of being cost-effective at a willingness-to-pay threshold of USD 13,410/QALY.

CONCLUSION: Currently, evolocumab demonstrates relative advantages in lipid-lowering efficacy, cardiovascular outcomes, and economic value for patients with ASCVD. Alirocumab represented a cost-effective alternative. In the scenario analysis incorporating a 72.1% reduction in the price of inclisiran, inclisiran became a potentially highly cost-effective option in the Chinese healthcare setting.

PMID:42630166 | PMC:PMC13493235 | DOI:10.3389/fcvm.2026.1853767

Front Psychol. 2026 Aug 7;17:1821604. doi: 10.3389/fpsyg.2026.1821604. eCollection 2026.

ABSTRACT

Based on findings from analyses with the random-intercept cross-lagged panel model (RI-CLPM), Ren et al. concluded reinforcing longitudinal effects between associative learning and fluid intelligence. However, the RI-CLPM is susceptible to spurious findings. Here, we analyzed data simulated to resemble the data used by Ren et al. with alternative models and found discrepant increasing, decreasing, and null prospective effects between associative learning and fluid intelligence. Hence, the conclusions by Ren et al. appear not to be supported by their own data. It is important for researchers to bear in mind that correlations, including effects in the RI-CLPM, in observational (i.e., non-experimental) data may be spurious and do, consequently, not prove genuine (i.e., non-spurious) influence. We recommend researchers to fit alternative models to data and to base conclusions on an aggregation of findings.

PMID:42630163 | PMC:PMC13493240 | DOI:10.3389/fpsyg.2026.1821604

Front Endocrinol (Lausanne). 2026 Aug 7;17:1852416. doi: 10.3389/fendo.2026.1852416. eCollection 2026.

ABSTRACT

BACKGROUND: There exists a close and complex bidirectional relationship between cardiovascular disease (CVD) and chronic kidney disease (CKD). CVD is a well-established risk factor for CKD, while the Triglyceride glucose-body mass index (TyG-BMI) has been considered as a predictor of cardiovascular events. This was a retrospective case-control study. This study aimed to investigate the relationship between preoperative TyG-BMI and estimated glomerular filtration rate(eGFR) during follow-up in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).

METHODS: This study was performed in 1020 patients with CHD after PCI without CKD from 01/01/2015 to 01/01/2025. We performed multifaceted analyses of the association between preoperative TyG-BMI and eGFR, including multiple linear regression for continuous eGFR outcomes, logistic regression to identify whether TyG-BMI independently influenced categorical eGFR status and quantify the magnitude of this association, and restricted cubic spline (RCS) analysis to explore non-linear relationships. Low eGFR (<60 mL/(min*1.73m²)) was set as the outcome variable, and was obtained from the latest follow-up.

RESULTS: The multivariate linear regression analysis revealed no statistically significant linear association between preoperative TyG-BMI and eGFR (t = -1.850, P = 0.065). Logistic regression indicated that TyG-BMI was not identified as an independent influencing factor of eGFR (P = 0.369, OR = 1.003, 95%CI:0.977~1.009). RCS analysis indicated that the nonlinear association between TyG-BMI and eGFR was not statistically significant (P for nonlinear > 0.05).

CONCLUSION: Preoperative TyG-BMI exerted no direct independent effect on long-term outcome of eGFR. It is unlikely that TyG-BMI serves as a primary determinant of CKD in patients with CHD after PCI. Future studies should evaluate combined risk models.

PMID:42630158 | PMC:PMC13493252 | DOI:10.3389/fendo.2026.1852416

Front Cardiovasc Med. 2026 Aug 7;13:1879458. doi: 10.3389/fcvm.2026.1879458. eCollection 2026.

ABSTRACT

BACKGROUND: Cardiac contractility is regulated by two myosin heavy chain (MHC) protein isoforms, α and β, encoded by the MYH6 and MYH7 genes. The intronic regions of these genes encode the microRNAs miR-208a and miR-208b, which are key regulators of cardiac hypertrophy. Functionally relevant long non-coding RNAs (lncRNAs) have also been identified at these loci, such as those transcribed in the antisense direction from the MYH7 gene, including the primary miR-208b transcript (MHRT) originating from an internal MYH7 promoter. Additionally, MYH7B, another cardiac sarcomeric myosin gene, serves as a precursor for miR-499a-5p.

AIM: This study aimed to comprehensively analyse the expression profiles of MYH6, MYH7, and MYH7B genes, microRNAs (miR-208a-3p, miR-208b-3p, and miR-499a-5p), and the lncRNA MHRT in non-failing and end-stage failing human left ventricles.

SUBJECTS AND METHODS: The relative expression of these transcripts was measured using RT-qPCR in left ventricular samples from 5 non-failing controls and 24 patients with end-stage heart failure, including hypertrophic cardiomyopathy (HCM, n = 4), dilated cardiomyopathy (DCM, n = 10), and coronary artery disease (CAD, n = 10). The findings were validated by comparison with two independent RNA-seq datasets (GSE141910 and GSE116250) for MYH6, MYH7, MYH7B, and MHRT.

RESULTS: Statistical analysis of independent RNA-seq datasets confirmed strong correlations among MYH7, MYH7B, and MHRT transcripts (p ≤ 0.0001), a trend also observed in our RT-qPCR cohort. A profound imbalance in the MYH7B/miR-499-5p ratio was identified, shifting from ∼250:1 in non-failing controls to ∼12-18:1 in failing hearts. The miR-208a-3p/miR-208b-3p expression ratio was heavily skewed toward miR-208b-3p (∼50:1) in all groups, regardless of disease status.

CONCLUSION: Our results suggest that MYH7, MYH7B, and MHRT transcripts exhibit coordinated expression patterns in human left ventricles, independent of pathological status. We further observed a dissociation between miR-208a-3p and its host gene (MYH6) under physiological conditions and confirmed altered miR-499a-5p/MYH7B relationships, consistent with findings in murine models. Moreover, the expression of two regulatory genes, SOX6 and TARBP2, known to modulate MYH7 and MYH7B in mice, showed that SOX6 is upregulated in the left ventricles of all pathological groups.

PMID:42630156 | PMC:PMC13493238 | DOI:10.3389/fcvm.2026.1879458

Front Neurol. 2026 Aug 7;17:1849476. doi: 10.3389/fneur.2026.1849476. eCollection 2026.

ABSTRACT

BACKGROUND: The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel composite biomarker reflecting systemic inflammation, nutritional status, and immune function. Emerging evidence suggests its potential prognostic value in acute ischemic stroke (AIS). However, no systematic analysis has been conducted to evaluate its association with functional outcomes in AIS patients. This systematic review with exploratory quantitative synthesis aimed to assess the prognostic value of the CALLY index for functional outcomes in AIS.

METHODS: We systematically searched the Cochrane Library, EMBASE, PubMed, and Web of Science databases from inception to March 2026. The search was initially conducted in February 2025 and updated in March 2026 prior to submission. Observational studies evaluating the association between the CALLY index and functional outcomes in AIS patients were included. The primary outcome was poor functional outcome defined by the modified Rankin Scale (mRS), with poor outcome defined as mRS ≥ 2, mRS > 2, or mRS ≥ 3 at 3 months. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Heterogeneity was evaluated using Cochran’s Q test and I ² statistic.

RESULTS: Three studies involving 1,161 AIS patients were included. The exploratory quantitative synthesis revealed that a higher CALLY index was significantly associated with a lower risk of poor functional outcome (pooled OR = 0.766, 95% CI: 0.695-0.845, p < 0.001), with no significant heterogeneity across studies (I ² = 0.0%, Q = 1.33, p = 0.516). All included studies were of high quality (NOS scores 8-9). Publication bias could not be reliably assessed due to the limited number of included studies.

CONCLUSION: This systematic review with exploratory quantitative synthesis provides preliminary pooled evidence suggesting that the CALLY index may be a potential predictor of functional outcome in AIS patients. A higher CALLY index was associated with a lower risk of poor functional outcomes. However, given the limited number of included studies (only three retrospective studies from China), these findings should be considered hypothesis-generating rather than confirmatory and require validation in large-scale, multicenter, prospective studies across diverse populations before clinical application.

SYSTEMATIC REVIEW REGISTRATION: The review was registered in PROSPERO: CRD420261350196 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261350196.

PMID:42630153 | PMC:PMC13493246 | DOI:10.3389/fneur.2026.1849476