Tag: nevin manimala

Neurocrit Care. 2026 Aug 7. doi: 10.1007/s12028-026-02597-x. Online ahead of print.

ABSTRACT

There is limited real-world evidence on the diagnosis, treatment, and outcomes of refractory status epilepticus (RSE) in Latin America. This study describes the clinical characteristics, management, and outcomes of RSE in a tertiary neurological intensive care unit (NICU) in Mexico. We conducted a retrospective cohort study of adults (≥ 18 years) with RSE admitted from 2010 to 2022. All patients were initially analyzed as a single cohort; a prespecified secondary analysis stratified patients by preexisting epilepsy and identified those with new-onset RSE (NORSE). Patients were identified via electronic medical records and met the International League Against Epilepsy (ILAE) definition. Clinical, imaging, laboratory, and EEG data were collected. Outcomes included seizure cessation, functional status at NICU discharge (mRS), and prognostic scores (STESS and END-IT). Statistical analysis involved descriptive measures, chi-square/Fisher’s exact tests, t-test or Mann-Whitney U test, and multinomial logistic regression. Significance was set at p < 0.05. We analyzed 102 patients with RSE; 52.9% were women, median age 34 (26-44) years. Preexisting epilepsy was present in 70.6%, and 29.4% had NORSE. Most common etiologies were infections (23.5%), structural/vascular (22.5%), and treatment-related (16.7%). EEG most commonly showed slowing; interictal epileptiform discharges appeared in 27.7%. Treatment was heterogeneous; 82.4% required third-line therapy. Median hospitalization was 21.5 days, with mechanical ventilation averaging 8 days. Resolution occurred in 87.3%. One patient underwent surgery, without complications. Preexisting epilepsy was significantly associated with prior SE (p = 0.011), resolution (p = 0.001), unfavorable mRS (p = 0.046), and higher STESS (p = 0.001) and END-IT (p = 0.021) scores. END-IT also correlated with third-line treatment (p < 0.001). This study offers real-world insights into RSE in a resource-limited setting, highlighting preventable causes, management complexity, and high care demands. Despite limitations, favorable outcomes are often achievable.

PMID:42568019 | DOI:10.1007/s12028-026-02597-x

Atten Percept Psychophys. 2026 Aug 7;88(7):174. doi: 10.3758/s13414-026-03319-3.

ABSTRACT

Previous research has shown that production of an action toward a visual stimulus may prioritize features of that stimulus for a brief period of time. One recent report has suggested that such an action effect specifically influences ensemble processing – the extraction of summary statistics from a display of multiple items. In the present study we replicate the results that led to that conclusion by having participants assess the mean size of elements in an ensemble after having made an action to either a small or large object. The size of the acted-on object biased the ensemble judgment, but merely viewing the same object produced no such bias. In two subsequent experiments we found the same pattern of results when participants were asked to judge the size of an individual object – not an ensemble. Because the same pattern occurred even when ensemble processing was not required, the action appears to affect some aspect of the task other than ensemble processing (such as perception of visual stimuli in general, or processes related to memory, decision making or response selection), limiting the conclusions that are possible about ensemble processing, but revealing an important new effect of action.

PMID:42568018 | DOI:10.3758/s13414-026-03319-3

Int Ophthalmol. 2026 Aug 8;46(1):329. doi: 10.1007/s10792-026-04201-9.

ABSTRACT

PURPOSE: To identify determinants of visually significant cataract among type 2 diabetes mellitus patients attending a tertiary eye care center hospital in south Ethiopia.

METHODS: An unmatched case-control study was conducted at Hawassa University Comprehensive Specialized Hospital-Tertiary Eye Care and Training Center from February to April 2024. We enrolled 80 cases and 160 controls. The data were collected through interviews, physical measurements, and medical records revision using a pretested questionnaire. Variables with a P-value < 0.2 in a Pearson’s chi-square test were included in a multivariate logistic regression model, where a P-value < 0.05 was used to declare statistical significance of the predictors.

RESULTS: The response rate was 91.95%. Significant predictors of visually significant cataract were urban residence (AOR = 3.58, 95% CI 1.53-7.42), current substance use (AOR = 6.29, 95% CI 3.16-9.28), diabetes duration of 2-5 years (AOR = 2.88, 95% CI 1.30-6.74), diabetes duration > 5 years (AOR = 4.35, 95% CI 2.14-7.38), and comorbid hypertension (AOR = 4.01, 95% CI 2.15-8.19).

CONCLUSION: Urban residency, current substance use, longer duration of diabetes mellitus, and hypertension were statistically significant predictors of visually significant cataract. Early and periodic eye screening for these high-risk groups is essential for timely intervention.

PMID:42568015 | DOI:10.1007/s10792-026-04201-9

Clin Oral Investig. 2026 Aug 8;30(9):379. doi: 10.1007/s00784-026-07060-x.

ABSTRACT

OBJECTIVES: This study aimed to investigate whether vertical occlusal anomalies are associated with deep cervical flexor endurance (DCFE), cervical flexor strength (CFS), and craniovertebral angle (CVA).

METHODS: Sixty-two adolescents (mean age: 12.8 ± 1.5 years) were included in this cross-sectional study and allocated to a vertical occlusal anomaly group (VOAG, n = 31) or a control group without vertical anomalies (NVOAG, n = 31). DCFE, CFS, and CVA were assessed using standardized clinical methods. Between-group comparisons were performed, and analysis of covariance (ANCOVA) was used to adjust for age, sex, and body weight.

RESULTS: DCFE was significantly lower in the VOAG compared with the NVOAG (17.1 ± 6.9 s vs. 22.2 ± 7.8 s; p = 0.009), representing an approximate 23% reduction and a medium effect size (Cohen’s d = – 0.68). No significant between-group differences were observed for CFS (p = 0.379) or CVA (p = 0.190). DCFE was positively correlated with age, body weight, and sex (all p < 0.05). After adjustment for covariates, vertical occlusal anomaly status remained independently associated with DCFE (F(1,57) = 8.18, p = 0.006, partial η² = 0.127).

CONCLUSIONS: Vertical occlusal anomalies are associated with reduced DCFE in adolescents, independent of growth-related factors. This association appears to be specific to endurance capacity, as cervical strength and head posture were not affected. Further studies are needed to determine the clinical significance of this finding.

CLINICAL RELEVANCE: Assessment of cervical muscle endurance may provide additional functional insight in adolescents with vertical occlusal anomalies and support interdisciplinary evaluation in orthodontic practice. Although statistically significant, the clinical relevance of this approximately 5-second difference remains uncertain, as no minimal clinically important difference has been established for DCFE.

PMID:42567993 | DOI:10.1007/s00784-026-07060-x

Qual Life Res. 2026 Aug 7;35(9):257. doi: 10.1007/s11136-026-04368-9.

ABSTRACT

PURPOSE: The Seattle Angina Questionnaire (SAQ) is widely used to measure disease-specific health status in coronary artery disease, but its psychometric properties have not been evaluated using multidimensional item response theory (MIRT). We evaluated the SAQ’s dimensional structure, measurement precision, differential item functioning (DIF), and short form performance in a population-based cohort.

METHOD: SAQ responses collected within two weeks of coronary angiography from 6,665 patients in the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry were analyzed using a confirmatory five-factor multidimensional graded response model. Item fit, local dependence, and conditional standard errors were evaluated. DIF by sex and age was examined using a two-step anchored multigroup approach. Short forms were derived based on discrimination, test information, and DIF magnitude.

RESULT: The confirmatory five-factor model demonstrated good global fit (RMSEA = 0.031, CFI = 0.987, TLI = 0.982), supporting three distinct Physical Limitation dimensions: Basic, Moderate, and Strenuous. Empirical reliability ranged from 0.748 (Basic Physical Limitation) to 0.900 (Moderate Physical Limitation), with precision sufficient for individual-level interpretation in Moderate and Strenuous Physical Limitation. Moderate sex-related DIF was noted on Basic and Moderate Physical Limitation items, with females scoring lower than males. Age-related DIF was negligible to small. The 14-item short form preserved all five factors with theta correlations of 0.964 with the 18-item version.

CONCLUSION: MIRT revealed three distinct Physical Limitation dimensions, enabling targeted functional monitoring. Precision gradients and sex-related DIF inform interpretation, and the 14-item short form is supported as the preferred version.

PMID:42567987 | DOI:10.1007/s11136-026-04368-9

Behav Res Methods. 2026 Aug 7;58(9):260. doi: 10.3758/s13428-026-03137-3.

ABSTRACT

Interoception, the capacity to sense, perceive, and metacognitively appraise viscerosensory and homeostatic signals, is a growing focus in psychology and psychiatry. Adaptive psychophysical tasks now allow quantification of perceptual sensitivity, bias, and precision in cardiac and respiratory domains. However, accurately estimating these parameters often requires large numbers of trials or participants, posing practical challenges, especially in clinical research where participant availability and tolerance are limited. One approach to reduce participant burden while maintaining statistical rigor is to optimize data analysis. Here, we present hierarchical Bayesian models tailored for cardiac and respiratory interoceptive psychophysics that efficiently estimate sensitivity, bias, and precision at both individual and group levels. Using simulations and empirical data, we validate these models and demonstrate that they allow enhanced inference relative to conventional approaches. To support adoption, we provide openly accessible resources, including a tutorial on implementing and fitting these models in R (written with researchers without modeling expertise in mind) and an app for sample-size justification. These tools facilitate robust, efficient, and generalizable modeling of interoceptive performance, enabling rigorous studies even with limited trials or participant availability.

PMID:42567971 | DOI:10.3758/s13428-026-03137-3

Nat Biomed Eng. 2026 Aug 7. doi: 10.1038/s41551-026-01742-3. Online ahead of print.

ABSTRACT

Healthcare artificial intelligence systems often degrade in performance when deployed across institutions, with documented performance drops and perpetuation of discriminatory patterns embedded in data. This brittleness comes, in part, from learning statistical associations rather than causal mechanisms. Causal graph neural networks address this by combining graph-based representations of biomedical data with causal inference to learn invariant mechanisms instead of just spurious correlations. This Perspective reviews the methodology of structural causal models, disentangled causal representation learning, and techniques for interventional prediction and counterfactual reasoning on graphs. We discuss applications across psychiatric diagnosis and brain network analysis, cancer subtyping with multi-omics causal integration, continuous physiological monitoring and drug recommendations. These methods provide building blocks for patient-specific causal digital twins that could support in silico clinical experimentation. Remaining challenges include computational costs that preclude real-time deployment, validation challenges that go beyond standard cross-validation, and the risk of causal-washing where methods adopt causal terminology without rigorous evidentiary support. We propose a tiered framework distinguishing causally inspired architectures from causally validated discoveries and outline future directions, including scalable causal discovery, multimodal data integration and regulatory pathways for these methods. Making practical causal digital twins possible will require an honest assessment of what current methods deliver, sustained collaboration across disciplines and validation standards that match the strength of the causal claims being made.

PMID:42567948 | DOI:10.1038/s41551-026-01742-3

Clin Oral Investig. 2026 Aug 8;30(9):380. doi: 10.1007/s00784-026-07070-9.

ABSTRACT

OBJECTIVE: To evaluate patient-reported changes in orofacial and masticatory symptoms after BoNT-A application in individuals presenting bruxism-related complaints.

MATERIALS AND METHODS: A retrospective cross-sectional observacional study was conducted with 61 adult participants (47 women, 14 men) who underwent BoNT-A treatment for bruxism. An online questionnaire, assessed masticatory and orofacial symptoms before and after treatment, using a five-point frequency scale. Data were analyzed with descriptive statistics, paired t-tests, and Spearman’s correlation (p < 0.05). This observational study was reported in accordance with the STROBE guidelines.

RESULTS: A statistically significant reduction in total symptom scores was observed after treatment (p < 0.05), with a mean decrease from 32.4 ± 11.5 (before) to 15.6 ± 6.59 (after), representing an overall reduction of approximately 52%. No significant differences in symptom improvement were observed between sexes or in relation to age. Although an overall difference among professional categories was identified, post hoc analysis did not show significant pairwise differences between groups.

CONCLUSION: Individuals with bruxism-related complaints reported improvement in pain-related and masticatory symptoms after BoNT-A application. BoNT-A may represent a supportive approach for managing orofacial and muscle-related complaints; however, further studies with standardized diagnostic criteria and objective outcome measures are needed to clarify its long-term clinical effects.

CLINICAL RELEVANCE: BoNT-A application may contribute to the management of pain-related and masticatory complaints reported by individuals with bruxism-related symptoms, supporting its potential use as an adjunctive approach in selected clinical situations.

PMID:42567938 | DOI:10.1007/s00784-026-07070-9

Commun Biol. 2026 Aug 7;9(1):1059. doi: 10.1038/s42003-026-10751-6.

ABSTRACT

Fast, highly constrained sensorimotor acts require rapid coordination of distributed cortical systems on subsecond timescales. Here, we used source-resolved magnetoencephalography to characterise time-locked cortical connectivity during voluntary swallowing in 74 healthy adults. Cluster-based network statistics revealed focal swallowing-related connectivity changes confined to anatomically selective subnetworks. Undirected phase-lagged connectivity identified theta- and low-gamma weighted phase lag index (wPLI) effects involving somatosensory, motor, supramarginal, and insular regions. Directed connectivity revealed sparse high-gamma phase slope index (PSI) subnetworks centred on the primary somatosensory cortex and anterior insula. Time-window analyses demonstrated temporally evolving low-gamma interactions between posterior parietal and insular regions, while laterality analyses showed rightward theta-band directed asymmetries during later swallowing phases. In contrast, global graph-theoretical metrics and node-level hub measures remained largely stable after correction for multiple comparisons. These findings indicate that voluntary swallowing is supported by focal, frequency-specific, and temporally structured cortical interactions rather than broad global network reconfiguration.

PMID:42567925 | DOI:10.1038/s42003-026-10751-6

Sci Rep. 2026 Aug 7;16(1):24453. doi: 10.1038/s41598-026-64336-8.

ABSTRACT

Two simple, sensitive, and eco-friendly spectroscopic methods were developed for the determination of ensartinib through ion-pair complexation with eosin Y. Method A represents the first reported spectrofluorometric assay for the studied drug and it is based on fluorescence quenching of eosin Y at pH 3.3, showing linearity over 100-1000 ng mL⁻¹ with LOD and LOQ values of 21.2 and 64.1 ng mL⁻¹, respectively. Method B is a spectrophotometric method based on measuring the absorbance of the formed ion-pair complex at 550 nm, obeying Beer’s law over 1.0-10.0 µg mL⁻¹, with LOD and LOQ values of 132 and 400 ng mL⁻¹, respectively. Both methods were validated according to ICH guidelines and exhibited excellent accuracy (98.51-101.68%) and precision (RSD < 2%). The proposed procedures were successfully applied to capsules, providing mean recoveries of 99.29 ± 1.11% and 100.39 ± 0.98% for Methods A and B, respectively. Statistical comparison with a reported chromatographic method showed no significant difference at the 95% confidence level. The environmental impact of the developed methods was assessed using AGREE and GAPI tools, confirming their compliance with green analytical chemistry principles.

PMID:42567906 | DOI:10.1038/s41598-026-64336-8