Tag: nevin manimala

JAMA Netw Open. 2026 May 1;9(5):e2614107. doi: 10.1001/jamanetworkopen.2026.14107.

ABSTRACT

IMPORTANCE: Phototherapy is widely used in the care of preterm newborns to prevent brain damage resulting from hyperbilirubinemia. However, concerns regarding its safety have been raised.

OBJECTIVE: To determine the associations between phototherapy and neonatal mortality or morbidity.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study from the Swedish Neonatal Quality Register included preterm newborns (gestational age, 22-31 weeks) admitted for care between November 2015 and December 2024, and followed up to hospital discharge. Deaths before 7 days of age, major congenital anomalies, or newborns without data on phototherapy were excluded.

EXPOSURES: Duration of phototherapy categorized as 0 to 3, 4 to 5, and 6 to 7 days. Peak bilirubin levels in the first week were categorized as less than 25th, 25th to 50th, 51st to 75th, and greater than 75th percentiles.

MAIN OUTCOMES AND MEASURES: The primary outcome was late neonatal mortality (LNM) on postnatal days 8 to 27 with a composite of severe neonatal morbidity as secondary outcome: intraventricular hemorrhage (IVH) grade 3 to 4; treated patent ductus arteriosus; necrotizing enterocolitis stage IIa or higher; severe bronchopulmonary dysplasia (BPD); or retinopathy of prematurity. Adjusted odds ratios (aORs) were calculated and adjusted for multiple pregnancy, preeclampsia, cesarean delivery, newborn sex, gestational age, Apgar score less than 4 at 5 minutes, and being small for gestational age or large for gestational age.

RESULTS: This study included a total of 4970 newborns. Median (IQR) gestational age was 29.1 (26.7-30.7) weeks, the median (IQR) birth weight was 1180 (860-1510) g, 2741 newborns (55.2%) were male, and 4746 newborns (95.5%) were treated with phototherapy. LNM occurred in 34 of 1995 newborns (1.7%) treated with phototherapy for 0 to 3 days, in 55 of 1921 newborns (2.9%) treated 4 to 5 days, and in 48 of 1054 newborns (4.6%) treated 6 to 7 days. Compared with 0 to 3 days of phototherapy, the aOR for LNM after 4 to 5 was 1.13 (95% CI, 0.71-1.78), and that for 6 to 7 days of treatment was 1.01 (95% CI, 0.62-1.65). Excluding newborns with IVH, hemolytic disease, or Apgar score below 4 at 5 minutes did not alter the results; neither did an evaluation of phototherapy duration and LNM stratified by peak bilirubin categories. Compared with 0 to 3 days, the aOR for composite morbidity after 4 to 5 days of phototherapy was 1.29 (95% CI, 1.04-1.59), and that for 6 to 7 days of phototherapy was 1.66 (95% CI, 1.31-2.09), which could be attributed to more prevalent IVH and severe BPD in newborns with longer treatment durations.

CONCLUSIONS AND RELEVANCE: In this cohort study of very preterm newborns, the duration of phototherapy for hyperbilirubinemia was not associated with neonatal mortality. Nevertheless, prolonged phototherapy in very preterm newborns should be avoided.

PMID:42166159 | DOI:10.1001/jamanetworkopen.2026.14107

Ital J Dermatol Venerol. 2026 May 21. doi: 10.23736/S2784-8671.26.08454-9. Online ahead of print.

ABSTRACT

BACKGROUND: Systemic sclerosis (SSc) is a chronic connective tissue disease characterized by skin and organ fibrosis, with high prevalence of emotional distress and impaired quality of life (QoL). Autogenic training (AT), a relaxation method, was found to be effective for managing symptoms in chronic illnesses, including SSc.

METHODS: The current observational, longitudinal study aimed at evaluating the feasibility and the effects of a four-month AT program on dispositional traits, emotional regulation, coping strategies, and physical function perceptions in SSc patients.

RESULTS: This longitudinal observational study included 44 patients with confirmed SSc, from a dermatological research hospital. Participants underwent six therapist-guided AT sessions with daily self-practice. Outcomes were assessed pre- and post-intervention using the Systemic Sclerosis Questionnaire (SySQ), Emotion Regulation Questionnaire (ERQ), COPE-NVI, and Millon Clinical Multiaxial Inventory-III. Statistical analyses included paired t-tests and Cohen’s d for effect sizes. Significant improvements were observed in SySQ scores (P<0.001, d=0.919), reflecting better QoL; in emotional regulation (P<0.001, d=1.255); in approach-oriented coping (P=0.005, d=0.489). Patients with specific personality traits (e.g., melancholic) showed greater QoL gains, while others (e.g., avoidant) reported worsened perceptions.

CONCLUSIONS: AT enhanced QoL, emotional regulation, and coping in SSc patients, though outcomes varied by personality traits. Personalizing interventions may optimize benefits according to patient’s psychological profiles.

PMID:42166115 | DOI:10.23736/S2784-8671.26.08454-9

Spine Deform. 2026 May 21. doi: 10.1007/s43390-026-01433-8. Online ahead of print.

ABSTRACT

PURPOSE: While 3D radiographic parameters are increasingly used to assess adolescent idiopathic scoliosis (AIS), barriers to 3D imaging limit their routine use. 2D-to-3D prediction algorithms have been proposed as a substitute. This study sought to determine if a predicted 3D kyphosis, derived from 2D images, is a more robust predictor of FEV1 in patients with AIS than a traditional 2D analysis.

METHODS: A retrospective, cross-sectional review of 259 AIS patients with surgical-range thoracic curves (> 40°) was performed. We built two multivariate linear regression models to predict FEV1. Due to structural multicollinearity, the deformity measures were tested separately. Model A included Main Thoracic Cobb, BMI, and Age. Model B included Predicted 3D T5-T12 Kyphosis, BMI, and Age. The models were compared using the Akaike Information Criterion (AIC) and adjusted.

RESULTS: The cohort (87% female, mean age 15.7 ± 3.3 years) presented with severe deformities (mean Main Thoracic Cobb 68.4° ± 16.5°) and widespread restrictive impairment (71%). Multivariate Analysis revealed that Model A, (2D Main Thoracic Cobb) was statistically superior to Model B (Predicted 3D T5 – T12 Kyphosis) with a lower AIC (-292.5 vs. -265.9) and a higher adjusted R² (0.241 vs. 0.159). All factors were significant independent predictors.

CONCLUSION: The predicted 3D-based model was not superior, while a parsimonious 2D-based multivariate model including Main Thoracic Cobb, BMI, and Age explained a significantly larger proportion of the variance in FEV1. This specific 2D-to-3D prediction algorithm is an imperfect proxy and is not a valid substitute for true 3D imaging in predicting pulmonary risk.

PMID:42166107 | DOI:10.1007/s43390-026-01433-8

Updates Surg. 2026 May 21. doi: 10.1007/s13304-026-02675-x. Online ahead of print.

ABSTRACT

Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed weight loss surgery. Omentopexy is believed to help reduce the risk of postoperative nausea and vomiting (PONV), bleeding, gastric leakage, and gastroesophageal reflux disease (GERD). In recent years, fibrin glue posterior fixation has emerged as an alternative method shown to reduce gastrointestinal symptoms after LSG surgery. However, the comparative evidence between these two fixed techniques is still limited. This study aims to compare the clinical efficacy of two gastric fixation methods, fibrin glue posterior fixation and Omentopexy, in LSG. This retrospective study included 649 patients who underwent LSG between 2022 and 2024, divided into two groups: fibrin glue posterior fixation (n = 331) and Omentopexy (n = 318). A 1:1 propensity score-matching (PSM) was performed to balance baseline characteristics between the groups. After matching, 480 patients were included (240 per group). There were no significant differences between the fibrin glue posterior fixation group and the Omentopexy group in operative time or intraoperative blood loss (P > 0.05). The incidence of PONV in the two groups was 6.6% (16/240) and 5.8% (14/240), respectively, with no statistically significant difference (P > 0.05). The incidence of postoperative bleeding was 0.8% (2/240), and there was no significant difference between the groups (P > 0.05). There was 1 case of gastric leakage (0.4%) in the fibrin glue posterior fixation group, and no gastric leakage was observed in the Omentopexy group, and the difference between the groups was not statistically significant (P > 0.05). Neither group experienced gastric torsion. The incidence of postoperative GERD was 5.8% (14/240) and 7.5% (18/240), respectively, with no statistically significant difference (P > 0.05). In addition, both groups of postoperative bleeding patients underwent reoperation, with a reoperation rate of 0.8% (2/240), and there was no significant difference between the groups (P > 0.05). This study demonstrates that there were no significant differences in short-term postoperative complications between fibrin glue posterior fixation and Omentopexy in LSG.

PMID:42166091 | DOI:10.1007/s13304-026-02675-x

Mamm Genome. 2026 May 21;37(1):71. doi: 10.1007/s00335-026-10245-0.

ABSTRACT

Osteosarcopenia-the concurrent presence of osteoporosis and sarcopenia-affects approximately 18.5% of older adults globally, yet its shared genetic basis remains poorly understood. We applied genomic structural equation modeling (Genomic SEM) to integrate genome-wide association study (GWAS) summary statistics across five phenotypes spanning the pathophysiological spectrum of osteosarcopenia: appendicular lean mass (ALM), bone mineral density (BMD), handgrip strength (HGS), walking pace, and fracture. Fine-mapping, transcriptome-wide association study (TWAS), pathway enrichment, cell-type enrichment, and spatial transcriptomic mapping were performed to functionally annotate the identified loci. A single-factor model (CFI = 0.976) captured the shared genetic liability, with HGS and ALM loading most strongly. A two-factor sensitivity analysis confirmed partial separability of muscle and bone dimensions, though the single common factor was retained for integrated downstream annotation. We identified 58,696 genome-wide significant single-nucleotide polymorphisms (SNPs) condensed into 1078 independent lead variants, including 29 novel loci. Fine-mapping prioritized 317 high-confidence causal variants, encompassing key genes including BMP6, ACAN, IHH, LRP5, and SOX5. TWAS and MAGMA converged on IGF1R, FOXO3, and IRS1 as dual susceptibility genes. Pathway analysis revealed significant enrichment in endochondral ossification and growth hormone/insulin-like growth factor-1 signaling. Cell-type enrichment localized genetic risk to mesenchymal stem cells and skeletal muscle satellite cells, while spatial mapping identified cartilage primordium as the most enriched developmental context. This study systematically elucidates the shared genetic architecture of osteosarcopenia, highlighting developmental, endocrine, and stem cell-related pathways as core mediators. These findings provide a theoretical foundation for precision geroscience and the development of dual-target therapeutic strategies.

PMID:42166073 | DOI:10.1007/s00335-026-10245-0

Cogn Res Princ Implic. 2026 May 21. doi: 10.1186/s41235-026-00733-x. Online ahead of print.

ABSTRACT

This study used a between-subjects experimental design to examine how five spoiler conditions, including a complete scene without spoiler, a chaotic scene without spoiler, a video spoiler, a verbal spoiler, and a written spoiler, influenced viewers’ narrative engagement, heart rate synchrony measured by inter-subject correlation, and task performance while watching suspenseful film clips. Seventy-six university students were randomly assigned to one of the spoiler groups and viewed clips from the film Revenge. Narrative engagement was assessed using the Narrative Engagement Scale (NES), and ECG signals were recorded to derive heart rate time series for ISC-HR analyses. Key cue search task was indexed by a sticker-counting task during viewing. Results indicated that the video spoiler group showed the most consistent advantages, including higher narrative engagement, more frequent key cue search task, and the highest ISC-HR during the spoiler exposure phase. In contrast, the chaotic scene without spoiler group showed the weakest subjective engagement profile, with differences most evident in comprehension-related engagement and partially attentional focus. ISC-HR varied by spoiler modality primarily during the spoiler exposure phase, with the video spoiler group eliciting the highest synchrony, whereas ISC-HR during movie watching did not show clear group differences. Overall, these findings suggest that spoiler modality and narrative coherence shape viewers’ cognitive processing and cue monitoring during film viewing, and that ISC-HR can be used as a complementary physiological indicator to support the interpretation of immersion-related self-reports by indexing shared response dynamics among viewers.

PMID:42166072 | DOI:10.1186/s41235-026-00733-x

Environ Geochem Health. 2026 May 21;48(8):366. doi: 10.1007/s10653-026-03260-2.

ABSTRACT

Many environmental pollutants are released during the dismantling of electronic waste (e-waste). Per- and polyfluoroalkyl substances (PFAS) and heavy metals are representative pollutants of persistent and hazardous contaminants that are known to pose threats to human health. In an e-waste dismantling area, 149 mothers with singleton births and their infants were recruited in 2021 to investigate associations between heavy metals and PFAS concentrations in postpartum breast milk and infant birth outcomes. The concentrations of six heavy metals and six PFAS compounds were measured in breast milk. The median concentration of chromium (Cr) in breast milk was 1.27 μg/L, whereas the median perfluorooctanoic acid (PFOA) concentration was 0.28 ng/mL. Birth weight and length were recorded and were subsequently used in stratified analyses via multiple regression models. Exploratory evidence suggests that higher log-transformed Cr (β = 0.371, 95% CI: 0.082-0.660) and PFOA (β = 0.163, 95% CI: 0.009-0.317) concentrations in breast milk were associated with greater birth length among female infants. These findings suggest that concentrations of Cr and PFOA in breast milk are associated with sex-specific infant growth patterns. Furthermore, quantile g-computation analyses did not identify any statistically significant mixture effects. However, the cross-sectional design and the sample size both limit the interpretation of these results. Therefore, the findings should be interpreted with caution. Larger longitudinal studies are needed to confirm these findings and to clarify their potential biological and health implications.

PMID:42166065 | DOI:10.1007/s10653-026-03260-2

J Orofac Orthop. 2026 May 21. doi: 10.1007/s00056-026-00644-y. Online ahead of print.

ABSTRACT

OBJECTIVE: Dental caries (DC), a biofilm-mediated permanent disease, affects approximately 50% of the global population. Diet is an important modifiable factor among many factors affecting DC. At present, the health benefits of foodborne microbe intake are widely recognized. We aimed to study the association of dietary active microbe intake with the occurrence of DC among American adults.

MATERIALS AND METHODS: Data of adults with complete clinical information were extracted from the National Health and Nutrition Examination Surveys (NHANES) 2015-2020. Occurrence of untreated DC was the primary outcome and DC experience was the secondary outcome. Dietary active microbe intake was divided into three groups: G1 (low), G2 (medium), and G3 (high). Logistics models were performed to test the association of dietary DC with untreated DC and DC experience. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Further subgroup analyses were performed to verify whether the association between them remained robust.

RESULTS: A total of 12,762 subjects were included; among them, 3458 (27.10%) had untreated DC. After adjusting all covariates, we observed subjects with G2 and G3 levels of dietary active microbe intake had lower occurrence of untreated DC (G2, OR = 0.81, 95%CI 0.69-0.94; G3, OR = 0.72, 95%CI 0.61-0.84). Subjects with G3 level of dietary active microbe intake were linked to a lower incidence of DC experience (OR = 0.72, 95%CI 0.55-0.94). Subgroup analysis suggested a robust association of dietary active microbe intake and untreated DC and DC experience.

CONCLUSION: Our study suggested the potential advantage of high levels of dietary active microbe intake for the prevention of DC in American adults.

PMID:42166043 | DOI:10.1007/s00056-026-00644-y

Eur Radiol. 2026 May 21. doi: 10.1007/s00330-026-12641-1. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the diagnostic accuracy of multiparametric breast MRI combining dynamic contrast-enhanced imaging with diffusion-weighted imaging (DWI) for differentiating benign from malignant non-mass enhancement (NME) breast lesions.

MATERIALS AND METHODS: This prospective diagnostic accuracy study recruited patients from seven tertiary centers with centralized imaging over a 20-month period. The index test was multiparametric MRI, including morphological assessment, kinetic curve analysis, and DWI with apparent diffusion coefficient (ADC) measurements. The reference standard was histopathological confirmation. Nine experienced radiologists from participating centers independently evaluated examinations while blinded to clinical history and outcomes.

INCLUSION CRITERIA: female patients aged ≥ 18 years with BI-RADS 3-5 NME lesions. Statistical analyses included ROC curve analysis, logistic regression, and inter-reader agreement (IRA) assessment.

RESULTS: A total of 351 female patients (mean age, 44.2 ± 11.1 years; 189 malignant, 162 benign lesions) were enrolled. Consensus-based multiparametric MRI achieved 98.4% (95% CI: 95.6-99.7) sensitivity, 86.4% (95% CI: 80.2-91.3) specificity, 89.4% (95% CI: 84.5-92.9) positive predictive value, 97.9% (95% CI: 94.0-99.6) negative predictive value (NPV), and 92.9% (95% CI: 89.6-95.3) accuracy (AUC = 0.94; 95% CI: 0.91-0.96). Individual reader performance averaged 97.1% sensitivity and 84.8% specificity. Five independent predictors were identified: Type III washout curves (OR = 26.84; p = 0.001), segmental distribution (OR = 9.12; p = 0.001), Type II plateau curves (OR = 6.58; p = 0.008), ADC values ≤ 1.3 × 10⁻³ mm²/s (OR = 6.24; p = 0.001), and regional distribution (OR = 5.34; p = 0.032). IRA was almost perfect (κ = 0.847; 95% CI: 0.801-0.893). High NPV was maintained across all BI-RADS categories (96.8-98.5%).

CONCLUSION: Multiparametric breast MRI demonstrates superior diagnostic accuracy for NME lesions with high NPV, supporting potential reduction of unnecessary biopsies while maintaining excellent sensitivity.

KEY POINTS: Question Can multiparametric MRI combining dynamic contrast-enhanced imaging with diffusion-weighted imaging improve diagnostic accuracy for non-mass enhancement breast lesions compared to individual imaging parameters? Findings Multiparametric MRI achieved 92.9% accuracy, 98.4% sensitivity, and 86.4% specificity with five independent malignancy predictors, significantly outperforming individual parameters, with almost perfect inter-reader agreement. Clinical relevance Multiparametric breast MRI demonstrates superior diagnostic performance for non-mass enhancement lesions, potentially reducing unnecessary biopsies while maintaining excellent sensitivity for malignancy detection.

PMID:42166016 | DOI:10.1007/s00330-026-12641-1

Eur Radiol. 2026 May 21. doi: 10.1007/s00330-026-12636-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare prenatal imaging-based subjective assessment of the ganglionic eminence (GE) on fetal MRI with three-dimensional volumetric analysis in patients with structural central nervous system anomalies.

MATERIALS AND METHODS: This retrospective study investigated 17 fetuses (undergoing 20 fetal MRIs, mean gestational age 26.3 weeks, SD 3.3, range 21.7-33.4 weeks) with enlarged GE based on subjective assessment of fetal neuroimaging experts and concurrent structural brain anomalies. Three-dimensional volumetry of super-resolution MRI was performed and compared to age-matched neurotypical controls (94 fetuses, 100 MRIs, mean age 27.2 weeks, SD 3.6, range 21.7-34.0 weeks).

RESULTS: Among 20 MR examinations, in only 5 cases (25%) GE hyperplasia was confirmed, while 12 (60%) were found to show normal GE volumes. In 3 (15%), GE volumes were smaller compared to controls. Most patients (80%) were found to have increased total brain volume, while only 30% had an increased intracranial volume-ventriculomegaly (75%) seemingly being the most common underlying cause. Brain parenchyma volume was enlarged in only 20%. No correlation was found between GE volumes and volumes of 10 other substructures of the fetal head in pathological cases.

CONCLUSION: The study suggests the unreliability of expert visual assessment of GE size, despite excellent examination conditions, emphasizing the need for three-dimensional volumetric GE measurements. Specifically in patients with structural brain anomalies, quantitative fetal neuroimaging serves as an emerging tool to identify abnormalities in GE size and complement current diagnostic techniques by objectifying subjective impressions.

KEY POINTS: Question To evaluate the reliability of expert visual assessment of ganglionic eminence size in fetal MRI compared to super-resolution brain volumetry. Findings Expert visual assessment and 2D fetal brain biometry were insufficient to provide correct volumetric quantification of the ganglionic eminence in the investigated patient collective. Clinical Relevance This study highlights the value of volumetric quantification of the ganglionic eminence in fetal MRI to provide an objective, reproducible and valid quantitative tool for assessment of the fetal brain, specifically in the presence of CNS anomalies.

PMID:42166015 | DOI:10.1007/s00330-026-12636-y