Tag: nevin manimala

Reprod Sci. 2026 May 28. doi: 10.1007/s43032-026-02128-1. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the impact of unfractionated heparin (UFH) use during pregnancy on maternal bone mineral density (BMD) by assessing BMD in pregnant women with heparin exposure using an artificial intelligence (AI)-assisted analysis of chest radiographs.

METHODS: This retrospective cohort study was conducted between April 2013 and October 2023. Pregnant women who received UFH therapy and underwent cesarean section (CS) were compared, using preoperative chest radiographs, with a control group who underwent CS without medication. Estimated BMD (eBMD) values for the lumbar spine (LS) and femoral neck (FN) were obtained via an AI-assisted diagnostic system. Statistical analyses included univariate and multivariate methods, adjusted for covariates.

RESULTS: Compared with the control group (n = 213), the UFH group (n = 86) exhibited significantly lower eBMD values at both LS and FN. Body mass index (BMI) correlated with eBMD in both groups, with underweight participants showing significantly lower eBMD, particularly in the UFH group. Multivariate analysis identified UFH as an independent factor associated with reduced eBMD in patients with LS. No significant correlation was found between the total UFH dose and eBMD.

CONCLUSION: UFH administration during pregnancy may be associated with decreased maternal eBMD, especially in underweight women, with the LS appearing more susceptible to bone loss than the FN. The estimation system may provide a safe, accessible, and effective method for early detection and risk stratification of pregnancy-associated bone loss, supporting future clinical management in at-risk populations.

PMID:42207474 | DOI:10.1007/s43032-026-02128-1

World J Pediatr. 2026 May 28. doi: 10.1007/s12519-026-01045-2. Online ahead of print.

ABSTRACT

BACKGROUND: Despite substantial global progress in reducing neonatal mortality, the deceleration in neonatal mortality decline in many low- and middle-income countries threatens attainment of Sustainable Development Goal 3.2. Intrapartum-related events and complications of preterm birth remain the leading causes of neonatal deaths. Therefore, this study aimed to examine temporal trends in neonatal and under-five mortality due to birth asphyxia, trauma, and prematurity from 2000 to 2021, with projections to 2040.

METHODS: This study used the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) cause-of-death dataset, which provides standardized annual estimates of under-five and neonatal mortality from birth asphyxia/trauma and prematurity for 194 countries and territories between 2000 and 2021. Causes of death were defined according to the dataset’s standardized classification. Country-specific mortality trends were examined in relation to four country-level indicators (the Socio-demographic Index, Human Development Index, Universal Health Coverage service coverage index, and Healthcare Access and Quality Index) using regression analyses. Temporal trends in cause-specific mortality were quantified using the estimated annual percentage change, and future mortality through 2040 was projected under three scenarios: (1) current-trend; (2) regional best-performer; (3) high-income country convergence based on country-specific annual rates of reduction.

RESULTS: Globally, neonatal mortality declined from 7.52 deaths per 1000 live births [90% uncertainty interval (90% UI): 7.13-7.88] to 4.18 (3.81-4.82) for birth asphyxia/trauma, and from 10.63 (10.05-11.33) to 6.49 (6.05-7.38) for prematurity between 2000 and 2021. West and Central Africa and Eastern and Southern Africa had the highest neonatal mortality in 2021 and achieved the slowest progress, whereas East Asia and Pacific and Eastern Europe and Central Asia had the most pronounced declines. Countries with lower sociodemographic and health system indicator values showed slower declines in mortality, while the greatest reductions were observed in those with intermediate-to-upper levels. Projections suggest that disparities could remain substantial by 2040 if current trends continue, although accelerated progress in high-burden regions could yield further reductions.

CONCLUSION: Despite substantial progress since 2000, neonatal mortality from birth asphyxia/trauma and prematurity remains persistently high, particularly in Africa, but scenario analyses suggest that substantial reductions could be achieved if future declines follow trajectories observed in the best-performing settings.

PMID:42207468 | DOI:10.1007/s12519-026-01045-2

Clin Rheumatol. 2026 May 28. doi: 10.1007/s10067-026-08186-9. Online ahead of print.

ABSTRACT

BACKGROUND: Heterogeneity in inflammatory arthritis (IA) outcomes limits the effectiveness of non-individualized treatment approaches, and digital health platforms can capture psychosocial and behavioral signals that may stratify responses beyond diagnosis or baseline severity.

OBJECTIVE: To identify clinically interpretable patient clusters and evaluate their associations with 12-week outcomes in IA, testing whether cluster membership adds information beyond demographics, diagnosis, and baseline symptom burden.

METHODS: We retrospectively analyzed the use of a CE-certified rheumatology application among adult patients. Baseline clinical and psychosocial variables (Patient’s Global Assessment of Disease Activity (PGADA) and Patient’s Global Assessment of Pain Intensity, sleep quality, social support, distress, fatigue, activity, diet/fasting) were winsorized (1st/99th), z-scaled, and imputed by median/mode for features only; outcomes were complete-case. Unsupervised k-means (k = 5) was selected based on silhouette, gap, and consensus diagnostics. The primary validation outcome was remission (12-week PGADA ≤ 20 mm for patients with baseline PGADA ≥ 40 mm), with distributional changes in PGADA and percentage change as secondary endpoints.

RESULTS: Among 2,924 patients, five clusters were identified (size range 17.7-22.9% of the cohort). The 12-week remission rate was 7.0%, with the “resilience” profile (characterized by better sleep, stronger social support, and lower distress) showing the highest probability of remission and the most favourable PGADA distribution. In contrast, distress-dominant clusters (characterized by poor sleep and weak support) showed the lowest remission rates and minimal improvement. The median ΔPGADA% was 8.3% (IQR – 8.2% to 32.0%). In adjusted analyses, the cluster signal persisted beyond baseline severity; percentage-change estimates were attenuated for clusters with lower baseline PGADA.

CONCLUSION: Cluster-level phenotypes derived from routinely collected app data align with short-term clinical outcomes, highlighting sleep, social support, and distress as modifiable factors that may influence short-term outcomes. Programs should emphasize the quality of activity and recovery (not just volume), particularly for patients with high distress and poor sleep. Future work should evaluate cluster-informed, multicomponent interventions in prospective studies. Key Points • Clinical-psychosocial archetypes derived from routinely collected app data (symptoms, sleep, social support, distress, lifestyle) were strongly associated with 12-week remission and PGADA change, beyond diagnosis and baseline severity. • Distress-dominant archetypes with poor sleep and weak social support had the lowest remission rates and minimal improvement, indicating that unaddressed psychological burden and sleep problems can blunt the benefits of otherwise appropriate pharmacological care. • Resilient archetypes, with better sleep, stronger social support, lower distress, and healthier lifestyle patterns, showed the most favourable outcomes, supporting a stratified care model in which digital tools help identify high-risk patients and prioritise targeted behavioral, psychosocial, and recovery-focused interventions rather than simply prescribing more physical activity.

PMID:42207465 | DOI:10.1007/s10067-026-08186-9

J Autism Dev Disord. 2026 May 28. doi: 10.1007/s10803-026-07367-4. Online ahead of print.

ABSTRACT

PURPOSE: Mental health (MH) challenges in autistic youth are often under-identified due in part to limited availability of assessment tools developed or adapted for the autism population. The K-CAT^®, a battery of computerized adaptive tests assessing up to nine MH domains in the general population, shows promise in addressing this need. Because these general instruments may not be valid or acceptable for use with autistic individuals, we evaluated the K-CAT^®‘s content validity for autistic youth with input from the autism community.

METHODS: Feedback was obtained from autistic youth, caregivers, and clinicians on the K-CAT^® through a mixed methods research design. One-hundred-fifty-one youth and caregivers provided feedback on ease of administration, relevance, comprehensiveness, and comprehensibility of the K-CAT^® overall. Thirty youth/caregiver dyads and 15 clinicians then participated in the mixed methods study of the K-CAT^® at the module- and item-level.

RESULTS: While participants had positive impressions of the K-CAT^® overall, weaknesses were identified by most participants and several recommendations for change were provided. The modules identified as most challenging were the Mania, Oppositional Defiant Disorder, and Conduct Disorder (CD) modules of the Child Version and the CD, Mania, and Anxiety modules of the Parent Version. The most commonly reported concerns were comprehension/clarity issues and symptom overlap between MH conditions and autism.

CONCLUSIONS: Modifications to the K-CAT^® appear both necessary and feasible. Findings will inform the development of a K-CAT^® Autism Version, which has the potential to transform the detection and monitoring of MH symptoms in autistic youth.

PMID:42207447 | DOI:10.1007/s10803-026-07367-4

J Behav Med. 2026 May 28. doi: 10.1007/s10865-026-00680-4. Online ahead of print.

ABSTRACT

Upwards of 40% of adults in the United States (US) meet criteria for obesity, highlighting obesity as a critical, ongoing public health crisis. Pain affects 33-40% of individuals with obesity, contributing to increased distress and added burden which necessitates a higher degree of coping resources. Individuals with obesity often manage distress through maladaptive eating behaviors, yet it is unclear what mechanisms may contribute to these individual differences in eating behaviors. One mechanism that is relevant to both obesity and pain is rumination, an aspect of repetitive negative thinking that is focused on past negative thoughts or problems and can influence behavioral responses. However, the role of rumination in terms of eating behavior among adults with obesity and pain is unexplored. The present study examined the role of rumination, including its sub-facets (brooding and reflection) in relation to emotional, external, and restrained eating behavior and related cognitions among individuals with comorbid obesity and pain. Participants were 137 adults with comorbid obesity and pain (M_age = 31.96 years, SD = 10.82, age range 18-75 years; 62.0% female). Results indicated that rumination was statistically significantly associated with emotional and external eating, such that higher levels of rumination were related to increased engagement in these specific eating behaviors and related cognitions. These findings indicate that rumination, and ruminative brooding specifically, may serve as a modifiable, clinically actionable mechanism, highlighting a novel opportunity to improve outcomes for maladaptive eating in individuals with comorbid obesity and pain.Trial Registration Number: NCT03917901. Registered 13 April 2019.

PMID:42207434 | DOI:10.1007/s10865-026-00680-4

World J Microbiol Biotechnol. 2026 May 28;42(6):309. doi: 10.1007/s11274-026-05058-x.

ABSTRACT

Microplastics (MPs) accumulate in soils, forming microbial habitats termed the “plastisphere”, which can concentrate hydrophobic pollutants like phenanthrene (PHE). This study investigated how PHE stress influences the microbial community in the polypropylene-amended soil plastisphere compared to bulk soil, revealing its “microbial refuge” function. Significant differences in microbial composition were observed. Under PHE stress, the number of unique genera in the plastisphere increased from 4 (without PHE) to 9, and the composition of significantly enriched genera changed substantially, with only 1 out of 6 enriched genera shared between PHE-stressed and non-stressed conditions. In contrast, the depleted genera remained largely consistent. Functional prediction indicated that PHE stress was associated with reduced health risks in the plastisphere relative to bulk soil. Carbon and methane metabolism pathways were significantly enriched in the plastisphere regardless of PHE stress. In contrast, nitrogen metabolism, aromatic compound degradation, and PAH degradation pathways did not differ significantly between the plastisphere and soil. Although several pathways reached statistical significance, fewer than 8.33% exhibited an absolute log₂FC > 1. This discrepancy indicates that microplastics exert a limited biological impact on the overall metabolic potential of the soil microbiome, irrespective of PHE contamination. Microbial co-occurrence networks initially showed similar complexity between plastisphere and soil. However, PHE stress markedly reduced network complexity (degree) in the plastisphere and increased the proportion of negative correlations (indicating competition/antagonism) from ~ 60% to ~ 50% in both habitats. This study advances the mechanistic understanding of pollutant-driven microbial responses in soil plastispheres, with a focus on how this unique plastic-associated microbial niche mediates microbial composition, function, and network under PAH stress, thereby informing targeted bioremediation and ecological risk models for microplastic-organic co-contaminated environments.

PMID:42207427 | DOI:10.1007/s11274-026-05058-x

Brain Imaging Behav. 2026 May 28;20(3):96. doi: 10.1007/s11682-026-01165-3.

ABSTRACT

Identifying brain phenotypes influencing social participation may help understand social deficits in psychiatric disorders. Previous research shows methodological inconsistencies, lacking consensus on which brain regions are crucial. Data-driven variable selection may overcome this, facilitating unbiased replication and discovery of social brain regions. We compare data-driven selection to literature-identification of brain regions in explaining social participation variation. In 37,576 UK Biobank participants (mean age 65 ± 8, 53% female) with structural and functional neuroimaging data, social participation (range 0-10) was derived by combining leisure activity participation and friend/family visits. First, literature review identified a subset of brain regions previously associated with social measures. Secondly, recursive feature elimination selected a subset of imaging-derived phenotypes in 25% (n = 9,394) of the sample. Hierarchical regression in the remaining 75% (n = 28,152) compared whether data-selected or literature-identified brain phenotype-sets explained more variance in social participation. Individual p-values were corrected for multiple comparisons using the false discovery rate. Recursive feature elimination selected 198 imaging-derived phenotypes. Data-selected imaging-derived-phenotypes explained more variance in social participation (1.31%) than literature-identified (0.84%, F = 3.17, p < 0.0001). Seventeen imaging-derived-phenotypes were associated with social participation including mid-posterior-cingulate, inferior-frontal/orbital and insular thickness, and functional connectivity between pericentral with medial frontoparietal and cerebellar networks. Multi-modal brain imaging-derived phenotypes can predict small but significant variation in social participation. We confirmed previously identified social brain associations of pericentral and medial frontoparietal, and orbital regions while also implicating novel relationships with the insula, acoustic radiation, and lateral frontoparietal networks. This highlights the value of data-driven approaches in solidifying social brain regional involvement, outperforming literature-based methods, and revealing previously undetected relationships.

PMID:42207420 | DOI:10.1007/s11682-026-01165-3

Eur J Epidemiol. 2026 May 28. doi: 10.1007/s10654-026-01404-3. Online ahead of print.

ABSTRACT

Data harmonization is a prerequisite for joint cohort analyses. In this review, we aim to identify and contrast statistical methods for retrospective harmonization of longitudinal data. We performed a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Studies were included if they described statistical methods for retrospectively harmonizing longitudinal data at the participant level. From 35 included papers out of 1,234 hits, we identified three types of statistical methods applicable to tabular data commonly collected in longitudinal epidemiological studies (e.g., questionnaires): (1) distribution-based methods, (2) the proportion score model, and (3) latent variable models. Our results suggest that the suitability of a statistical harmonization method mainly depends on the measurement scales of the original variables as well as on the type of target variable (directly measurable vs. latent). The chosen harmonization method influences how missing subsets of variables are addressed. None of the included studies applied more automated approaches such as machine learning-based procedures for deriving a harmonized dataset. Based on our findings, we present a roadmap that can guide researchers in selecting the most appropriate statistical method for a specific harmonization task and in handling variables collected only in a subset of studies. Data harmonization is still a demanding task that requires the development and application of novel tools for automating the procedures.

PMID:42207414 | DOI:10.1007/s10654-026-01404-3

Head Neck Pathol. 2026 May 28;20(1):53. doi: 10.1007/s12105-026-01930-2.

ABSTRACT

PURPOSE: Oral pseudoperineurioma (OPP) is a recently recognized peripheral nerve-associated lesion characterized by pseudo-onion bulb-like perineurial cell proliferations surrounding axon-Schwann cell units. Although now is included in the current World Health Organization (WHO) Classification of Head and Neck Tumors within the spectrum of neuromas, it remains underrecognized and is frequently misdiagnosed as other neural lesions, particularly traumatic neuroma. The full histopathologic spectrum of OPP has not yet been well defined.

METHODS: Following Institutional Review Board approval, a retrospective review of University of Florida Oral Pathology Biopsy Service archives was performed to identify lesions meeting WHO-defined diagnostic criteria for OPP. Cases were retrieved through re-evaluation of lesions originally diagnosed as traumatic neuroma, intraneural perineurioma, or related peripheral nerve lesions. Hematoxylin and eosin-stained slides were reviewed and immunohistochemical studies (EMA, GLUT-1, CD56, and S-100) were performed. Clinical and pathologic data were recorded, and lesions were subclassified based on architectural growth patterns. Descriptive statistics were used for analysis.

RESULTS: Twenty-one cases of oral pseudoperineurioma were identified. Patients ranged in age from 14 to 73 years (mean 36 years), with a slight female predominance (52%). The tongue was the most commonly affected site (86%), followed by the lip (14%). Lesions were small, measuring 0.3-1.5 cm, with most measuring ≤ 1.0 cm. None were clinically suspected to represent a neural lesion, and the majority were originally diagnosed as traumatic neuroma. Histologically, cases demonstrated a spectrum of architectural patterns, including serpiginous and non-serpiginous forms, as well as papillary growth and distinctive intraneural and extraneural perineurial proliferations not previously described. Immunohistochemistry showed a uniform profile, with EMA and GLUT-1 positivity in all cases, frequent CD56 positivity, and absence of S-100 expression in perineurial cells.

CONCLUSIONS: OPP is an uncommon benign peripheral nerve lesion with a strong predilection for the tongue and a highly reproducible immunophenotype. The identification of previously undescribed morphologic patterns expands the recognized histopathologic spectrum of OPP and highlights the importance of awareness of this entity to avoid diagnostic misclassification.

PMID:42207401 | DOI:10.1007/s12105-026-01930-2

Curr Med Sci. 2026 May 28. doi: 10.1007/s11596-026-00210-y. Online ahead of print.

ABSTRACT

OBJECTIVE: Complete removal of filling material from complex anatomies such as the mesiobuccal isthmus remains a challenge in endodontic retreatment. This study aimed to compare the efficacy of XP-endo Shaper (XPS), Reciproc (REC), and WaveOne Gold (WOG) in removing root canal filling material during the retreatment of 3D-printed maxillary first molars, as quantified by micro-CT.

METHODS: Fifteen standardized 3D-printed resin teeth with Vertucci type II mesiobuccal canals were prepared, obturated, and randomly assigned to retreatment using XPS, REC, or WOG (n = 5 per group). Micro-CT scans were acquired before and after retreatment to analyze residual filling material volume in the coronal, middle, and apical thirds. Statistical analysis was performed using the Kruskal‒Wallis H test with post hoc Mann‒Whitney U tests (Bonferroni corrected).

RESULTS: While all the systems achieved near-complete coronal debridement (> 97%), REC demonstrated significantly greater removal in the middle third (99% ± 1% vs. 97% WOG and 94% XPS; P < 0.05). Crucially, in the apical isthmus region, both XPS (95% ± 3%) and REC (90% ± 7%) significantly outperformed WOG (76% ± 3%) (P < 0.05). No significant difference was detected between XPS and REC in the apical third.

CONCLUSION: Residual filling material persisted in all the samples. REC showed the highest overall efficiency, whereas XPS achieved comparable apical debridement to REC. These quantitative, region-specific findings support the preferential use of XPS or REC over WOG for retreatment cases involving complex apical anatomy or isthmus configurations.

PMID:42207399 | DOI:10.1007/s11596-026-00210-y