Tag: nevin manimala

J Int AIDS Soc. 2026 Jul;29(7):e70151. doi: 10.1002/jia2.70151.

ABSTRACT

INTRODUCTION: Multi-month dispensing (MMD), as a differentiated service delivery model, can reduce the frequency of clinic visits, waiting time and travel costs for clinically stable people living with HIV. This study aimed to evaluate the impact of 6-month MMD of antiretroviral therapy (ART) on retention and conduct a cost analysis in China.

METHODS: We conducted a randomized, non-blind, non-inferiority study from December 2022 to March 2023 at The First Hospital of China Medical University. Eligible participants were randomly assigned to a 3-month dispensing group (n = 789) or a 6-month dispensing group (n = 799) and followed up for 18 months. The proportion of patients continuing ART after 18 months, virological suppression rate (<50 copies/mL) and average treatment cost per patient were evaluated. Cox regression analysis was used to compare treatment retention rates and virological suppression rates between groups, while descriptive statistical analysis was applied to assess cost differences. Cost metrics comprised the average cost per clinic visit and the price of ART medications, among other factors. This trial is registered with ChiCTR2200066438.

RESULTS: A total of 1588 participants were included (median age 40.0 years, IQR 34.0-50.0; 94.8% male), with no significant between-group differences in demographic and clinical characteristics (all p>0.05). In the intention-to-treat analysis, treatment retention rates at 18 months were 94.9% (749/789) in the 3-month dispensing group and 94.2% (753/799) in the 6-month dispensing group. The risk difference (6-month minus 3-month) was -0.7% (95% CI -2.9% to 1.5%); non-inferiority was demonstrated as the lower bound of the 95% CI (-2.9%) exceeded the pre-specified margin of -5%. Viral suppression rates (<50 copies/mL) were similarly high in both groups in intent-to-treat analysis: 94.9% (3-month) versus 94.2% (6-month), with no statistically significant difference. Per-protocol analysis confirmed these findings (viral suppression 97.59% vs. 97.75%; χ² = 0.0421, p = 0.8375). In terms of cost, the 6-month dispensing group had two fewer annual outpatient visits (3 vs. 5), with total treatment costs reduced by 27.7% (¥931.82 vs. ¥1288.85) and work value loss decreased by 16.7% (¥174.20 vs. ¥209.04 yearly).

CONCLUSIONS: Six-month MMD of ART did not reduce treatment retention; instead, it decreased patients’ clinic visit costs, thereby meeting cost-effectiveness criteria.

CLINICAL TRIAL NUMBER: ChiCTR2200066438.

PMID:42339560 | DOI:10.1002/jia2.70151

Circ Arrhythm Electrophysiol. 2026 Jun 24:e014913. doi: 10.1161/CIRCEP.126.014913. Online ahead of print.

ABSTRACT

BACKGROUND: The origins of left ventricular outflow tract premature ventricular contractions (PVCs) differ in depth and may involve preferential pathways, potentially requiring complex ablation. However, a noninvasive method to preprocedurally estimate ablation complexity has not been established.

METHODS: Sixteen patients with idiopathic left ventricular outflow tract PVCs (V2 transition ratio ≥0.6) underwent 2-dimensional speckle-tracking echocardiography during monomorphic PVCs. Endocardial peak systolic strain timing in 18 left ventricular segments was displayed on a bull’s-eye map using 8 color-coded intervals (0-800 ms). Patients were classified as localized (n=6) when the earliest interval appeared in 1 segment and nonlocalized (n=10) when it involved ≥2 segments. Ablation outcomes were compared according to whether a simple ablation approach (PVC elimination within 30 s at a single site) was achieved.

RESULTS: Baseline electrocardiographic characteristics were comparable between the groups. Ablation-related parameters, including contact force, power output, and impedance drop at the initial ablation site, were also similar. However, the nonlocalized group required statistically significantly greater total radiofrequency energy to eliminate the targeted PVCs (median, 22 206 versus 10 409 J; P=0.031) and demonstrated a statistically significantly lower rate of successful simple ablation approach compared with the localized group (20.0% versus 83.3%; P=0.035). Nonlocalized patterns may reflect conduction from deeper origins with preferential pathways, thereby requiring more complex ablation strategies.

CONCLUSIONS: A localized earliest-strain pattern was associated with successful PVC elimination using a simple ablation approach, whereas a nonlocalized pattern indicated the need for more complex ablation. This simple, noninvasive metric may aid preprocedural planning for left ventricular outflow tract PVC ablation.

PMID:42339551 | DOI:10.1161/CIRCEP.126.014913

Ann Bot. 2026 Jun 24:mcag178. doi: 10.1093/aob/mcag178. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Xylopodia and woody rhizomes are highly lignified belowground bud-bearing organs (BBOs) reaching extensive depths in soil, persisting through a viable belowground bud bank over many years. In this context, maintaining hydraulic functionality and storing resources are essential secondary xylem functions for their survival in environments prone to disturbances such as fire and drought. Here, we examine how secondary xylem traits vary between roots and both BBOs (woody rhizomes and xylopodia) in resprouting woody species from Cerrado.

METHODS: We evaluated cross-sections of secondary xylem from two BBO types and their taproots of ten native woody species in a Cerrado area under regeneration after decades of pine cultivation. We applied linear mixed models (LMMs) to test whether secondary xylem traits differ between roots and BBOs.

KEY RESULTS: Xylopodium-type BBOs had narrower, dense vessels, a higher fiber fraction, and lower hydraulic potential conductivity than their roots. Woody rhizome-type BBOs had narrower vessel diameters and lower densities than their roots. Woody rhizome-type BBOs had narrower vessels and a higher density than xylopodia. Xylem fractions (vessels, rays, and axial parenchyma) were not statistically different between roots and BBOs.

CONCLUSIONS: BBOs share similar strategies regarding storage capacity and mechanical support. Storage is a key trait for belowground bud bank resourcing during unfavorable periods and supporting resprouting after fire and drought. Fibers are essential for the mechanical stability of new branches. In addition, high lignification could help prevent wood decay and herbivory in the soil, as BBOs remain buried throughout the species’ lifespan.

PMID:42339527 | DOI:10.1093/aob/mcag178

Front Oral Health. 2026 Jun 8;7:1789741. doi: 10.3389/froh.2026.1789741. eCollection 2026.

ABSTRACT

BACKGROUND: Molar Incisor Hypomineralization (MIH) is one of the most prevalent enamel development defects in contemporary dental practice. Understanding perceptions, knowledge, and attitudes of professionals towards this condition is key to optimizing clinical protocols and improving therapeutic results.

OBJECTIVE: To evaluate the perception, knowledge and attitudes of Ecuadorian dentists about diagnosis and management of patients with MIH.

METHODS: A cross-sectional observational study was carried out using a self-administered survey of registered dentists in Ecuador. A validated 19-question questionnaire was applied that explored demographic characteristics, knowledge of etiology and prevalence, attitudes towards clinical management, and therapeutic choices. In addition, two clinical cases with photographic support were included to evaluate treatment decisions. The statistical analysis incorporated descriptive statistics, chi-square or Fisher’s exact tests, and multivariate logistic regression models.

RESULTS: A total of 352 dentists participated, predominantly working in private practice (71.9%), particularly in general dentistry (61.1%). Most practitioners reported observing MIH monthly (45.7%) and perceived an increase in its occurrence (67.0%). Demarcated opacities were the most frequent clinical manifestation (93.2%), with antibiotics being the main reported etiological factor (31.8%). The frequency of observation varied significantly between specialties (p < 0.05). Management was considered difficult, with durability of restorations being the main concern. Glass ionomer (37.5-71.4%) was the primary therapeutic choice, followed by fluoride varnish (22.6-37.5%). In the multivariate logistic regression model, professionals with 6-10 years of experience showed significantly higher odds of adequate knowledge (adjusted OR = 2.23, 95% CI: 1.14-4.37, p = 0.019). No independent predictors of favorable attitude towards MIH management reached statistical significance after multivariate adjustment.

CONCLUSIONS: MIH is recognized as a growing and complex problem. It is frequently observed with demarcated opacities as the predominant sign and antibiotics as the main etiological factor. Its management is challenging, and professional experience appears to influence clinical knowledge. Continuing education and the development of standardized clinical protocols are needed to strengthen professional competence in MIH management.

PMID:42339505 | PMC:PMC13284098 | DOI:10.3389/froh.2026.1789741

J Ophthalmol. 2026 Jun 22;2026:6643075. doi: 10.1155/joph/6643075. eCollection 2026.

ABSTRACT

PURPOSE: Our purpose is to report the results of a prospective study on ocular discomfort and objective tear film parameters (osmolarity and NIKBUT), in myopic patients, and observe the possible differences at 1 month between randomized groups in the use of topical lubricants 1 week prior to surgery or just after surgery.

METHODS: This is a prospective, single masked, randomized, comparative study. Refractive error and UDVA, BCVA, tear osmolarity, OSDI test, and keratograph analysis of the tear film were performed per patient by a masked examiner before and 1 day, 1 week, and 1 month after FS-LASIK performed to correct myopia in both pre and post groups. A total of 22 patients per group were included.

RESULTS: Mean age was 32.27 ± 5.4 and 32.85 ± 5.3 years, and mean preop sphere was -3.17 ± 2.3 and 2.75 ± 1.3 D in pre and post groups, respectively (p > 0.05). In addition, no statistically significant difference was found in preoperative OSDI, tear osmolarity, or NIKBUT between both groups. In the whole cohort, the OSDI worsened significantly from a preop value of 6.94 ± 7.15 to a value of 15.66 ± 12.55 at 1-month postop (p < 0.0001).We did not find any statistically significant differences in the OSDI score, NIKBUT, or osmolarity at the 1-month postop between the pre and post groups.

CONCLUSION: Femto-LASIK increased OSDI at 1 month. One-week pretreatment with hyaluronate-HP-guar did not improve symptoms, osmolarity, or NIKBUT compared with postoperative use only. More trials with longer follow-up are needed. Trial Registration: Spanish Agency of Medicines and Medical Devices (AEMPS): Code 25-0055.

PMID:42339499 | PMC:PMC13284676 | DOI:10.1155/joph/6643075

Clin Interv Aging. 2026 Jun 18;21:600367. doi: 10.2147/CIA.S600367. eCollection 2026.

ABSTRACT

PURPOSE: Osteoporotic vertebral compression fractures (OVCFs) cause significant morbidity in aging populations. Hounsfield unit (HU) from CT and the vertebral bone quality (VBQ) from MRI show promise in assessing bone quality and fracture risk. This study aims to directly compare the predictive efficacy of HU and VBQ for OVCFs and develop a nomogram model integrating HU and VBQ.

PATIENTS AND METHODS: A retrospective study was conducted involving 385 patients (127 with OVCFs, 258 controls) who were hospitalized at our hospitals between September, 2020 and September, 2024. HU and VBQ were derived from picture archiving and communication system (PACS). Other variables included demographic, clinical, and radiological data. Statistical analyses included t-tests, chi-square tests, multivariable logistic regression, the least absolute shrinkage and selection operator method (LASSO) regression, and receiver operating characteristic (ROC) curve analysis. Then, a nomogram model was established. The calibration, discrimination and clinical practicability of the nomogram model were also evaluated.

RESULTS: The OVCF group had significantly higher VBQ and lower HU compared to controls. ROC analysis showed higher diagnostic accuracy for HU than VBQ.A nomogram model for predicting the risk of OVCF occurrence in patients has been developed based on three independent predictors, namely BMI, HU and VBQ. The AUC was 0.84 in the training set and 0.87 in the test set. The model has good practicability for clinics according to the decision curve analysis (DCA) and clinical impact curve (CIC).

CONCLUSION: Both HU and VBQ are effective predictors of OVCFs. The nomogram model showed good internal discrimination and calibration in our study. These findings suggest potential utility for opportunistic screening of OVCF risk in patients undergoing routine spinal CT and MRI. However, external validation in prospective and multi-center cohorts is needed before clinical implementation.

PMID:42339495 | PMC:PMC13285745 | DOI:10.2147/CIA.S600367

ArXiv [Preprint]. 2026 Jun 8:arXiv:2606.10109v1.

ABSTRACT

Computational simulation provides a powerful toolkit for in silico experimentation. However, while the field has developed best practices for the design and implementation of such models, there remains ambiguity in discussions about how to understand and/or interpret their results due to their inherent ability to overwhelm traditional frequentist statistics by simply increasing the number of trials simulated. This fails the discipline in two ways: first, it leaves the community unsure of what constitutes a best practice for uniform understanding, and second, it potentially overburdens computational studies that burn clock cycles solely to ensure “enough runs to satisfy peers” without any theoretical underpinning for a definition of “enough”. We propose a simple and straightforward standard for when to stop simulating additional trials, the Ω test, designed to be analogous to the function of traditional frequentist P-tests. Community adoption of a reasonable and uniform standard will permit more efficient computational experimentation and clearly communication/interpretation of the findings discovered in this way.

PMID:42339494 | PMC:PMC13286023

ArXiv [Preprint]. 2026 Jun 9:arXiv:2606.11415v1.

ABSTRACT

Neural recordings are often interpreted as local measurements, yet the signal at any one sensor can also reflect structured activity distributed across the broader network. This raises a basic question: to what extent does an electrode’s signal reflect local versus distributed information in the underlying system? More specifically, how much of an electrode’s activity is carried by its immediate neighborhood, and how much is embedded more broadly across the array? We address this with a Spatially Masked Regression (SMR) framework that reconstructs each electrode’s timeseries from the remaining electrodes while excluding a configurable neighborhood around the target. By progressively increasing this mask, spatial locality becomes an experimental control for quantifying how much predictive information survives after nearby channels are withheld. We apply SMR to intracranial EEG with heterogeneous electrode coverage and to scalp EEG with standardized montages over sensorimotor cortex. Using distance correlation between original and reconstructed signals, we find strong within-subject reconstruction in both modalities, substantial residual predictability even when local neighbors are excluded, and markedly stronger cross-subject transfer in EEG than in iEEG. Masking shows that nearby electrodes contribute strongly to reconstruction but do not account for all of it, indicating that individual channels reflect both local redundancy and broader distributed structure. Surrogates that preserve selected marginal or spectral properties while disrupting phase structure or temporal ordering substantially reduce performance, supporting the conclusion that SMR depends on structured temporal and cross-channel organization rather than on marginal statistics alone. These results position SMR as an interpretable framework for quantifying the balance between local and distributed information in recordings.

PMID:42339492 | PMC:PMC13286020

Anim Reprod. 2026 May 25;23(2):e20250103. doi: 10.1590/1984-3143-AR2025-0103. eCollection 2026.

ABSTRACT

This study aimed to evaluate the applicability of fetal heart rate variability (FHRvar%), umbilical artery resistivity index (RI-UmbArt), and maternal body temperature (Temp, °C) for predicting parturition in bitches. Fifteen bitches (1-6 years old) were included. Gestational age was estimated using fetal biometry (inner chorionic cavity or biparietal diameter), and during the last week of pregnancy the animals were evaluated twice daily until parturition. Data were retrospectively grouped according to the hours before parturition (HBP). The evaluated parameters were FHRvar% (measured over 5-10 minutes using pulsed Doppler abdominal ultrasonography), RI-UmbArt (assessed by triplex Doppler in three fetuses per session), and Temp (rectal thermometry). Data were statistically compared and correlated with HBP. FHRvar% showed a gradual increase (P = 0.010) beginning at 84 HBP, reaching a peak between 24 and 12 HBP, whereas Temp significantly decreased during the last 24 HBP (P < 0.001). Both FHRvar% and Temp were significantly correlated with HBP (P < 0.001); however, these correlations were weak (Pearson’s r = -0.338 and -0.491, respectively). RI-UmbArt showed no significant variation across HBP (P = 0.711). An FHRvar% > 31.5% predicted parturition within 24 hours with a sensitivity of 65% and a specificity of 67%, whereas a Temp < 37.5°C predicted parturition with 69.6% sensitivity and 77.8% specificity. In conclusion, although FHRvar% and maternal body temperature are influenced by the proximity of parturition, they may not be reliable predictors of parturition timing, while RI-UmbArt appears to remain unchanged close to delivery.

PMID:42339481 | PMC:PMC13286526 | DOI:10.1590/1984-3143-AR2025-0103

IJID Reg. 2026 May 22;20:100921. doi: 10.1016/j.ijregi.2026.100921. eCollection 2026 Sep.

ABSTRACT

OBJECTIVES: Acute respiratory infections (ARIs) such as influenza-like illness (ILI) and severe acute respiratory infection (SARI) are leading causes of morbidity among children aged under 5 years (under-5) in Bangladesh. In Cox’s Bazar, the ARI burden is compounded by high population density and seasonal monsoons; yet under-5-specific evidence on virus seasonality and clinical features remains limited. This study aimed to assess the seasonality and clinical characteristics of ILI and SARI among children under-5 in Cox’s Bazar, Bangladesh, between 2021 and 2023, with additional analyses to support interpretation of detection findings.

METHODS: Prospective hospitalized based surveillance was carried out from January 2021 up to December 2023 at the District Head Quarter Hospital Cox’s Bazar. Children under-5 with ILI (fever ≥38°C and a cough, symptom onset ≤10 days) or SARI (ILI with hospitalization or severe manifestations) were recruited. Nasopharyngeal and throat swabs were processed for testing by a multiplex real-time reverse-transcriptase polymerase chain reaction for influenza A/B (H3N2/Victoria), SARS-CoV-2, and respiratory syncytial virus (RSV). Demographic, clinical, and geographic information was recorded. Analyses included descriptive statistics, chi-square tests, and multivariable logistic regression.

RESULTS: Among 968 children (median age 9 months; 60.7% ILI, 39.3% SARI), pathogens were detected in 12.4% (95% confidence interval [CI]: 10.4-14.7%). Among the limited pathogens tested, influenza comprised most positive cases (65%); A(H3N2) was identified in 5.0%, and B(Victoria) in 3.1%. SARS-CoV-2 and RSV were detected only occasionally (2.5% and 1.9%, respectively). The monsoon season (June-September) was the peak detection period, with A(H3N2) being dominant in June and July and B(Victoria) dominating from August to September. Positivity was higher among SARI cases (25.8%) than ILI cases (16.4%) in the months of peak activity. Clinical severity indicators associated with detection were SARI (adjusted odds ratio [aOR] 3.42, 95% CI: 2.28-5.13), breathlessness (aOR 2.87, 95% CI: 1.84-4.48), age ≥6 months to <2 years (aOR 1.92, 95% CI:1.21-3.05) and fever ≥101.5°F (aOR 1.68, 95% CI: 100-276). The highest positivity rate observed was 24.0%. Most (87.6%) were negative for the tested pathogens.

CONCLUSION: Among the viruses tested, influenza contributes to seasonal under-5 ARIs in Cox’s Bazar, but the large negative proportion indicates that most cases were caused by pathogens not included in the limited testing panel (e.g. rhinovirus, adenovirus, parainfluenza, or bacteria). Markers of severity and age are associated with influenza positivity. Expanded multiplex testing and surveillance are required to inform vaccination and interventions in this high burden setting.

PMID:42339474 | PMC:PMC13285367 | DOI:10.1016/j.ijregi.2026.100921