Tag: nevin manimala

Am J Cardiovasc Drugs. 2026 Aug 7. doi: 10.1007/s40256-026-00818-4. Online ahead of print.

ABSTRACT

BACKGROUND: Short-term studies have demonstrated that single-pill combinations (SPCs) improve adherence, reduce hypertension-related complications, and lower costs; however, long-term benefits remain unclear. This study compared adherence, healthcare resource utilization (HCRU), and costs over 11 years in patients treated with SPCs versus free-pill combinations (FPCs) of antihypertensive drugs in routine Italian practice.

METHODS: We analyzed a large administrative dataset (2010-2022) covering approximately 7 million Italian citizens. Adults initiating perindopril (PER)-based SPC or FPC with amlodipine and/or indapamide were included. PER-based therapies were selected because their SPCs were among the first marketed in Italy, allowing for extended follow-up. Adherence was measured by proportion of days covered (PDC), with high adherence defined as PDC ≥ 80%.

RESULTS: Among 24,476 patients (mean age: 64.6 years; 59.7% male), 92.6% received SPCs, and 6.0% FPCs. High adherence was observed in 75.5% of SPC users compared with 32.0% of FPC users. SPC users had fewer all-cause hospitalizations and outpatient visits (both p < 0.001). Average annual healthcare costs were €242.96 lower for SPC users (95% CI €55.03-€430.89; p < 0.05), with significant reductions in costs related to all-cause and cardiovascular-related hospital admissions (p < 0.001).

CONCLUSIONS: In this long-term, real-world study, SPC use was associated with better adherence, reduced HCRU, and lower healthcare costs compared with FPC regimens. These economic benefits were evident within 1 year and may yield substantial long-term savings for national health systems, given the high prevalence and chronic nature of hypertension.

PMID:42566123 | DOI:10.1007/s40256-026-00818-4

Radiol Phys Technol. 2026 Aug 7. doi: 10.1007/s12194-026-01103-4. Online ahead of print.

ABSTRACT

MRI provides essential insights into tissue microstructure, and high angular resolution diffusion imaging (HARDI) enables detailed assessment of complex white matter architecture through fiber orientation distribution (FOD) analysis. However, HARDI requires high b-values and multiple diffusion directions, leading to reduced signal-to-noise ratio (SNR) and long scan times. Conventional zero-fill interpolation processing (ZIP) is widely used for super-resolution but is limited by edge blurring and artifacts. This study evaluated an AI-based reconstruction method, Precise IQ Engine (PIQE). Specifically, low-resolution diffusion data were reconstructed to standard resolution and compared with standard-resolution acquisitions. Ten healthy volunteers underwent HARDI at 3T, and FOD were estimated using constrained spherical deconvolution. Quantitative comparisons with reference data demonstrated that PIQE exhibited higher distributional similarity (lower Jensen-Shannon divergence) and directional agreement (higher angular correlation coefficient) compared with ZIP+Advanced Intelligent Clear-IQ Engine (AiCE), with statistically significant similarity observed. These findings indicate potential usefulness in advanced diffusion MRI applications.

PMID:42566117 | DOI:10.1007/s12194-026-01103-4

J Mater Sci Mater Med. 2026 Aug 7;37(1):103. doi: 10.1007/s10856-026-07109-z.

ABSTRACT

For centuries, natural extracts such as Aloe vera have been used in wound care due to their soothing, anti-inflammatory, and healing properties. However, their clinical efficacy can be limited by instability, low bioavailability, and restricted antimicrobial potency. Nanotechnology offers promising strategies to enhance and complement the therapeutic benefits of herbal extracts. In this study, we investigated the wound-healing potential of Aloe vera gel combined with ZnO/SWCNT/Ag (zinc oxide-single-walled carbon nanotubes-silver nanoparticles) nanocomposite. Forty full-thickness excisional wounds (15 mm) were created on the dorsum of 20 Sprague Dawley rats and divided into four treatment groups: ZnO/SWCNT/Ag alone (1 mg/mL), Aloe vera gel (30 mg/mL), the combination of Aloe vera gel with the NPs, and control (saline 0.9%). Wound areas were tracked at days 0, 3, 10, 15, and 21 using calibrated imaging, and skin samples were harvested for histopathological analysis. The ZnO/SWCNT/Ag nanocomposite alone accelerated wound closure compared to Aloe vera and saline control, while combining Aloe vera with the nanocomposite improved wound healing compared to Aloe vera alone at day 10 (p < 0.05). Although wound closure was similar across all groups by day 21, nanoparticle-treated wounds showed less variability and more uniform healing. Scar area analysis revealed significant reductions for ZnO/SWCNT/Ag based treatment and the combination compared to Aloe vera (p < 0.05), whereas differences versus saline control were not statistically significant. Additionally, the formulations demonstrated strong antibacterial activity against Escherichia coli and enhanced antioxidant properties. These findings suggest that ZnO/SWCNT/Ag nanoparticles may serve as a supportive platform to enhance the wound-healing behaviour of Aloe vera.

PMID:42566106 | DOI:10.1007/s10856-026-07109-z

Front Nutr. 2026 Jul 23;13:1868410. doi: 10.3389/fnut.2026.1868410. eCollection 2026.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide, highlighting an urgent need for non-invasive early biomarkers. The cholesterol, high-density lipoprotein, and glucose index (CHG) is a novel composite marker reflecting disturbances in glucose and lipid metabolism. However, the independent association between CHG and MASLD, and the potential statistical mediating effect of visceral adiposity, as represented by the body roundness index (BRI), remains unclear, especially in non-diabetic individuals.

METHODS: This cross-sectional study included 13,682 non-diabetic Japanese adults. Multivariable logistic regression, generalized additive models, and two-piecewise linear regression were used to explore the association, nonlinear relationship, and threshold effect between CHG and MASLD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate CHG’s discriminatory performance. Exploratory mediation analysis was performed to statistically decompose the association between CHG and MASLD via BRI.

RESULTS: The prevalence of MASLD was 15.25%. After full adjustment, each 1-unit increase in CHG was independently associated with a higher risk of MASLD (OR = 4.46, 95% CI: 3.00-6.64). A significant dose-response trend was observed across CHG quartiles (Q4 vs. Q1: OR = 4.09, 95% CI: 2.83-5.91). A nonlinear threshold effect was identified at CHG = 5.52. CHG showed excellent discriminatory performance (AUC = 0.84), with an optimal cutoff at 5.23 (sensitivity = 0.81, specificity = 0.73), and retained robust discriminatory capacity in non-obese and young individuals. BRI showed a significant statistical mediating effect in the CHG-MASLD association, accounting for 46.15% of the total observed association. Subgroup mediation analyses revealed that this mediating effect was more pronounced in non-obese and normotriglyceridemic individuals.

CONCLUSION: In non-diabetic Japanese adults, CHG is independently and nonlinearly associated with MASLD risk, with BRI as a potential statistical mediator. This mediating effect exhibits heterogeneity and is more pronounced in non-obese individuals. The causal direction of this pathway remains to be verified in prospective studies. CHG shows potential as a low-cost indicator for early MASLD risk stratification, especially in non-obese and younger populations who are often missed by conventional screening.

PMID:42564740 | PMC:PMC13446269 | DOI:10.3389/fnut.2026.1868410

Front Ophthalmol (Lausanne). 2026 Jul 23;6:1755069. doi: 10.3389/fopht.2026.1755069. eCollection 2026.

ABSTRACT

PURPOSE: To evaluate visual and refractive outcomes of the Alcon Clareon^® T2 toric IOL (1.00 D cylinder at the IOL plane, ~ 0.65 D at the corneal plane) versus the Clareon^® non-toric IOL.

SETTING: Single ophthalmology clinic in Haugesund, Norway.

METHODS: This was an exploratory single site randomized, unmasked, prospective clinical trial. The study was registered with clinicaltrials.gov (NCT06717607, registered retrospectively on 12/5/2024). Patients presenting for routine cataract surgery in one or both eyes, where at least one eye qualified for implantation of the T2 lens, were enrolled. Qualifying eyes were randomized to a T2 lens or a non-toric lens. Subjects were evaluated monocularly before surgery and three months postoperative. Testing included uncorrected and corrected distance visual acuity (VA), the manifest refraction, low contrast VA (photopic and mesopic, with and without glare) and contrast sensitivity (photopic and mesopic). These latter two tests were conducted with the distance correction in place.

RESULTS: Fifty eyes of 43 subjects were successfully enrolled from 6/2022 to 5/2024, including 30 eyes (25 subjects) randomized to the toric IOL and 20 eyes (18 subjects) to the non-toric IOL. Analysis included all enrolled eyes. Subjects were matched for age (p = 0.59), sex (p = 0.30), mean keratometry (p = 0.44), anterior corneal astigmatism (p = 0.97), axial length (p = 0.12) and anterior chamber depth (p = 0.40). Postoperatively, there was no statistically significant difference in the spherical equivalent refraction (p = 0.08). Residual refractive cylinder was statistically significantly lower in the T2 group (0.22 ± 0.22 D vs. 0.59 ± 0.28 D, p < 0.01). The T2 group also had statistically significantly better uncorrected logMAR distance VA than the non-toric group (0.00 ± 0.08 vs. 0.09 ± 0.13, p < 0.01). Low contrast VA was not statistically significantly different between the two lens types under any test condition (p = 0.49 or higher in all cases), nor were photopic or mesopic contrast sensitivity (p = 0.71 and p = 0.63, respectively).

CONCLUSIONS: Use of the low cylinder power toric IOL provided significantly better UDVA, with no significant differences in distance-corrected contrast sensitivity or low contrast acuity. The achieved cylinder correction was consistent with expectations.

CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/, identifier NCT06717607.

PMID:42564736 | PMC:PMC13444364 | DOI:10.3389/fopht.2026.1755069

iScience. 2026 Jul 25;29(8):116915. doi: 10.1016/j.isci.2026.116915. eCollection 2026 Aug 21.

ABSTRACT

Cryptic transcription is an aberrant form of transcription that initiates from non-canonical, non-promoter regions within the gene. In mammals, a repressive chromatin state effectively inhibits cryptic transcription, preserving transcriptional fidelity. Aging-induced loss of trimethylated lysine 36 on histone H3 reduces DNA methylation, and accumulation of promoter-like histone modifications renders gene bodies permissive to spurious initiation by RNA polymerase II. This allows previously repressed intragenic regions to acquire promoter-like chromatin features. Cryptic transcription produces aberrant RNAs that interfere with normal gene expression, leading to truncated proteins or nonfunctional mRNAs. The aberrant RNA and protein products impair stem cell self-renewal and differentiation, thereby contributing to the development of aging and disease. This review summarizes the mechanisms underlying age-related cryptic transcription, focusing on the function of H3K36me3, DNA methylation, H3K4me3, H3K27ac, and transcription factors. In addition, we discuss the effects of cryptic transcription on aging stem cells and aged tissues.

PMID:42564700 | PMC:PMC13444477 | DOI:10.1016/j.isci.2026.116915

Laryngoscope Investig Otolaryngol. 2026 Aug 6;11(4):e70530. doi: 10.1002/lio2.70530. eCollection 2026 Aug.

ABSTRACT

OBJECTIVES: Total parotidectomy (TP) has been advocated to ensure complete tumor clearance and removal of intraparotid lymph nodes; however, less-than-total parotidectomy (LTT) may offer comparable oncologic control with superior functional outcomes. In this systematic review and meta-analysis, we compared oncologic and functional outcomes between LTT and TP for patients with T1-2 low-grade parotid malignancies.

METHODS: A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four retrospective cohort studies of T1-2 low-grade parotid cancer were included. Patients underwent either LTT or TP. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Pooled hazard ratios with 95% confidence intervals were calculated using random-effects models. Heterogeneity was assessed using I ² statistics and the Cochran’s Q test.

RESULTS: The pooled analysis demonstrated no significant difference in OS between LTT and TP based on three studies. Across the four studies, RFS was comparable between the two surgical approaches, and statistical heterogeneity was negligible for both OS and RFS. No evidence of publication bias was detected.

CONCLUSION: In selected patients with T1-2 low-grade parotid malignancies confined to the superficial lobe, LTT showed no statistically significant disadvantage in OS or RFS compared with TP based on the available retrospective evidence. However, the high risk of bias across included studies limits causal interprettion. Surgical strategy should therefore be individualized and should prioritize negative margins and functional preservation when oncologically appropriate. Prospective studies with standardized oncologic and functional outcome reporting are warranted.

LEVEL OF EVIDENCE: 3.

PMID:42564699 | PMC:PMC13445257 | DOI:10.1002/lio2.70530

Front Digit Health. 2026 Jul 23;8:1877420. doi: 10.3389/fdgth.2026.1877420. eCollection 2026.

ABSTRACT

BACKGROUND/OBJECTIVES: Multimodal large language models are increasingly being explored for medical image interpretation, but their performance in thyroid nodule ultrasound assessment remains uncertain. This study compared ChatGPT-5.4 and DeepSeek-VL2 for C-TIRADS-based risk stratification of thyroid nodules using static ultrasound images.

METHODS: This single-center retrospective diagnostic accuracy study included 206 pathologically confirmed thyroid nodules, including 117 benign and 89 malignant nodules. For each nodule, paired transverse and longitudinal ultrasound images were analyzed by both models using the same standardized English prompt. The models generated structured outputs for C-TIRADS-related ultrasound features and estimated C-TIRADS category. Pathology served as the reference standard for malignancy, and expert-assigned C-TIRADS served as the imaging reference standard. Model-assigned C-TIRADS categories were used as ordinal risk scores. The primary analysis used C-TIRADS ≥4B as the binary positive threshold for predicting pathology-confirmed malignancy, and a sensitivity analysis used C-TIRADS ≥4A.

RESULTS: At the ≥4B threshold, ChatGPT-5.4 achieved higher accuracy, sensitivity, and specificity than DeepSeek-VL2: 70.9%, 61.8%, and 77.8% vs. 57.8%, 50.6%, and 63.2%, respectively. Its non-diagnostic rate was also lower (6.3% vs. 15.5%). In the valid-output ROC analysis, AUCs were 0.903 for expert assessment, 0.790 for ChatGPT-5.4, and 0.757 for DeepSeek-VL2; model-based ROC analyses excluded indeterminate outputs and should be interpreted as per-protocol estimates. At the C-TIRADS category level, ChatGPT-5.4 showed higher exact agreement with expert assessment than DeepSeek-VL2 (45.6% vs. 36.4%) and higher within-one-category agreement (87.6% vs. 82.2%). Feature-level analysis showed that both models performed best on echogenicity but poorly on margin and echogenic foci. At the ≥4A threshold, sensitivity increased but specificity decreased substantially for both models.

CONCLUSIONS: ChatGPT-5.4 showed a more favorable performance profile than DeepSeek-VL2, but differences in sensitivity and valid-output AUC were not statistically significant. Both models remain investigational adjunctive tools and should not be used for unsupervised clinical decision-making or standalone triage.

PMID:42564679 | PMC:PMC13444745 | DOI:10.3389/fdgth.2026.1877420

S Afr J Psychiatr. 2026 Jul 30;32:2634. doi: 10.4102/sajpsychiatry.v32i0.2634. eCollection 2026.

ABSTRACT

BACKGROUND: Childhood traumatic experiences are known to have profound and lasting effects on mental health; however, there are limited data on the relationship between types of childhood trauma and social anxiety in non-clinical populations.

AIM: This study aimed to explore the associations between types of childhood trauma and social anxiety symptoms in non-clinical young adults.

SETTING: The study was conducted at the Faculty of Health Sciences of a university in Istanbul, Turkey.

METHODS: This cross-sectional study included 486 university students. Sample size was determined via G*Power analysis to ensure statistical power. Participants completed the Liebowitz Social Anxiety Scale (LSAS) and the Childhood Trauma Questionnaire (CTQ) to assess childhood trauma types and social anxiety symptoms. Data were analysed using stepwise multiple regression.

RESULTS: The mean age of the participants was 21.8 ± 4.0 years, and 81% were female, with emotional abuse and neglect scoring highest in both genders. The sample’s LSAS total mean score was 63.87 ± 11.68. When the subscales were compared by gender, females had significantly higher mean fear and avoidance scores than males (p < 0.05). The results show that childhood abuse and neglect were significant predictors of social anxiety and explained 23% of the social anxiety variance.

CONCLUSION: Childhood abuse and neglect are clearly associated with social anxiety symptoms. Interventions and treatments for individuals with social anxiety should incorporate a detailed assessment of childhood trauma history, with a particular focus on emotional abuse and neglect.

CONTRIBUTION: This study contributes to the literature by clarifying the associations between specific types of childhood trauma and social anxiety symptoms in a non-clinical young adult population.

PMID:42564676 | PMC:PMC13444311 | DOI:10.4102/sajpsychiatry.v32i0.2634

Health SA. 2026 Apr 27;31:3197. doi: 10.4102/hsag.v31i0.3197. eCollection 2026.

ABSTRACT

BACKGROUND: Despite the high academic ratings of South African universities, research on burnout in academia, particularly among health professional academics, is limited. This gap in scholarly knowledge underscores the need for immediate studies in this area.

AIM: The study assesses the burnout dimensions and demographics of health professional academics.

SETTING: Faculty of Medicine and Health Sciences, Walter Sisulu University, Eastern Cape, South Africa.

METHODS: A quantitative, descriptive, cross-sectional research design was followed. Respondents were recruited via the census (n = 56). The Modified Maslach Burnout Inventory (MMBI) Likert scale questionnaire was used. Statistical Package for the Social Sciences was used to analyse the data: Analysis of variance (ANOVA) was employed to compare mean burnout scores across multiple categorical independent variables. The chi-square test was used for associations between categorical variables. The significance level was set at p < 0.05.

RESULTS: Respondents experienced moderate levels of emotional exhaustion (EE; 46.8%), low-to-moderate levels of depersonalisation (DP; 40.4%) and moderate levels of personal accomplishment (PA; 42.6%). There is no statistically significant difference in burnout dimensions across age groups (p = EE: 0.466, DP: 0.414, PA: 0.467), gender (p = EE: 0.917, DP: 0.593, PA: 0.952), type of degree (p = EE: 0.909, DP: 0.657, PA: 0.939), academic position (p = EE: 0.982, DP: 0.907, PA: 0.430), work experience (p = EE: 0.730, DP: 0.951, PA: 0.905).

CONCLUSION: The findings suggest that health professional academics are either at risk for burnout or are experiencing moderate levels of burnout.

CONTRIBUTION: Staff welfare can be improved through strategies to reduce work-related stress, provide mental health support, and promote a healthy work-life balance.

PMID:42564672 | PMC:PMC13443551 | DOI:10.4102/hsag.v31i0.3197