Tag: nevin manimala

Sci Rep. 2026 Feb 28. doi: 10.1038/s41598-026-37724-3. Online ahead of print.

ABSTRACT

Brazil is the world’s leading coffee producer and increasingly adopts shaded agroforestry systems to enhance sustainability. However, the influence of topography on soil functionality within these systems remains insufficiently understood. This study evaluated soil physical and chemical properties across slope positions (Upper, Middle, and Lower Thirds) and depths (0-60 cm) in a shaded coffee agroforestry system using multivariate statistics and Bayesian network modeling. Results revealed that upper slope positions exhibited greater macroporosity (15-20%) and lower bulk density (1.10-1.15 g cm⁻³), whereas lower slope positions accumulated higher total organic carbon (2.5-3.0%) and microporosity (28-32%). Principal Component Analysis indicated that topography modulated soil porosity and carbon distribution, with total organic carbon (TOC) positively correlating with nutrient availability and negatively with acidity. Bayesian network analysis identified TOC as the most influential attribute, displaying the highest expected influence (1.25) and strength (1.15), along with elevated centrality in conserved environments. These results demonstrate that TOC functions as a central integrator linking soil structure, chemistry, and fertility across topographic gradients. Overall, shaded coffee agroforestry enhanced soil quality and functionality, particularly in upper slope areas, underscoring its potential for sustainable land management in tropical landscapes.

PMID:41764216 | DOI:10.1038/s41598-026-37724-3

Nat Commun. 2026 Feb 28. doi: 10.1038/s41467-026-69816-z. Online ahead of print.

ABSTRACT

Imaging genetics links genetic variations to brain structures and functions, but the computational challenges posed by high-dimensional imaging and genetic data are significant. In voxel-level genome-wide association studies, we introduce a Representation learning-based Voxel-level Genetic Analysis (RVGA) framework that reduces computational time and storage burden by over 200 times. RVGA enhances statistical power by denoising images and shares minimal datasets of summary statistics for associations across the whole genome of the entire image for secondary analyses. Additionally, it introduces a unified estimator for voxel heritability, genetic correlations between voxels, and cross-trait genetic correlations between voxels and non-imaging phenotypes. Applying RVGA to hippocampus shape and white matter microstructure in the UK Biobank (n = 53,454) reveals 39 and 275 novel loci, respectively. We identify heterogeneity in heritability within images and subregions that share genetic bases with 14 brain-related phenotypes, such as the genetic correlation between the hippocampus and educational attainment, and between the anterior corona radiata and schizophrenia. RVGA replicates known genetic associations and uncovers new discoveries.

PMID:41764180 | DOI:10.1038/s41467-026-69816-z

J Orthop Sports Phys Ther. 2026 Mar;56(3):158-175. doi: 10.2519/jospt.2026.13561.

ABSTRACT

OBJECTIVE: To compare the effects of supervised physical therapy to home exercise programs on functional outcomes in patients after distal radius fractures. DESIGN: Intervention systematic review with meta-analysis of randomized clinical trials (RCTs). LITERATURE SEARCH: We searched MEDLINE, EMBASE, Web of Science, Scopus, CENTRAL, Epistemonikos, Cumulative Index of Nursing and Allied Health Literature, SPORTDiscus, Physiotherapy Evidence Database, and LILACS databases from inception to April 2025. STUDY SELECTION CRITERIA: We included RCTs comparing supervised physical therapy with a home exercise program on functional outcomes in patients with distal radius fracture. DATA SYNTHESIS: We used a random-effects meta-analysis for clinically homogeneous RCTs. We assessed risk of bias using the Cochrane Risk of Bias 2.0 and applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to judge the certainty of evidence. RESULTS: Thirteen RCTs were included. At 6 weeks, there were significant differences for Patient-Rated Wrist Evaluation (mean difference [MD] = -11.64 points, P < .001) with moderate certainty of evidence, for grip strength relative to the unaffected side (MD = 12.85%, P = .03) with low certainty of evidence, and for wrist extension range of motion (MD = 8.99°, P = .03) with moderate certainty of evidence. All results were in favor of the supervised physical therapy group. There were significant differences in favor of supervised physical therapy for wrist function and extension range of motion in patients over 65 years (P < .05). A greater number and frequency of supervised physical therapy sessions were associated with greater pain relief and improved wrist range of motion (P < .05). CONCLUSION: Supervised physical therapy had statistically significant short-term benefits in wrist function, grip strength, and wrist extension range of motion. J Orthop Sports Phys Ther 2026;56(3):158-175. Epub 4 February 2026. doi:10.2519/jospt.2026.13561.

PMID:41764173 | DOI:10.2519/jospt.2026.13561

Transl Psychiatry. 2026 Feb 28. doi: 10.1038/s41398-026-03925-7. Online ahead of print.

ABSTRACT

Stimulants are the first-line pharmacological treatment for ADHD and generally effective, yet 35-61% of individuals discontinue treatment within a year. We investigated the contribution of common and rare genetic variants to early stimulant discontinuation using data from 18,362 individuals with ADHD (31% female) initiating stimulants in iPSYCH, a Danish population-based case-cohort linked to national registers. Discontinuation was defined as a ≥ 180-day gap between dispensations within one year of initiation. We examined genetic differences by age groups, estimated SNP-heritability (h²_SNP), conducted genome-wide association studies (GWAS), polygenic score (PGS) analyses, and assessed associations with protein truncating variants (PTV). Within one year, 7102 individuals (39%) had discontinued stimulants. Age-stratified analyses (cut-off: age 16) revealed low genetic correlation (r₉ = 0.23, 95% CI: -0.37, 0.83) between children and adolescents/adults. The h²_snp for discontinuation was 0.06 (95% CI: 0.02, 0.11) overall, 0.08 (95% CI: 0.02, 0.14) in children, and 0.14 (95% CI: 0.02, 0.27) in adolescents/adults. No genome-wide significant loci were identified overall or in adolescents/adults; however, one locus (SLC5A12, chromosome 11) reached genome-wide significance in children. Ten of 36 PGSs were associated with discontinuation, with higher psychiatric risk PGSs predicting increased discontinuation, while educational attainment and BMI PGSs showed divergent effects by age. Reduced burden of dopamine-related PTVs was nominally associated with discontinuation, particularly in adolescents/adults. These findings suggest modest contributions of both common and rare variants to stimulant discontinuation in ADHD and point to potential developmental differences in genetic architecture.

PMID:41764167 | DOI:10.1038/s41398-026-03925-7

Brain Behav. 2026 Mar;16(3):e71276. doi: 10.1002/brb3.71276.

ABSTRACT

BACKGROUND: Cerebrovascular disease (CVD) remains a leading cause of death, with obesity exacerbating stroke risk through multiple metabolic pathways. However, long-term trends in CVD-related mortality among obese adults in the United States remain inadequately defined.

METHODS: We analyzed national mortality data from 1999 to 2020 using the CDC WONDER database. Deaths were included if CVD (ICD-10 I60-I69) was the underlying cause and obesity (E66) a contributing cause. Age-adjusted mortality rates (AAMRs) were calculated, and temporal trends were evaluated using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC).

RESULTS: From 1999 to 2020, 26,410 CVD-related deaths occurred among obese adults. The overall AAMR was 0.53 per 100,000, with an AAPC of 4.59% (95% CI: 3.94 to 5.24). A statistically significant change in trend slope was observed after 2008, with accelerated mortality increases. Females had higher AAMRs (0.56) than males (0.49), though males experienced steeper increases (AAPC 5.98% vs. 3.64%). American Indian/Alaska Native and Black adults had the highest AAMRs (1.11 and 1.01, respectively). Mortality increased in all racial/ethnic groups, most rapidly among White individuals (AAPC 4.66%). Non-metropolitan areas showed higher mortality than metropolitan areas (0.71 vs. 0.50), with a widening urban-rural gap. Regionally, the West and Midwest had the highest AAMRs (0.59 and 0.57, respectively). Mortality rose across all age groups, with the steepest increases in younger adults aged 25-54 years. Most deaths occurred in hospitals (56%), followed by home (22.8%) and nursing facilities (15.7%).

CONCLUSIONS: CVD-related mortality among obese adults has increased significantly since 1999, with substantial disparities across sex, race, geography, and age, highlighting the need for focused public health strategies.

PMID:41764043 | DOI:10.1002/brb3.71276

J Cardiothorac Vasc Anesth. 2026 Feb 5:S1053-0770(26)00111-4. doi: 10.1053/j.jvca.2026.02.004. Online ahead of print.

ABSTRACT

OBJECTIVES: The prognostic value of the leuko-glycemic index (LGI) as a marker of postoperative outcomes in pediatric cardiac patients is not known. This study aimed to determine the predictive value of LGI in predicting composite outcomes, including prolonged mechanical ventilation, after the repair of a complete atrioventricular septal defect in infants with Down syndrome.

DESIGN: An ambidirectional cohort study.

SETTING: A single tertiary cardiac care center.

PARTICIPANTS: Patients with Down syndrome and a complete atrioventricular septal defect.

INTERVENTIONS: All patients underwent primary intracardiac repair of a complete atrioventricular septal defect and received standard perioperative anesthesia and hemodynamic management.

MEASUREMENTS AND MAIN RESULTS: A total of 110 patients were enrolled, of whom 104 completed the study and were included in the final analysis. Prolonged mechanical ventilation was defined as a duration ≥24 hours. We found a statistically significant correlation between postoperative LGI and prolonged mechanical ventilation (p = 0.042). A postoperative LGI cutoff value >1,640.16 was associated with the need for prolonged mechanical ventilation. The area under the receiver operating characteristic curve (AUC) was 0.659 (95% CI, 0.548-0.771) with a sensitivity of 47.50% and a specificity of 81.25% (p = 0.005). A cutoff LGI value >2,657.88 was found to differentiate between patients who developed renal failure and those who did not, with an AUC of 0.723 (p = 0.019).

CONCLUSIONS: The LGI, a cost-effective and easily measured index, could be a valuable prognostic tool to stratify children with Down syndrome in the immediate postoperative period after complete atrioventricular septal defect correction. High LGI values may identify patients who could benefit from greater monitoring and early therapeutic strategies to reduce the duration of mechanical ventilation and the incidence of acute kidney injury.

PMID:41764019 | DOI:10.1053/j.jvca.2026.02.004

J Voice. 2026 Feb 27:S0892-1997(25)00507-7. doi: 10.1016/j.jvoice.2025.11.027. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the predictive capacities of the University of Rhode Island Change Assessment of voice (URICA-VOICE) questionnaire and completion rate in assessing adherence, and their impact on therapeutic outcomes of voice therapy in patients with voice disorders.

METHOD: At the Voice Treatment Center of Sun Yat-sen Memorial Hospital, 127 patients with voice disorders were recruited between April and September 2023. Initial adherence was gauged using the URICA-VOICE questionnaire. Following voice therapy, adherence was assessed by examining the actual completion rate. The concordance between the two evaluations and their influence on treatment outcomes, including voice handicap index (VHI), Jitter, and Shimmer, was scrutinized.

RESULTS: Notable discrepancies arose between both assessment methodologies. The predicted poor adherence, as delineated by URICA-VOICE, stood at 62.99%, surpassing the actual poor adherence rate of 56.69% indicated by the completion rate. Considering the completion rate as the benchmark, 72 participants demonstrated actual poor adherence. Of these, 54 were precisely pinpointed by URICA-VOICE, achieving a sensitivity of 75.00%. Evaluation strategies divergently impacted outcome appraisal. With the completion rate, the enhancements in VHI, Jitter, and Shimmer were statistically superior for the 55 actually good adherent individuals compared to the 72 actually poor adherent ones (P < 0.01). In contrast, the URICA-VOICE discerned no significant variances between its 47 subjects with predicted good adherence and 80 subjects with predicted poor adherence (P > 0.05).

CONCLUSIONS: While completion rate portrays tangible behavioral adherence, URICA-VOICE gauges prospective behavioral adherence via the evaluation of mental readiness. The latter can detect those prone to diminished adherence pre-training, but falls short in predicting end results. Direct adherence assessment via completion rate is congruent with tangible treatment efficacy. Enhancing adherence is pivotal for optimizing therapeutic results and voice quality.

PMID:41764018 | DOI:10.1016/j.jvoice.2025.11.027

J Voice. 2026 Feb 27:S0892-1997(26)00057-3. doi: 10.1016/j.jvoice.2026.02.003. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to make a comparison between the short-term effects of low- and high-resistance water phonation exercises, adjusted using the DoctorVox® device, on acoustic parameters and voice self-perception in healthy adults.

METHOD: Forty-seven healthy adults (37 females, 10 males) performed both low- and high-resistance exercises in a comparative experimental design. Low resistance was achieved with 3 cm of water in the DoctorVox® device, whereas high resistance was achieved by adjusting the DC-Valve® to a 3-mm opening at the same water depth. Acoustic voice recordings (fundamental frequency [F0], jitter, shimmer, harmonics-to-noise ratio [HNR], and acoustic voice quality index) and self-perception ratings (voice quality, phonatory comfort, and vocal fatigue) were collected at baseline, immediately post exercise, and 30 minutes post exercise. The analysis employed both parametric and nonparametric statistical tests.

RESULTS: The low-resistance condition resulted in a significant immediately post exercise increase in F0 and HNR, and a significant decrease in jitter; however, these effects largely disappeared by the 30-minute mark. In the high-resistance condition, only HNR demonstrated a significant change over time, but subsequent pairwise comparisons were not significant. The only significant difference between the two conditions was a higher HNR in favor of the high-resistance condition at 30 minutes post exercise. Despite the absence of any significant difference between the conditions in self-perception ratings, participants in both groups exhibited a tendency to report heightened voice quality and comfort, alongside diminished fatigue, subsequent to the exercises.

CONCLUSION: The findings suggest that low-resistance exercises may produce immediate acoustic trends in specific parameters and may be useful as a voice warm-up in healthy individuals. Although the effects of high-resistance exercises appear more limited, the results suggest a potential trend toward more sustained changes in certain acoustic parameters. This study highlights the importance of individualizing resistance levels in voice therapy based on specific goals and provides foundational data to guide clinical practice.

PMID:41764016 | DOI:10.1016/j.jvoice.2026.02.003

J Prosthet Dent. 2026 Feb 27:S0022-3913(26)00097-1. doi: 10.1016/j.prosdent.2026.02.013. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Additively manufactured (AM) polymethyl methacrylate (PMMA) crowns exhibit limited color stability, suboptimal surface texture, and insufficient strength. The development of effective reinforcement strategies is essential to overcome these shortcomings.

PURPOSE: The purpose of this in vitro study was to evaluate the effects of incorporating silica (SiO₂) and titanium dioxide (TiO₂) nanoparticles on the fabrication trueness and the optical, surface, and mechanical properties of AM PMMA crowns.

MATERIAL AND METHODS: Mandibular first molar AM PMMA crowns (N=80) were fabricated using 4 materials (n=20 per group): unmodified PMMA (control; FREEPRINT), PMMA with 1 wt% SiO₂ (S), PMMA with 2 wt% TiO₂ (T), and PMMA with a combination of 1 wt% SiO₂ and 2 wt% TiO₂ nanoparticles (ST). Fabrication trueness was evaluated as the root mean square (RMS) surface deviation of the marginal and intaglio surfaces (µm) and their total. Color stability (ΔE₀₀) was assessed using spectrophotometry, and surface roughness (Ra) was measured via noncontact optical profilometry. Wear was assessed by occlusal RMS (µm) after thermomechanical aging; fracture resistance was recorded as peak load to failure (N) on a universal testing machine. Statistical analyses were performed using 1-way ANOVA followed by Bonferroni-adjusted post hoc tests (α=.05).

RESULTS: Fabrication trueness differed among groups (marginal, intaglio, and total RMS; all P<.001), ranking ST<T<S<Control. ΔE00 differed (P=.004): T highest, ST lowest; Control, S, and T exceeded the 0.8 perceptibility threshold, and no group exceeded the 1.8 acceptability threshold. Ra differed (P=.001): Control highest; T higher than S and ST; S and ST not different. Wear differed (P<.001) with the hierarchy Control>S>T>ST; qualitative joint evaluation technique (JET) heatmaps showed the same pattern. Fracture load differed (P<.001): T and ST were higher than Control and S, with no significant difference between T and ST.

CONCLUSIONS: Incorporating SiO₂ and TiO₂ nanoparticles into PMMA formulations synergistically enhanced the overall performance of AM crowns.

PMID:41764005 | DOI:10.1016/j.prosdent.2026.02.013

Int J Gynecol Cancer. 2025 Nov 21:102821. doi: 10.1016/j.ijgc.2025.102821. Online ahead of print.

ABSTRACT

BACKGROUND: Pelvic and para-aortic lymphadenectomy remains the standard procedure for nodal staging in apparent early-stage ovarian cancer, but it is associated with considerable morbidity and lacks clear evidence of improving survival. Sentinel lymph node mapping may offer a less invasive alternative while still enabling accurate upstaging in a sub-set of patients with occult lymph node metastasis.

PRIMARY OBJECTIVE: This study aims to evaluate the negative predictive value of the sentinel lymph node technique for detecting lymphatic metastases in early-stage ovarian cancer compared with systematic pelvic and para-aortic lymphadenectomy (gold standard).

STUDY HYPOTHESIS: The sentinel lymph node technique is non-inferior to systematic lymphadenectomy for detecting lymphatic metastasis.

TRIAL DESIGN: This is a multi-center phase III clinical trial. Eligible patients with confirmed early-stage ovarian cancer will undergoing sentinel lymph node mapping and a subsequently complete staging surgery, including systematic lymphadenectomy. The concordance between both methods will be analyzed.

MAJOR INCLUSION/EXCLUSION CRITERIA: Inclusion: Women aged ≥18 years, with histologically confirmed epithelial ovarian malignancy in apparent International Federation of Gynecology and Obstetrics I to II stage, planned for staging surgery either at the time of initial surgery (after intra-operative frozen section confirmation) or after a deferred histologic diagnosis.

EXCLUSION: Age <18 years, previous vascular or lymphatic pelvic/aortic surgery, previous lymphoma or abdominopelvic tumors, allergy to Technetium-99m or indocyanine green, pregnancy/lactation.

PRIMARY ENDPOINT: Negative predictive value of the sentinel lymph node technique compared to systematic lymphadenectomy for lymph node metastasis.

SAMPLE SIZE: The planned sample size is 100 patients with negative sentinel lymph node results to ensure adequate statistical power (80%) to detect a negative predictive value for the sentinel lymph node technique above 95%. An interim analysis will be performed once 50% of the recruitment has been reached to adjust the exact total sample size. Recruitment period is estimated at 24 to 36 months in 11 high-volume Spanish centers.

ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: Patient accrual: November 2025 to November 2028.

FINAL RESULTS EXPECTED: January 2029.

TRIAL REGISTRATION: NCT06963268.

PMID:41763980 | DOI:10.1016/j.ijgc.2025.102821