Tag: nevin manimala

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

Mult Scler J Exp Transl Clin. 2026 Aug 5;12(3):20552173261472661. doi: 10.1177/20552173261472661. eCollection 2026 Jul-Sep.

ABSTRACT

BACKGROUND AND OBJECTIVES: Family planning and treatment management in women with multiple sclerosis (MS) require complex decision-making. In most cases, patients express their intention to start a family, giving physicians time to monitor their MS and align treatment plans accordingly. However, not all pregnancies are planned, which can make timely communication with healthcare providers challenging. This study explores the dynamics between patients and healthcare professionals in MS care, focusing on family planning and treatment decisions before, during, and after pregnancy.

METHODS: People with MS aged 20-50 in the Swedish MS register (SMSreg) were invited to participate in an online survey in 2021. Responses of 3078 women were linked to SMSreg and other national register datasets. Descriptive statistics and multinomial logistic regression explored information sources, care, family planning discussion, treatment satisfaction, and its impact on their disease and breastfeeding decisions.

RESULTS: Women with MS reported receiving annual care from a neurologist (88%), nurse (68%) or general practitioner (46%), with satisfaction ranging from 40-77%. Most were treated with high efficacy (HE) disease-modifying treatments (DMTs) (66%), of whom 49% used rituximab. Treatment satisfaction was higher among younger women, milder EDSS, and those on HE DMTs. Women who became pregnant after their MS diagnosis (41%) were more likely to have discussed family planning with a physician (78%) compared to those who had not been pregnant post-diagnosis (59%).

DISCUSSION: In Sweden, women with MS generally have regular contact with healthcare professionals, though satisfaction varies. Family planning discussions were more frequent among women who became pregnant after diagnosis, highlighting the importance of proactive communication. Treatment choices influence both satisfaction and reproductive decisions, underscoring the need for clear guidance and shared decision-making. Real-world data also indicate that rituximab is commonly used during peripregnancy, likely due to its favourable safety profile and long-lasting effect.

PMID:42564659 | PMC:PMC13443254 | DOI:10.1177/20552173261472661

Depress Anxiety. 2026 Aug 6;2026:9727081. doi: 10.1155/da/9727081. eCollection 2026.

ABSTRACT

BACKGROUND: Depressive symptoms (DSs) are highly prevalent among medical students and may adversely affect both student well-being and future healthcare quality. Although personality traits (PTs) are closely associated with mental health, the psychological processes underlying these associations remain incompletely understood. This study examined the associations between the five PT dimensions and DS and explored whether psychological capital (PsyCap) and perceived stress (PS) statistically mediated these associations.

METHODS: A multicenter cross-sectional survey was conducted among 583 third-year undergraduate clinical medicine students from three medical universities in China. Standardized questionnaires were administered to assess PTs, PsyCap, PS, and DS. Correlation, regression, and sequential mediation analyses were performed.

RESULTS: Correlation analyses showed that neuroticism was negatively correlated with PsyCap and positively correlated with PS and DS, whereas extraversion, openness to experience, agreeableness, and conscientiousness demonstrated the opposite pattern (all p < 0.001). Regression analyses indicated that neuroticism, openness to experience, agreeableness, and conscientiousness were significantly associated with DS (β = 0.39, -0.14, -0.15, -0.10, respectively, all p < 0.001), whereas the direct association between extraversion and DS was not statistically significant (β = -0.05). Mediation analyses supported statistically significant indirect associations through PsyCap alone, PS alone, and the proposed sequential pathway through PsyCap and PS. Among the five PT dimensions, the association between extraversion and DS was primarily reflected through the indirect pathways.

CONCLUSION: The findings suggest that PTs may be associated with DS through psychological resources and stress appraisal. By integrating PsyCap and PS into a sequential mediation framework, this study provides an expanded perspective on the psychological processes linking PTs and DS among medical students. Given the cross-sectional design, the proposed mediation pathways should be interpreted as statistical associations rather than causal relationships. Future longitudinal and intervention studies are needed to further evaluate these associations.

PMID:42564616 | PMC:PMC13444726 | DOI:10.1155/da/9727081

Cureus. 2026 Jul 6;18(7):e112190. doi: 10.7759/cureus.112190. eCollection 2026 Jul.

ABSTRACT

INTRODUCTION: High-resolution pelvic magnetic resonance imaging (MRI) is essential for local staging of primary rectal carcinoma and for communicating surgically relevant risk factors before multidisciplinary treatment planning. Free-text MRI reports may describe the primary tumor but may inconsistently document key management-relevant findings, including mesorectal fascia and circumferential resection margin status, depth of extramural spread, extramural vascular invasion, lateral pelvic lymph nodes, and low rectal sphincter complex involvement. This retrospective audit assessed whether use of a structured MRI reporting template was associated with improved completeness of primary rectal cancer staging reports.

METHODS: This retrospective audit included 60 pelvic MRI reports performed for suspected or biopsy-proven primary rectal carcinoma at a tertiary care radiology department. Thirty consecutive reports prepared before template implementation were assigned to the free-text reporting group, and 30 reports prepared after template implementation were assigned to the structured reporting group. Reports were assessed using a predefined checklist of essential MRI staging elements, including tumor location, distance from the anal verge, craniocaudal tumor length, circumferential tumor position, relationship to the anorectal junction and anterior peritoneal reflection, MRI T category, depth of extramural spread, mesorectal fascia/circumferential resection margin status, extramural vascular invasion, mesorectal nodes, tumor deposits, lateral pelvic lymph nodes, sphincter complex involvement, levator ani involvement, adjacent organ invasion, and final MRI-based risk summary. The primary and only measured outcome was report completeness.

RESULTS: The mean completeness score was higher in the structured reporting group than in the free-text group, with mean scores of 91.3% and 58.6%, respectively. Structured reports showed more complete documentation of several clinically important staging domains that were inconsistently recorded in free-text reports, including mesorectal fascia/circumferential resection margin relationship, depth of extramural spread, extramural vascular invasion, lateral pelvic nodal assessment, and low rectal sphincter complex assessment. Structured reports also more frequently included a concise MRI-based risk summary integrating tumor level, T stage, nodal status, margin risk, extramural vascular invasion, and anticipated surgical relevance. No formal statistical hypothesis testing was performed; therefore, these findings should be interpreted descriptively rather than inferentially.

CONCLUSIONS: Implementation of a structured MRI reporting template was associated with higher report completeness in this descriptive retrospective audit of primary rectal cancer staging reports. The structured template was associated with more complete documentation of clinically relevant reporting elements, particularly margin status, extramural spread, extramural vascular invasion, lateral pelvic nodes, and low rectal sphincter complex involvement. However, report completeness was the only measured outcome, and no formal statistical testing was performed. Further studies with statistical testing, reviewer blinding, and assessment of diagnostic accuracy or clinical outcomes are needed.

PMID:42564594 | PMC:PMC13443989 | DOI:10.7759/cureus.112190

Food Sci Nutr. 2026 Aug 5;14(8):e72211. doi: 10.1002/fsn3.72211. eCollection 2026 Aug.

ABSTRACT

Broccoli sprouts produce sulforaphane (SFN), a dietary isothiocyanate with anti-cancer and anti-inflammatory properties. Human intervention trials observe large variation in metabolite generation and bioactivity with broccoli sprout consumption across individuals. We hypothesize that interactions between pre-intervention diet and personalized gut microbiome composition contribute to this variation. This exploratory analysis leverages a small existing dataset to test novel mediation pathways, with the goal of identifying associations for future validation in larger, prospectively designed studies. In a trial of 38 healthy adults, we analyzed participant-recorded 7-day food diaries, profiled baseline gut microbiome compositions, and quantified urinary SFN metabolites over 72 h after broccoli sprout consumption. Using regression-based mediation analysis, we modeled two complementary predictions: (1) that specific gut bacterial genera mediate how pre-intervention diet composition influences SFN metabolism, and (2) that particular dietary components mediate how gut microbiome composition influences SFN metabolism. These analyses found that seven genera, including Collinsella, Ruminococcus, and Bifidobacterium, mediated relationships between pre-intervention diet and SFN metabolites, particularly the bioactive forms. Unsupervised clustering further revealed three distinct baseline gut microbiome community “types,” each exhibiting differential production of SFN-nitrile, a biologically inert metabolite, with effects mediated by the consumption of specific carbohydrate classes. Together, these findings indicate that microbiome structure, in concert with diet, shapes individual SFN metabolic outcomes. Considering pre-intervention diet and gut microbiome may therefore enhance the design and personalization of cruciferous vegetable interventions.

PMID:42564592 | PMC:PMC13443138 | DOI:10.1002/fsn3.72211

J Orthop Translat. 2026 Jul 24;60:101184. doi: 10.1016/j.jot.2026.101184. eCollection 2026 Sep.

ABSTRACT

BACKGROUND/OBJECTIVE: Knee osteoarthritis (KOA) is the most common joint disorder and causes pain and functional limitation. Patients who are refractory to conservative treatment or unsuitable for surgery owing to advanced age or comorbidities have limited options. Vascular endothelial growth factor (VEGF) is implicated in synovitis, angiogenesis and pain in KOA. microRNA (miRNA) based therapies have recently attracted attentions. This study aimed to investigate whether intra-articular delivery of VEGF-targeting miRNA can reduce synovitis and pain.

METHODS: Human synovial sarcoma cell line HS-SY-II was used for screening of VEGF-targeting miRNAs and primary synovial fibroblasts derived from KOA patients was used for confirmation of the efficacy. miRNA mimics were transfected and VEGF production was quantified. In vivo analyses, KOA was induced by anterior cruciate ligament transection and medial meniscectomy (ACLT model). Wistar rats were randomly allocated to 5 groups in 2 cohorts (n = 5 per group per cohort): normal (no ACLT), ACLT + negative control miRNA (NC), ACLT + miR-126-3p, ACLT + miR-140-5p, and ACLT + a combination of miR-126-3p and miR-140-5p (miR-Mix). miRNA mimics were injected intra-articularly. Hindlimb weight-bearing was assessed using incapacitance tester. Synovitis and cartilage degeneration were evaluated histologically. VEGF levels in synovial fluid, synovium and cartilage were quantified by Simple Western analysis. Non-parametric tests and repeated-measures analyses were performed, with p < 0.05 considered statistically significant.

RESULTS: Combination of miR-126-3p and miR-140-5p suppressed VEGF production in HS-SY-II cells than either miRNA alone and the suppressive activity on VEGF production was confirmed in primary synovial fibroblasts from KOA patients. In ACLT rats, synovial VEGF levels were increased in NC group compared with normal rats and tended to be lower in all miRNA-treated groups. Hindlimb weight-bearing ratios were reduced to about 30% after ACLT and remained low in the NC group, whereas they gradually improved in the miR-126-3p and miR-140-5p monotherapy groups and almost recovered in the miR-Mix group. At final time point, weight-bearing ratio was significantly higher in miR-Mix group than NC group. Histologically, Krenn scores were tend to lower in miR-126-3p and miR-Mix groups than NC group, indicating amelioration of synovitis, whereas OARSI histopathology scores for femoral cartilage did not differ significantly among groups and tended to be higher in miR-treated groups. There was a strong negative correlation between Krenn synovitis score and hindlimb weight-bearing ratio (Spearman’s ρ = -0.7, p < 0.001).

CONCLUSION: Intra-articular administration of VEGF-suppressive miR-Mix ameliorated synovitis and pain-related behaviour. In highly unstable traumatic model, however, structural protection of articular cartilage was not observed and cartilage degeneration even tended to be worse in miR-treated groups, possibly due to increased weight-bearing following pain relief.

THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE: These findings suggest intra-articular delivery of VEGF-suppresive miRNAs may represent novel analgesic strategies for KOA by reducing synovitis within joint. miRNA-based modulation of VEGF production could potentially be translated into future disease-modifying and analgesic treatments, however further studies using non-traumatic KOA models, safety evaluation and clarifying molecular mechanisms are required.

PMID:42564586 | PMC:PMC13444623 | DOI:10.1016/j.jot.2026.101184

Depress Anxiety. 2026 Aug 6;2026:8846772. doi: 10.1155/da/8846772. eCollection 2026.

ABSTRACT

BACKGROUND: Despite being a modifiable risk factor for cognitive decline, the influence of depressive symptoms on cognitive decline lacks a systematic assessment of its cumulative exposure intensity, temporal dimensions, and dynamic change.

AIM: To systematically evaluate the multidimensional associations of depressive symptom exposure-including cumulative exposure, burden, duration, and dynamic change patterns-with incident cognitive decline, by adopting an analytical framework that integrates “static accumulation and dynamic evolution.”

METHODS: Among 8847 Health and Retirement Study (HRS) participants free of cognitive decline at baseline, cumulative depressive symptoms were quantified as the area under the curve (AUC) across 2012-2016 waves. A cut-point was identified by maximizing the log-rank statistic for cognitive decline risk within a clinically relevant range (2.5-3.5) and used to define cumulative burden and high-exposure duration. Dynamic symptom patterns across three waves were identified, and their interaction with cumulative burden was examined. Multivariable Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cognitive decline risk associated with these exposure metrics.

RESULTS: During 3.67 median follow-up years, 2311 incident cognitive decline cases occurred. Cognitive decline risk rose with escalating cumulative depressive exposure: the highest tertile (HR 1.42; 1.28-1.58), cumulative burden ≥0 (HR 1.34; 1.21-1.49), longest duration (HR 1.29; 1.12-1.48), and a progressively worsening trend (HR 1.52; 1.25-1.84) all significantly increased risk.

CONCLUSIONS: Our findings demonstrate that the effect of depressive symptoms on cognitive decline is cumulative, time-dependent, and dynamic. These results emphasize that sustaining a stable, low-severity depressive symptom profile is essential for lifelong cognitive health.

PMID:42564581 | PMC:PMC13444727 | DOI:10.1155/da/8846772