Tag: nevin manimala

Chiropr Man Therap. 2026 Jun 19. doi: 10.1186/s12998-026-00659-7. Online ahead of print.

ABSTRACT

BACKGROUND: The back squat is a commonly prescribed exercise for developing lower body strength. The ability to squat can be affected by reduced ankle dorsiflexion range of motion (DF-ROM), leading to limited squat depth and dysfunctional compensatory movement patterns.

OBJECTIVE: To investigate the effect of high-velocity low-amplitude lower limb manipulations on 1 repetition maximum (1RM) back squat strength, sagittal plane ankle kinematics during a squat, and active DF-ROM in individuals with asymptomatic deficits in DF-ROM.

METHODS: Twenty-six enrolled; Twenty-four analysed resistance-trained participants with asymptomatic deficits in DF-ROM participated in this double-blind randomised sham-controlled cross-over trial. Interventions involved high-velocity low-amplitude joint manipulations targeting ankle DF-ROM, and a sham which mimicked the manipulations using a mechanical drop mechanism. The primary outcome was a change in back squat 1RM between baseline to post-intervention, with secondary outcomes being maximal ankle DF-ROM during the 1RM squat using 3D motion capture, and change in DF-ROM during the weightbearing lunge test.

RESULTS: There was no statistically significant difference between interventions for back squat 1RM (p = 0.27). From baseline, the 1RM increased by 4.75 kg (3.6%) following manipulation and 2.75 kg (2.1%) following the sham. There were no statistically significant differences between interventions on maximal DF-ROM during the back squat (p = 0.24) and no statistically significant differences in ankle DF-ROM immediately following either intervention (p = 0.39).

CONCLUSION: Based on these results a single session of high-velocity low-amplitude manipulations targeting ankle DF-ROM does not significantly improve 1RM back squat strength compared to sham, and does not influence short-term ankle DF-ROM. Trial registration The study was pre-registered with ANZCTR (ACTRN12622000811707).

PMID:42321886 | DOI:10.1186/s12998-026-00659-7

Ital J Pediatr. 2026 Jun 19. doi: 10.1186/s13052-026-02298-3. Online ahead of print.

ABSTRACT

BACKGROUND: The 2024 international pediatric sepsis consensus definition has undergone a paradigm shift from a systemic inflammatory response syndrome (SIRS)-based framework to the organ dysfunction-centered Phoenix Sepsis Criteria (PSC). We aimed to evaluate the diagnostic concordance, predictive performance for 28-day pediatric intensive care unit (PICU) mortality, and phenotypic overlap between these two pediatric sepsis definitions.

METHODS: This single-center retrospective cohort study included 1034 children aged > 1 month to < 18 years with confirmed or suspected infection who were directly admitted to the PICU of Children’s Hospital of Chongqing Medical University between January 1, 2020, and November 21, 2023. All patients were independently evaluated for sepsis using both the 2005 International Pediatric Sepsis Consensus Conference (IPSCC) SIRS criteria and the 2024 PSC. Diagnostic agreement was assessed using the Kappa coefficient. Binary logistic regression was employed to establish association models between factors and phenotypes, as well as between factors and PICU 28-day mortality. Predictive performance was compared using the C-statistic.

RESULTS: Among 1034 patients, 613 (59.3%) met the Sepsis-SIRS criteria with a 28-day PICU mortality of 15.2% (93/613), 744 (72.0%) met the Sepsis-Phoenix criteria with a mortality of 16.3% (121/744), 489 (47.3%) met both criteria with a mortality of 18.6% (91/489), and 166 (16.1%) met neither criterion with a mortality of 2.4% (4/166). Agreement between the two criteria was poor (kappa = 0.202, 95% CI: 0.143-0.261). After adjusting for clinically relevant confounders, the PSC remained a strong independent predictor of 28-day mortality (adjusted OR = 5.123, 95% CI: 2.128-12.333, p < 0.001), whereas the SIRS criteria showed no independent predictive value (adjusted OR = 0.937, 95% CI: 0.523-1.678, p = 0.827). The PSC demonstrated significantly superior discriminatory ability compared with the SIRS criteria (C-statistic = 0.809 vs. 0.589, p < 0.001). Notably, 20.2% of SIRS-positive patients were not classified as sepsis by the Phoenix Criteria, and this subgroup had an extremely low mortality of 1.6%, reflecting higher specificity of the PSC.

CONCLUSIONS: The SIRS and PSC identify partially overlapping populations with distinct risk stratification, showing poor diagnostic concordance. The PSC has superior independent predictive performance for PICU 28-day mortality and may be considered for prognostic assessment of infected children in the PICU setting. Importantly, historical study results based on the SIRS criteria should be extrapolated cautiously to PSC-defined populations.

PMID:42321878 | DOI:10.1186/s13052-026-02298-3

BMC Psychol. 2026 Jun 19. doi: 10.1186/s40359-026-04960-1. Online ahead of print.

ABSTRACT

BACKGROUND: Combat athletes face unique psychological demands, and stress may influence both their cognitive experiences and psychological well-being. This study aimed to examine the mediating role of mental fatigue awareness in the relationship between perceived stress and psychological well-being among combat athletes, thereby contributing to a clearer understanding of a potential cognitive mechanism linking stress to well-being in this population.

METHODS: A total of 303 combat athletes voluntarily participated. Participants completed the Perceived Stress Scale, Mental Fatigue Awareness Scale, and Psychological Well-being Scale. Statistical analyses assessed the direct effects of perceived stress on psychological well-being, the effect of stress on mental fatigue awareness, and the potential mediating role of mental fatigue awareness.

RESULTS: Perceived stress significantly increased mental fatigue awareness (b = 0.732, SE = 0.064, β = 0.549, p = 0.001) and directly decreased psychological well-being (b = – 0.488, SE = 0.166, β = – 0.191, p = 0.004). Mental fatigue awareness negatively affected psychological well-being (b = – 0.374, SE = 0.124, β = – 0.195, p = 0.003) and partially mediated the relationship between stress and well-being (indirect effect: b = – 0.274, SE = 0.115, β = – 0.107, p = 0.003; 95% CI = – 0.504 to – 0.049).

CONCLUSION: Perceived stress was associated with psychological well-being both directly and indirectly through increased mental fatigue awareness. These findings suggest that mental fatigue awareness may represent a relevant cognitive pathway linking stress perceptions to well-being. Accordingly, stress management and strategies aimed at regulating mental fatigue may be considered as potentially beneficial components in efforts to support psychological well-being among combat athletes.

PMID:42321877 | DOI:10.1186/s40359-026-04960-1

BMC Vet Res. 2026 Jun 20. doi: 10.1186/s12917-026-05577-7. Online ahead of print.

ABSTRACT

BACKGROUND: As the threat of antimicrobial resistance (AMR) escalates globally, the influence of indiscriminate antimicrobial use (AMU) in livestock cannot be overlooked. Antimicrobial use practices are continually explored in larger food-producing animals; however, small ruminants (sheep and goats) receive comparatively less research attention. Our study addresses this gap by investigating small ruminant production practices in Nigeria and exploring how they affect the use of antimicrobials and alternatives.

METHODS: We adopted a mixed-methods study design. A semi-structured questionnaire was administered to 785 farmers. Following this, a focus group discussion (FGD) was conducted with 23 small ruminant industry stakeholders, which included farmers, para-veterinarians, and butchers. Participants were split into three round tables, with 7-8 participants per table.

RESULTS: Of questionnaire respondents, 68% of farmers never vaccinated their flock against peste de petits ruminants (PPR) nor contagious caprine pleuropneumonia virus. Several health problems were regularly experienced by animals, including PPR, mastitis, and dermatophilosis. Diseases were mostly self-managed with antibiotics and herbs (> 70%) rather than through reliance on veterinary care (< 15%). More farmers (48%) used antibiotics than herbal remedies (14%) over the previous three months. Farmers’ use of herbs was affected by their having low awareness of available options and how to use them appropriately. Perceived effectiveness also influenced farmers’ choice between antibiotics and herbs, while economic considerations also led them to sell off sick animals before or during treatment. Among farmers who used animal health services, more farmers (59%) consulted unlicensed para-veterinarians and drugstore vendors rather than licensed government and private veterinarians (36%), a disparity attributed to the unavailability of qualified veterinary doctors. Most farmers had poor knowledge (62%), attitudes (47%), and practices (43%) towards AMU and AMR.

CONCLUSIONS: We recommend conducting further studies to identify and investigate the efficacy of currently used herbs in treating common diseases. There is a crucial need to improve farmers’ access to vaccines, veterinary care, and laboratory diagnostics. Barriers that hinder better compliance with regulations that govern the use of non-prescribed antimicrobials should be explored. Awareness programmes could be conducted to improve farmers’ awareness of AMR and appropriate disease preventive practices.

PMID:42321859 | DOI:10.1186/s12917-026-05577-7

Epigenetics Chromatin. 2026 Jun 19. doi: 10.1186/s13072-026-00685-y. Online ahead of print.

ABSTRACT

BACKGROUND: Asthma is a clinically heterogeneous airway disorder characterized by complex interactions between environmental exposures, immune activation, and molecular regulatory programs, whose underlying mechanisms are not fully elucidated by known genetic loci. DNA methylation serves as a mechanistic interface bridging genetic predisposition and environmental influences; however, most epigenetic studies remain confined to isolated CpG sites, lacking robust biological interpretability.

METHODS: We developed a cross-tissue, multi-cohort, and mechanistically interpretable epigenetic framework to delineate pathway-level methylation mechanisms underlying asthma. Leveraging data from 908 participants across one combined training cohort and three independent validation cohorts, we constructed a linear support vector classifier based on pathway-derived methylation scores. Additionally, SHapley Additive exPlanations (SHAP) were applied to quantify the contributions of individual pathways. To assess the statistical significance of pathway contributions, one-sample t-tests were performed for each pathway’s SHAP values against zero, followed by Benjamini-Hochberg false discovery rate (FDR) correction to obtain adjusted p values.

RESULTS: The model exhibited reproducible and cross-tissue performance, achieving area under the curve (AUC) values of 0.792 (95% CI: 0.782-0.799; GSE65163) and 0.980 (95% CI: 0.974-0.990; GSE201872) in two airway epithelial cohorts, and 0.736 (95% CI: 0.690-0.771; GSE104471) in peripheral blood samples. Pathway interpretability analyses identified dominant roles of amino acid metabolism, epithelial and mesodermal developmental programs, metabolic-immune transport pathways, and neuroimmune signalling in shaping asthma-associated methylation patterns. Mediation analyses further revealed that these pathways influence asthma both directly and indirectly via eosinophil activity, epithelial proliferative dynamics, and nitric oxide-linked airway inflammation. Notably, pathways annotated by GO:0061205 and GO:0098727 exerted significant direct effects independent of immune intermediates.

CONCLUSIONS: This study describes a pathway-level methylation model designed for biological interpretability that shows associations with both clinical severity and latent molecular heterogeneity. It provides statistical evidence contributing to the understanding of epigenetic, immune, and metabolic signatures in asthma, offering a potential framework warranting further validation for precision respiratory medicine.

PMID:42321852 | DOI:10.1186/s13072-026-00685-y

Cancer Imaging. 2026 Jun 20. doi: 10.1186/s40644-026-01069-x. Online ahead of print.

ABSTRACT

Hypoxia is associated with poor outcomes in soft tissue sarcoma (STS) and is linked to increased expression of hypoxia-inducible factor 1-alpha (HIF-1α), carbonic anhydrase IX (CAIX), and lysyl hydroxylase 2 (PLOD2). These factors are potential therapeutic targets. This exploratory study aimed to investigate the correlation between ¹⁸F-fluoromisonidazole (¹⁸F-FMISO) positron emission tomography (PET) imaging, a marker of hypoxia, and the expression of these biomarkers in STS. This imaging phase II clinical trial (NCT #03730077) recruited 5 patients with suspected soft tissue sarcoma (STS) and imaged these patients with ¹⁸F-Fluorodeoxyglucose (¹⁸F-FDG) and ¹⁸F-FMISO within 2 weeks of each other. STS tissue was analyzed for HIF-1α, CAIX, and PLOD2 expression using immunohistochemistry and western blotting. Collagen formation was assessed by Masson’s trichrome. In this small sample, a correlation was found between STS size and PLOD2 expression (r = 0.996, P = 0.004). STS grade correlated positively with ¹⁸F-FMISO T/M (tumor/muscle) SUVmax (r = 0.894, P = 0.041). ¹⁸F-FDG correlated positively with ¹⁸F-FMISO SUVmax (r = 0.994, P = 0.006). Positive but non-significant associations were noted between ¹⁸F-FMISO T/M SUVmax and CAIX (r = 0.95, P > 0.05) and PLOD2 (r = 0.93, P > 0.05). These preliminary observations in a small sample are hypothesis-generating at best and must be interpreted with substantial caution due to the extremely limited number of patients, which precludes robust statistical inference and generalizability. No definitive conclusions can be drawn regarding the relationship between 18F-FMISO uptake and hypoxia biomarker expression. Larger, adequately powered prospective studies are essential to validate these findings, clarify potential correlations, and determine the clinical utility of 18F-FMISO PET/CT as a noninvasive hypoxia biomarker in STS.

PMID:42321847 | DOI:10.1186/s40644-026-01069-x

Head Face Med. 2026 Jun 19. doi: 10.1186/s13005-026-00630-0. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the in vitro effects of commercially available teething gels with different formulations on epithelial barrier integrity and cellular viability.

MATERIALS AND METHODS: Six commercially available teething gels were tested at concentrations of 0.1%, 20%, 50%, and 80%. Cellular viability was assessed using the MTT assay in human gingival mesenchymal stem cells after 72 h of exposure. Epithelial barrier integrity was evaluated by measuring transepithelial electrical resistance (TEER) in HaCaT keratinocyte cells cultured on transwell inserts at 24, 48, and 72 h. Statistical analyses were performed using IBM SPSS Statistics 27, applying mixed-design and two-way ANOVA with appropriate post hoc tests, with significance set at p < 0.05.

RESULTS: TEER values differed significantly according to gel type, concentration, and exposure time (p < 0.05). At 0.1%, significant intergroup differences were observed at 24 h (p = 0.001) and 72 h (p = 0.017), with Dentinox showing significantly lower TEER values than Gengigel, Aftamed, Buccotherm, and Jack N’Jill. At 20%, 50%, and 80% concentrations, Dentinox consistently exhibited reduced TEER levels at 24-72 h (p = 0.001), whereas Gengigel showed higher TEER values mainly at 24 h (20%) and 72 h (50%), and Buccotherm at 48 h across higher concentrations. MTT analysis revealed significant gel- and concentration-dependent differences at 20%, 50%, and 80% (p = 0.001). Jack N’Jill exhibited higher cell viability at 20%, while both Jack N’Jill and Buccotherm showed higher viability at 50% and 80%.

CONCLUSIONS: Teething gels exert formulation, concentration, and time-dependent effects on epithelial barrier integrity and cellular viability, emphasizing the need for careful evaluation of products intended for infant use.

CLINICAL RELEVANCE: This study demonstrates that teething gels with different formulations and concentrations can differentially affect epithelial barrier integrity and cellular viability. These findings highlight the clinical importance of carefully evaluating teething gel composition and concentration, particularly for products intended for use in infants and young children.

PMID:42321842 | DOI:10.1186/s13005-026-00630-0

Harm Reduct J. 2026 Jun 20. doi: 10.1186/s12954-026-01479-x. Online ahead of print.

ABSTRACT

BACKGROUND: People who inject drugs (PWID) are at increased risk of infective endocarditis (IE). While opioid injection is a major risk factor for IE, the risk associated with specific prescription opioids, such as hydromorphone, remains unclear and is inconsistently reported, despite a hypothesized pathway whereby the insolubility of controlled-releaseformulations may promote injection equipment reuse and bacterial contamination. Therefore, we estimated and compared the 1-year incidence rates of IE among PWID reporting injection of hydromorphone versus non-hydromorphone opioid medications and versus other opioids/drugs.

METHODS: Baseline questionnaire data on PWID in the Ontario Integrated Supervised Injection Services cohort (November 2018-March 2020) were linked to health administrative databases. IE incidence was calculated over 1-year post-baseline. Participants were followed until first of IE, death, or 1-year censoring. Exposure was self-reported recent (past 6 months) injection of: hydromorphone, non-hydromorphone opioid medications of interest, or other opioids/drugs. Cox regression estimated associations, adjusting for age, gender, ethnicity, injection drug use, and prior injection-related infections.

RESULTS: Among the 514 participants included, 191 reported recent injection of hydromorphone, 32 non-hydromorphone opioid medications of interest, and 291 other opioids/drugs. IE incidence rates were low across groups: 1.6, 3.3, and 1.8 per 100 person-years. Adjusted hazard ratio comparing recent hydromorphone injection versus non-hydromorphone opioid medications of interest was 0.64 (95% confidence interval (CI) 0.06-6.53); versus other opioids/drugs was 0.82 (95% CI 0.19-3.51).

CONCLUSIONS: In this cohort of PWID, no clear association was found between hydromorphone injection and IE when compared to non-hydromorphone opioid medications or to other opioids/drugs. Due to low event rates and the resulting wide CIs, the findings are limited by low statistical precision. Further research with larger cohorts is warranted to quantify IE risk of specific injected drugs among PWID.

PMID:42321840 | DOI:10.1186/s12954-026-01479-x

Reprod Health. 2026 Jun 20. doi: 10.1186/s12978-026-02386-x. Online ahead of print.

ABSTRACT

BACKGROUND: Home delivery continues to be a significant factor contributing to maternal mortality in Africa, particularly among rural women with limited access to skilled birth attendants and healthcare facilities. Factors influencing home delivery operate at individual, household, and community levels. Therefore, this study aimed to examine the prevalence and risk factors of home delivery among rural women in 28 African countries.

METHODS: This retrospective cross-sectional study analyzed the most recent Demographic and Health Surveys (2011-2024) from 28 African countries. The weighted sample included 103,011 rural women of reproductive age. We performed descriptive analysis, chi-square tests, and binary logistic regression. Results are presented as frequencies, percentages, and odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was set at p < 0.05.

RESULTS: The overall prevalence of home delivery among rural women in Africa was 34.01% [95% CI: 23.33%-35.26%], ranging from 5.91% in Rwanda to 85.19% in Chad. Women with mistimed pregnancy [aOR = 0.79, 95% CI = 0.76-0.82] and those with unwanted pregnancy [aOR = 0.86, 95% CI = 0.81-0.92] had lower odds of home delivery. Risk factors included having four or more births [aOR = 2.04, 95% CI = 1.91-2.17], no/other religion [aOR = 2.41, 95% CI = 2.24-2.56] and those in Central Africa [aOR = 2.09, 95% CI = 1.98-2.19].

CONCLUSION: This research reveals that home delivery remains prevalent among rural women in Africa, with significant between-country disparities. Key risk factors include high parity, no/other religion, and Central African residence. Programs should prioritize multiparous women and expand maternal health services across all religious groups. Additionally, context-specific policies and targeted investments are needed in Central Africa to address regional disparities.

PMID:42321838 | DOI:10.1186/s12978-026-02386-x

J Cardiothorac Surg. 2026 Jun 19. doi: 10.1186/s13019-026-04476-0. Online ahead of print.

ABSTRACT

BACKGROUND: Pectus excavatum (PE) is commonly associated with spinal abnormalities. However, the effect of the Nuss procedure on thoracic scoliosis remains unclear. This study therefore aimed to characterize the dynamic changes in the thoracic Cobb angle (tCA) among adult PE patients undergoing Nuss procedure.

METHODS: A total of 186 Patients with PE who underwent the Nuss procedure and subsequent bar removal (BR) were retrospectively analyzed. Clinical data were collected, including serial tCA measurements from posteroanterior chest radiographs taken preoperatively, at 1 month, 3-6 months, and 1 year postoperatively, as well as 1 day before and 1 week after BR for analysis. Subgroups were stratified by sex, Haller index (≥ 4 vs. <4), bar number (1-3), bar orientation (oblique vs. horizontal), bar flipping within 3 months, and preoperative tCA (≥ 10° vs. <10°).

RESULTS: Compared to the preoperative mean tCA, the tCA increased significantly at 1 month postoperatively (5.4 ± 4.2° vs. 5.9 ± 4.4°, p < 0.001). It then decreased significantly by 1 day before BR (5.4 ± 4.2° vs. 4.9 ± 3.9°, p < 0.001) and further at 1 week after BR (5.4 ± 4.2° vs. 4.4 ± 4.0°, p < 0.001). All subgroup analyses demonstrated a significant reduction in the tCA following BR.

CONCLUSIONS: The Nuss procedure induced a temporary increase in tCA at 1 month postoperatively, followed by gradual improvement during the bar maintenance period and a net reduction below the preoperative level after bar removal. Notably, patients with mild thoracic scoliosis also experienced a reduction in tCA after complete PE correction. While this reduction was not clinically meaningful, it still indicates that the procedure does not worsen thoracic spinal alignment and may offer some improvement.

PMID:42321835 | DOI:10.1186/s13019-026-04476-0