Tag: nevin manimala

Sci Rep. 2026 Feb 15. doi: 10.1038/s41598-026-37791-6. Online ahead of print.

ABSTRACT

The purpose of this study was to evaluate the predictive value of monocyte-to-lymphocyte ratio (MLR) on the short-term (28 days) and long-term (365 days) mortality risk in patients with acute pancreatitis (AP) using multiple statistical and machine learning (ML) models. Studies selected 1,044 eligible AP patients from the MIMIC-IV database and divided them into four groups based on their MLR values (MLR<0.32; 0.32 ≤ MLR<0.57; 0.57 ≤ MLR<1; MLR ≥ 1). Findings revealed that MLR demonstrated a U-shaped relationship with patient mortality risk, with the minimal mortality risk occurring at an MLR of approximately 0.57. Cox regression model analysis showed that after adjusting for multiple parameters, MLR was still significantly associated with the risk of death. Moreover, ML model analysis identified that MLR has potential value in predicting AP patient outcomes. This study suggests that MLR can be used as a potential indicator to assess prognostic risk in critically ill patients with AP to support clinical decision-making.

PMID:41692893 | DOI:10.1038/s41598-026-37791-6

Commun Biol. 2026 Feb 16. doi: 10.1038/s42003-026-09715-7. Online ahead of print.

ABSTRACT

Our thoughts fluctuate dynamically, driven either by external stimuli and tasks (on-task thoughts) or drifting to task-unrelated contents (off-task thoughts or mind wandering). Although research has identified neural markers distinguishing different thought types, the temporal signature (dynamics) of on- and off-task thoughts remains poorly understood. This EEG study investigated different neurodynamical features-autocorrelation window (ACW), Lempel-Ziv complexity (LZC), power-law exponent (PLE), and median frequency (MF)-to differentiate these thoughts in their underlying dynamics during a signal-response task. Off-task thoughts exhibited prolonged ACW, reduced LZC, increased PLE, and smaller MF compared to on-task thoughts, establishing a distinct neurodynamic signature. Through statistical modeling, we identified a hierarchical background-foreground structure among these measures that unfolds along a temporal continuum, transitioning from longer block-level (17-second) to shorter trial-level (3-second) timescale. Notably, the longer background (block-level ACW) and shorter foreground (trial-level ACW and LZC) layers are tightly coupled during the “faster and shorter” on-task thoughts whereas they are more loosely related during “slower and longer” off-task thoughts. These findings, replicated in an independent dataset, demonstrate how the organization of our brain’s dynamics, along a temporal continuum of longer background durations to shorter foreground durations, shapes on-task and off-task thoughts thereby yielding their distinct signatures.

PMID:41692886 | DOI:10.1038/s42003-026-09715-7

J Robot Surg. 2026 Feb 16;20(1):255. doi: 10.1007/s11701-026-03228-5.

ABSTRACT

The objective of this study was to evaluate the efficacy of an integrated whole-process nursing approach grounded in smart healthcare principles for perioperative care in patients undergoing Mako robot-assisted total knee arthroplasty (RA-TKA), thereby proposing an innovative nursing protocol for clinical use. A total of 445 patients who received Mako robot-assisted TKA between January 2022 and May 2025 were retrospectively analyzed. Participants were divided into two groups: a control group received conventional nursing interventions and an observation group received the smart healthcare-based whole-process nursing model. Outcome variables compared between the groups included postoperative pain levels, hematological indices (erythrocyte sedimentation rate [ESR], albumin, hemoglobin, and D-dimer), Hospital for Special Surgery (HSS) scores, length of stay (LOS), and complication rates. Results indicated that, compared to the control group, the observation group exhibited significantly improved postoperative hemoglobin and albumin concentrations (P < 0.01), along with notably lower pain scores, D-dimer levels, and complication incidences (P < 0.01). Additionally, significant enhancements in knee joint function scores were observed following implementation of the smart healthcare-based nursing model (P < 0.001 or P < 0.05). Thus, applying a whole-process nursing model integrated with smart healthcare effectively mitigates hemoglobin depletion, reduces postoperative pain, decreases D-dimer elevation, shortens hospital stays, enhances knee functionality, and lowers the rate of complications, demonstrating substantial clinical value and potential for broader implementation.

PMID:41692876 | DOI:10.1007/s11701-026-03228-5

J Robot Surg. 2026 Feb 16;20(1):256. doi: 10.1007/s11701-026-03218-7.

ABSTRACT

Uniportal video-assisted thoracoscopic surgery (uVATS) is an established minimally invasive approach for lung cancer. Uniportal robotic-assisted thoracoscopic surgery (uRATS) is a recent innovation integrating robotic technology with single-incision access. Comparative data between these techniques remain scarce. We retrospectively analyzed patients who underwent anatomic pulmonary resection via uVATS or uRATS at Chang Gung Memorial Hospital between July 2023 and July 2025. Propensity score matching (1:1) was applied using key baseline variables. Perioperative outcomes and cost-effectiveness were assessed. A total of 356 patients (251 uVATS, 105 uRATS) were included; 98 matched pairs were analyzed. Operative time was longer with uRATS (median 179.50 vs. 117.00 min, p < 0.001). uRATS was associated with shorter hospital stay (2.70 vs. 3.00 days, p < 0.001), reduced chest drainage duration (1.45vs. 2.00 days, p < 0.001), and lower postoperative day 1 pain scores (p = 0.04). Median N1 and N2 lymph node counts were similar in uRATS and uVATS. Postoperative complication rates did not differ significantly between groups (2.04% vs. 9.18%, p = 0.06). Cost analyses quantified the incremental costs associated with short-term recovery benefits of uRATS. uRATS was associated with modest, short-term differences in selected early postoperative recovery parameters compared with uVATS, accompanied by longer operative time and higher cost. Oncologic surrogate outcomes were comparable between groups, while definitive conclusions regarding long-term oncologic and economic benefits require confirmation in larger, multicenter studies with extended follow-up.

PMID:41692862 | DOI:10.1007/s11701-026-03218-7

Support Care Cancer. 2026 Feb 16;34(3):206. doi: 10.1007/s00520-026-10434-2.

ABSTRACT

PURPOSE: Allogenic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for hematological disorders but often results in micronutrients deficiency and complications. Vitamin C, a potent antioxidant, may improve endothelial function, tissue protection, and immune recovery. This study evaluated the effects of early high-dose vitamin C supplementation on plasma vitamin C levels and post-HSCT complications.

METHODS: In this pilot, triple-blind, placebo-controlled trial, 31 adult allo-HSCT patients were randomized to receive intravenous vitamin C (50 mg/kg/day) or placebo from day + 1 to + 14, followed by oral vitamin C (500 mg/day) or placebo until day + 100. Plasma vitamin C levels were measured at days 0, + 7, + 15, and discharge. Patients were monitored for post-HSCT complications until day + 100.

RESULTS: Plasma vitamin C levels were significantly higher in the vitamin C group at all time points (P < 0.001). Trends toward reduced acute graft-versus-host disease (33% vs. 44%), lower oral mucositis severity (46.6% vs. 62.5%), and shorter duration (7.5 ± 3.6 vs. 9.1 ± 3.7 days) were observed, though not statistically significant. No significant adverse events were reported.

CONCLUSION: High-dose vitamin C effectively corrected plasma levels, and while trends toward reduced complications were observed in allo-HSCT patients, larger trials are needed to confirm these findings.

PMID:41692856 | DOI:10.1007/s00520-026-10434-2

Diabetologia. 2026 Feb 16. doi: 10.1007/s00125-026-06675-9. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: Type 1 diabetes develops gradually, and previous exposures may influence incidence. We aimed to assess the geographical variation in type 1 diabetes incidence in Sweden by considering all residential locations from birth to diagnosis in individuals aged 0-30 years, diagnosed between 2005 and 2022. Significant high- and low-risk clusters were identified for different life stage exposure windows.

METHODS: In 21,774 individuals with type 1 diabetes, all residential geographical locations from birth to diagnosis were geocoded. Geostatistical analysis of the incidence of type 1 diabetes was conducted at the municipality level using the most common residential location during four life stage-specific exposure windows (at diagnosis, the first 5 years after birth, 5 years prior to diagnosis, and from birth to diagnosis). Spatial scan statistics were used to identify statistically significant high- and low-risk clusters for each window. Land use and land cover within these clusters were also characterised.

RESULTS: Significant geographical variation in the incidence of type 1 diabetes was observed. The incidence was consistently higher in rural, low-population-density areas, particularly in central Sweden, and lower in major urban areas. The largest number of spatial clusters of both high risk (RR 1.29-16.0) and low risk (RR 0.32-0.73) was identified when using the most common residential location during the first 5 years after birth. High-risk clusters for this exposure window were characterised by forested and agricultural land, while low-risk clusters were characterised by urban land and open land other than agricultural land.

CONCLUSIONS/INTERPRETATION: Our findings suggest that the development of type 1 diabetes in Sweden varies geographically and is associated with specific features of the local surroundings in early childhood. This is important knowledge as a basis for identifying possible environmental risk factors and the relationship with risk of type 1 diabetes in future studies.

PMID:41692841 | DOI:10.1007/s00125-026-06675-9

Sci Rep. 2026 Feb 15. doi: 10.1038/s41598-026-40365-1. Online ahead of print.

ABSTRACT

Fathers’ involvement in child feeding positively influences feeding practices and child nutrition. Inadequate feeding practices are a major contributor to preventable childhood illnesses and mortality. Although fathers’ participation is important, evidence on the level and factors associated with their involvement in the study area is limited. This study aimed to assess the magnitude of fathers’ involvement in child feeding and associated factors among fathers of children aged 6-24 months in Chena district, Kaffa zone, Southwest Ethiopia, 2025. A community-based cross-sectional study was conducted from February 1 to June 20, 2025, among 622 fathers of children aged 6-24 months, selected using systematic random sampling. Data were collected via structured, pretested questionnaires, coded, entered into EpiData v4.6, and analyzed using SPSS v27. Variables with p < 0.25 in bivariable analysis were included in multivariable logistic regression. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and p < 0.05 was considered statistically significant. Of the 622 fathers, 259 (41.6%) were involved in child feeding. Factors positively associated with involvement included college education or above (AOR = 4.41, 95% CI: 1.67-11.66), good knowledge of child feeding (AOR = 2.84, 95% CI: 1.78-4.51), positive attitude (AOR = 2.10, 95% CI: 1.34-3.28), and good cultural beliefs regarding child feeding (AOR = 2.22, 95% CI: 1.40-3.51). Fathers whose workplaces were far from home and who were mostly absent at night were less likely to be involved (AOR = 0.44, 95% CI: 0.22-0.90). Fathers’ involvement in child feeding in Chena district is low. Educational status, workplace proximity, knowledge, attitude, and cultural beliefs significantly influence fathers’ engagement. Interventions promoting father participation should address these factors to improve child feeding practices.

PMID:41692827 | DOI:10.1038/s41598-026-40365-1

Sci Rep. 2026 Feb 15. doi: 10.1038/s41598-026-40155-9. Online ahead of print.

ABSTRACT

This paper presents a study of pitch (F0) and duration related features of transition and non-transition regions of speech, carried out to better understand and characterize speech recorded from stroke patients. A speech corpus consisting of read speech as well as five sustained vowels, recorded from 50 stroke patients and 50 healthy speakers in a clinical environment, was developed for this purpose. A gender specific statistical analysis of F0 contour showed that median F0 of an utterance shows consistent trend in distinguishing utterances from the stroke patients and healthy control speakers across all vowel categories. The utterances from female speakers of the stroke study group tended to have a lower F0 median in comparison with that of the healthy control group. In contrast, male speakers in the stroke study group exhibited a higher F0 median compared to the control group. The durations of the transition and non-transition (steady state) regions in the utterances were estimated by an analysis of the gradient of cepstral coefficient vector as a function of frame index. The male and female speakers of the stroke study group showed shorter transition regions with higher relative transition areas as compared to those of the healthy control group. In contrast, the non-transition (steady state) regions tend to show longer duration in the stroke study group. The observed statistical trends in the F0 and duration analysis were validated using one-way ANOVA tests.

PMID:41692813 | DOI:10.1038/s41598-026-40155-9

Ann Gen Psychiatry. 2026 Feb 15. doi: 10.1186/s12991-026-00640-x. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment discontinuation remains a major challenge for patients with schizophrenia, often resulting in relapse and subsequent rehospitalization. While treatment persistence is a practical marker of real-world effectiveness, findings related to lurasidone continuation in clinical settings in Japan are limited.

METHODS: For this retrospective observational study, the records of 62 patients with schizophrenia who had lurasidone treatment initiated at Aichi Medical University Hospital between June 2020 and December 2024 were analyzed. Treatment persistence was defined as continuation of lurasidone for ≥ 180 days. Associations of baseline characteristics, including illness duration, prior antipsychotic class (serotonin-dopamine antagonist, SDA; dopamine partial agonist, DPA; multi-acting receptor-targeted antipsychotic, MARTA), and other clinical variables, with six-month persistence were analyzed using Kaplan-Meier survival analysis and log-rank testing.

RESULTS: The six-month treatment persistence rate was 54.8%. Patients with illness duration < 5 years showed a significantly greater rate of persistence (71.4%) as compared to those with a longer duration (46.3%) (P = 0.046). Persistence also varied based on prior antipsychotic class, with the rate 76.5% for SDA, 50.0% for DPA, and 35.0% for MARTA (P = 0.045). No statistically significant differences in six-month persistence were observed across sex, treatment setting, or lurasidone dose range.

CONCLUSIONS: This is the first known study to evaluate real-world lurasidone persistence in patients in Japan. The findings indicate that both pharmacodynamic compatibility and early-phase treatment can enhance persistence. The insights obtained underscore the importance of individualized treatment planning, though require further validation by use of prospective, multi-center studies.

PMID:41692791 | DOI:10.1186/s12991-026-00640-x

Eur J Med Res. 2026 Feb 15. doi: 10.1186/s40001-026-04014-7. Online ahead of print.

ABSTRACT

BACKGROUND: The American Heart Association (AHA) recently proposed the cardiovascular-kidney-metabolic (CKM) syndrome to unify cardiovascular, renal, and metabolic dysfunctions into a single framework. However, the relationship between the Dietary Inflammatory Index (DII) and CKM progression remains unclear. Leveraging data from the National Health and Nutrition Examination Survey (NHANES), this study investigated the dose-response relationship and potential heterogeneity between DII and CKM stages.

METHODS: A total of 15,335 participants from the 2005-2018 NHANES cycles were included. CKM stages (0-4) were categorized following the AHA 2023 framework. DII scores were computed, and their associations with CKM stages were assessed using multivariable logistic regression, considering both continuous and quartile-based (Q1-Q4) DII measures. Restricted cubic spline (RCS) analysis was applied to explore nonlinear relationships, and subgroup analyses were conducted for sensitivity.

RESULTS: In multivariable logistic regression analyses, higher DII was robustly associated with CKM progression in a dose-response manner. For each one-unit increase in the continuous DII, the odds of being in Stage 4 were 31% higher (OR = 1.31; 95% CI 1.04-1.65). In quartile analysis, the highest DII quartile (Q4) was associated with a 4.18-fold higher odds of Stage 4 compared to Q1 (OR = 4.18; 95% CI 1.65-10.6). RCS analysis showed a linear association between DII and CKM Stages 1, 2, and 4, whereas Stage 3 exhibited slightly reduced odds when DII > 1.5. Subgroup analyses indicated that higher DII was consistently linked with more severe CKM stages across most demographic and lifestyle factors.

CONCLUSIONS: Elevated DII scores substantially increase the risk of advanced CKM stages, with potential threshold effects. Behavioral factors (e.g., smoking and alcohol intake) and socioeconomic status may modify the DII-CKM relationship.

PMID:41692773 | DOI:10.1186/s40001-026-04014-7