Nevin Manimala

Women Birth. 2026 Feb 26;39(2):102184. doi: 10.1016/j.wombi.2026.102184. Online ahead of print.

ABSTRACT

PROBLEM: Despite evidence supporting benefits of upright and flexible sacral positions during labour, most women continue to birth in supine positions.

BACKGROUND: Historically, women have laboured and birthed in positions that optimise gravity, encouraging physiological birth. However, many women birth in supine positions, even though upright positions are associated with shorter duration of second stage and favourable outcomes.

AIM: To observe the proportion of time nulliparous women spent in upright and supine positions during the active second stage of labour, and to explore associations with birth outcomes.

METHODS: This prospective observational study included term nulliparous women who were planning a vaginal birth. Midwives recorded commencement of, and all position changes during second stage. Data were analysed using descriptive statistics and regression modelling.

FINDINGS: Of 330 participants, 216 (65%) birthed physiologically, 114 (35%) had an instrumental birth. Women who birthed physiological more frequently adopted all-fours position or used a birth stool, whereas those who had an instrumental birth were more often in semi-recumbent or lithotomy positions. For every 10% increase in time spent in upright positions during the active second stage, the likelihood of physiological birth increased by 26%. Conversely, each 10% increase in time spent in a supine position there was a 30% increased likelihood of instrumental birth.

DISCUSSION: Findings indicate a clear association between upright positioning during the active second stage of labour and increased rates of physiological birth.

CONCLUSION: Nulliparous women may benefit from being actively supported to adopt upright positions during the second stage of labour.

PMID:41762541 | DOI:10.1016/j.wombi.2026.102184

Cancer Epidemiol. 2026 Feb 26;102:103030. doi: 10.1016/j.canep.2026.103030. Online ahead of print.

ABSTRACT

BACKGROUND: Timely treatment is a vital component of high-quality cancer care. We compared a national purpose-specific dataset of cancer waiting times (CWT) with routinely collected hospital datasets (‘comparator datasets’) as sources of data on the timeliness of kidney cancer treatment in England.

METHODS: 11,937 patients diagnosed with kidney cancer between 1st July 2022 and 31st December 2023 were included, using national linked cancer registry and CWT records. The primary analysis compared CWT records and those in comparator datasets (Hospital Episode Statistics, Systemic Anti-Cancer Therapy, and Radiotherapy datasets) in terms of the number, percentage, and timing of patients receiving treatment. Using CWT records, a secondary analysis assessed the effects of the ‘waiting time adjustment policy’ to account for patient treatment deferral on distributions of waiting times at patient and provider levels.

RESULTS: 6971 patients were identified as having received treatment (within 100 days of decision-to-treat) according to either CWT or comparator datasets. Of these patients, 6434 (92.3%) had treatment according to both CWT and comparator datasets, with 5836 patients (90.7% of 6434) identified as receiving treatment on the same day across both dataset groups, demonstrating strong agreement. Using the waiting time adjustment policy, the mean number of days to treatment decreased from 29.2 to 27.3 days at the patient-level and from 24.3 to 22.6 days at the provider-level.

CONCLUSION: This study demonstrates strong agreement in treatment records from a national, purpose-specific, and comparator datasets. Strengths of both data sources can be harnessed in linked data to evaluate treatment timeliness, enabling more detailed assessments of specific treatments and better definition of the start of treatment pathways.

PMID:41762537 | DOI:10.1016/j.canep.2026.103030

Cancer Epidemiol. 2026 Feb 26;102:103016. doi: 10.1016/j.canep.2026.103016. Online ahead of print.

ABSTRACT

BACKGROUND: The target trial emulation (TTE) framework, proposed by Hernán and Robins, uses observational data to emulate a randomized controlled trial (RCT). TTEs are increasingly being applied in oncology research. This scoping review aims to describe the characteristics of oncology TTEs, evaluate their adherence to the TTE framework, and assess the concordance of results between TTEs and corresponding RCTs.

METHODS: A comprehensive search was conducted in MEDLINE and Embase from inception to December 25th 2025. Only oncology TTEs evaluating treatment interventions were eligible. Data was extracted on study characteristics, adherence to the TTE framework, reported cohort characteristics, the concordance of TTEs emulating specific RCTs using Cohen’s Kappa coefficient, and the correlation of Ln hazard ratio (HR) using Pearson’s correlation coefficient.

RESULTS: A total of 94 studies were identified, representing 106 unique TTEs. All TTEs reported on the treatment strategies, outcomes measured, and data analysis plan, while only 75.5 % presented a clearly defined time zero. In addition, only 20.8 % of TTEs reported on patient performance status, for the purpose of adjusting confounders. Additionally, among the 20 TTEs that explicitly emulated a published RCT, there was poor to fair concordance (Cohen’s Kappa = 0.20) between the reported results of the statistical hypothesis testing of survival outcomes between the respective TTE and corresponding RCT. The Pearson’s correlation coefficient between Ln HRs of TTE and RCT was 0.44.

CONCLUSION: The TTE framework adoption and adherence in oncology has been substantial. However, the poor to fair agreement between corresponding TTEs and RCTs demonstrates the potential caveats of using TTEs as a replacement for RCTs in the evaluation of treatment efficacy, notwithstanding atypical scenarios where RCTS may not be feasible. One potential source of residual bias may be the lack of adjustments based on patient performance status. Significant gaps in reporting of critical oncology endpoints pose further challenges. Future research should continue to standardize reporting guidelines, specifically aligning with the recently published TARGET framework, to improve the utilization of TTEs in oncology.

PMID:41762536 | DOI:10.1016/j.canep.2026.103016

J Environ Manage. 2026 Feb 26;402:129141. doi: 10.1016/j.jenvman.2026.129141. Online ahead of print.

ABSTRACT

Phosphorus (P) limitation constrains ecological restoration in arid limestone mine regions, where inorganic P is predominantly present in recalcitrant forms. We examined whether soil amendments and drought-tolerant shrub species are associated with shifts in inorganic phosphorus (IP) fractions through modifications of soil properties and microbial community structure during early-stage restoration. A field experiment combining four substrate amendment strategies and seven drought-tolerant shrub species was conducted under microsite-based planting conditions in degraded calcareous soils. Our results demonstrate that organic amendments increased available P by 10.73% relative to the control and were associated with higher soil water content (SWC) and microbial biomass. Partial least squares structural equation modeling (PLS-SEM) revealed that SWC was positively associated with labile P (LP), whereas microbial biomass indicators showed statistical associations with recalcitrant P (RP) pools. Microbial community analyses revealed that Actinobacteriota and Bacteroidota were significantly correlated with LP and RP fractions, while Proteobacteria were linked to moderate-cycling P (MP), suggesting potential functional differentiation among microbial groups. We therefore propose a conceptual framework of “functional specialization-dynamic equilibrium”, in which soil physicochemical conditions and microbial community composition jointly influence IP distribution patterns at the microsite scale. These findings highlight how localized amendment strategies and shrub selection may contribute to improving P availability during early restoration stages, while longer-term and multi-season validation is required to assess temporal stability and field-scale generalizability.

PMID:41762507 | DOI:10.1016/j.jenvman.2026.129141

Radiography (Lond). 2026 Feb 26;32(3):103363. doi: 10.1016/j.radi.2026.103363. Online ahead of print.

ABSTRACT

INTRODUCTION: Selecting a college major is a critical decision with long-term implications. While personality assessments like the Myers-Briggs Type Indicator (MBTI) explore person-career fit, radiographers’ personality profiles and their relationship with professional quality of life remain uninvestigated. This study aims to identify predominant MBTI types among radiographers and examine their correlation with career satisfaction facets, including compassion satisfaction, burnout, and secondary traumatic stress.

METHODS: Cross-sectional, quantitative study was conducted among radiographers in public healthcare setups in Bahrain. Participants (n = 98) completed an online MBTI assessment and a survey comprising demographic questions and the Professional Quality of Life Scale (ProQOL). Data were analyzed for descriptive statistics and one-way ANOVA.

RESULTS: The most prevalent personality types were ESTJ (21.1 %) and ESFJ (18.4 %), with the Sentinel (SJ) temperament group comprising 50 % of the sample. The sample was characterized by preferences for Extraversion (60.5 %), Sensing (63 %), Feeling (63.2 %), and Judging (76.3 %). No statistically significant relationships were found between the 16 MBTI types and the ProQOL subscales of Compassion Satisfaction, Burnout or Secondary Traumatic Stress.

CONCLUSION: A distinct MBTI profile is prevalent among radiographers, yet no significant association with ProQOL-measured career satisfaction was found. This suggests satisfaction is influenced by factors beyond personality. The findings provide a foundational typology and call for longitudinal studies on the personality-profession interplay.

IMPLICATIONS FOR PRACTICE: The common profile (ESTJ/ESFJ) does not predict job satisfaction, refining recruitment into a guide rather than a filter. This informs tailored education and career mentoring, enhancing support for all profession members beyond typological constraints.

PMID:41762474 | DOI:10.1016/j.radi.2026.103363

J Hazard Mater. 2026 Feb 22;506:141575. doi: 10.1016/j.jhazmat.2026.141575. Online ahead of print.

ABSTRACT

The impacts of microplastics (MPs) are becoming increasingly concerning. Although many ecotoxicological studies have examined potential effects of MPs on organisms, most have tested only a limited range of pristine plastic types, which do not reflect the properties of environmentally conditioned plastics. This limits the extent to which the results can be applied to real-world situations. Additionally, understanding the ecological impact of MPs requires studies that begin at the lower levels of the food web. In freshwater ecosystems, unicellular ciliophora are a key part of these trophic levels. Studying the effects of MPs on this group is essential for understanding their overall impact on the ecosystem. This study aimed to address both issues by examining MP uptake and the impact of environmentally conditioned MPs on the ciliophora Paramecium caudatum. A 72-hour exposure was conducted using six petroleum-based (PB-) and four biodegradable bio-based (BB-) MP types at three concentrations, albeit higher than those found in the environment, along with three types of particle controls. All particles were incubated in ultrapure and freshwater to compare the effects of pristine versus environmentally conditioned MPs. Verification of particle uptake was performed with µ-Raman spectroscopy, confirming particle uptake without the need for fluorescent dyes, except for two control particles. The exposure experiments showed increased reproduction in all treatments with BB-MPs and control particles, except for one, whereas results for PB-MPs were inconsistent. No significant differences were observed between different particle incubation conditions. Our findings indicate that MP effects depend on plastic type, regardless of environmental conditioning, and that uptake by P. caudatum alters the Raman spectra of BB-MPs and PET particles.

PMID:41762458 | DOI:10.1016/j.jhazmat.2026.141575

Accid Anal Prev. 2026 Feb 26;230:108477. doi: 10.1016/j.aap.2026.108477. Online ahead of print.

ABSTRACT

BACKGROUND: Graduated drivers licensing (GDL) programs are being simplified across Canada. In April 2023, Alberta removed advanced road testing for full (Class 5) licenses and lifted previous restrictions on alcohol use, nighttime driving, and passengers for learners (Class 7). As of June 25, 2023, ∼700,000 drivers gained full licensure without advanced testing. New Alberta drivers are younger, less restricted, and have higher motor vehicle collision (MVC) rates than other provinces.

MATERIALS & METHODS: We used interrupted time series analysis with publicly available data from January 2022 to January 2025. Negative binomial regression was used to estimate immediate and longer-term effects of the policy change on emergency department (ED) visits due to MVCs, adjusting for age, gender, and seasonality, with subgroup analyses by road user type.

RESULTS: Following the changes to GDL programming, drivers and passengers experienced modest increases in visit rates immediately after the intervention (driver IRR: 1.05, 95% CI: 1.00-1.11; passenger IRR: 1.11, 95% CI: 1.02-1.21). Motorcycle drivers showed larger increases, though estimates for motorcycle passengers were imprecise due to small sample size (motorcycle driver IRR: 1.40, 95% CI: 1.09-1.78; motorcycle passenger IRR: 1.49, 95% CI: 0.81-2.73).

DISCUSSION: Removing GDL restrictions in Alberta led to immediate increases in MVC-related ED visits, particularly among motorcycle users, younger age groups, and males. Minimal ongoing trends suggest the effects were largely immediate and no statistically significant lasting impacts are noted. These findings highlight potential safety risks from relaxing licensing restrictions and the need for targeted interventions for high-risk groups as other provinces consider similar policy changes.

PMID:41762447 | DOI:10.1016/j.aap.2026.108477

Accid Anal Prev. 2026 Feb 26;230:108479. doi: 10.1016/j.aap.2026.108479. Online ahead of print.

ABSTRACT

Road traffic safety assessment is critical for mitigating traffic accidents, safeguarding human life and property, and fostering socioeconomic development. Existing methods, which rely on the statistical analysis of historical traffic accidents and conflicts as well as the evaluation of road design parameters, play a pivotal role in assessing road traffic safety. Driving visibility acts as a critical indicator of the driver’s field of view and serves as a significant supplement to these methods. Consequently, this study proposes a method for quantifying 3D driving visibility utilizing LiDAR point cloud data. The approach establishes a computational framework for 3D visible space from the driver’s perspective and introduces a novel Driving Visibility Index (DVI) to enable visibility-based safety evaluation. The proposed method consists of three primary components: road point cloud acquisition and preprocessing, driving visibility field computation, and DVI computation. We validated the proposed method along Yixian Avenue at Sun Yat-sen University’s Zhuhai Campus, generating a driving safety map. The results revealed that the overall DVI for bidirectional travel on Yixian Avenue ranges from 0.2 to 0.6, indicating suboptimal safety conditions. Further comparative analysis with field-collected data subsequently confirmed the robustness of our proposed method. The proposed method’s objective and intuitive quantification of 3D visible space from the driver’s perspective provides a novel basis for traffic management, with significant applications spanning road design, traffic facility layout, and the validation of intelligent transportation networks.

PMID:41762446 | DOI:10.1016/j.aap.2026.108479

Probiotics Antimicrob Proteins. 2026 Feb 28. doi: 10.1007/s12602-025-10738-5. Online ahead of print.

ABSTRACT

Growing evidence has suggested that probiotic consumption can decrease the incidence of Atopic dermatitis (AD) in infants and children. However, even meta-analyses have reported uncertain findings. The current umbrella meta-analysis aimed to assess the findings of multiple meta-analyses on the efficacy of probiotic supplementation on AD and other atopic manifestations in infants and children. A systematic search of the Literature was carried out in PubMed, ISI Web of Knowledge, Scopus, Cochrane Central Library, EMBASE, and Google Scholar from inception up to September 2024. Random-effects model was utilized when there was a significant between-study heterogeneity; otherwise, fixed-effects model was employed. The quality of the selected meta-analyses was assessed using a measurement tool to assess multiple systematic reviews 2 (AMSTAR2). Of the 1302 articles identified in the search, 22 articles that met the criteria were included in the present comprehensive umbrella meta-analysis. Findings indicated a notable decrease in AD severity based on WMD (ES = -4.16; 95%CI: -6.75, -1.57, p < 0.000) and Eczema (ES = 0.75; 95% CI: 0.69,0.81, p < 0.000) among infants. Subgroup analysis showed that factors such as type of probiotic, sample size, duration, and population were not significant sources of heterogeneity. Our research suggests that probiotics could play a beneficial role in managing AD and eczema. However, we found no statistically significant link between probiotic use and IgE levels, wheezing, allergies, or asthma.

PMID:41762435 | DOI:10.1007/s12602-025-10738-5

Sports Med. 2026 Feb 28. doi: 10.1007/s40279-026-02401-y. Online ahead of print.

ABSTRACT

BACKGROUND: Concurrent training (CT), the combination of resistance training (RT) and endurance training (ET), is widely used in athletic and clinical settings. However, concerns about a potential interference effect have prompted ongoing debate regarding its impact on strength, power, hypertrophy, and aerobic capacity.

METHODS: A systematic search was conducted in PubMed, Web of Science, SPORTDiscus, and PsycNet following PRISMA guidelines and the four-eyes principle (28th February 2025). Main outcomes included aerobic capacity, muscle strength, power, and hypertrophy. Subgroup analyses were performed based on training modality, performance level, age, resistance training load, and endurance intensity.

RESULTS: Seventeen meta-analyses comprising 144 individual studies and 1492 healthy participants were included. Umbrella data revealed comparable improvements in aerobic capacity for CT and ET. CT revealed significantly greater strength adaptations compared with ET (standardized mean difference [SMD] 0.59; p < 0.001). Compared with RT, CT significantly improved aerobic capacity (SMD 0.77; p = 0.02), while strength, power, and hypertrophy outcomes were comparable. No significant effects of training sequence were found; however, trends suggest performing RT before ET may favor strength (SMD 1.69; p < 0.001) and hypertrophy (SMD 0.83; p = 0.36) gains.

CONCLUSION: CT improves both aerobic capacity and strength-related outcomes, making it a valuable strategy for comprehensive fitness development for recreationally trained individuals. While no relevant differences were found regarding the training sequence, performing RT before ET may enhance strength and hypertrophy adaptations. However, data from highly trained to elite athletes remain scarce and warrant further investigation.

PROSPERO REGISTRATION NUMBER: CRD42025646460.

PMID:41762427 | DOI:10.1007/s40279-026-02401-y