Nevin Manimala

Adv Colloid Interface Sci. 2026 Jun 9;356:103970. doi: 10.1016/j.cis.2026.103970. Online ahead of print.

ABSTRACT

Nanostructured sensors are increasingly deployed to mitigate the complexities of the global polycrisis, including climate instability, antimicrobial resistance, pandemics, and emerging technological disruptions. While advanced nano-interfaces (such as MXenes, quantum dots, and MOFs) possess the requisite sensitivity, their efficiency is hindered by large-scale, high-dimensional, and stochastic physicochemical responses. This review articulates a necessary paradigm shift toward unsupervised machine Intelligence as the primary interface between nanostructured sensor hardware, raw data manifolds, and system-level interpretation. It critically examines the foundational methodologies, including clustering for discrete-state identification, Principal Component Analysis for decoupling cross-sensitive material kinetics, manifold learning for nonlinear structure visualization, Independent Component Analysis for blind source separation, and autoencoders for nonlinear denoising and anomaly detection. These approaches extract latent dynamical structures directly from raw nanosensor measurements without dependence on extensive labelled datasets, effectively handling drift, hysteresis, and environmental noise. Moving beyond purely statistical optimisation, it analyse hybrid architectures that embed conservation principles, symmetry conditions, and topological regularities directly into learning algorithms, ensuring outputs follow the system’s physical constraints. Finally, to address scalability challenges, including edge-native computing and privacy-preserving federated learning, it argues that converging advanced sensing nano-interfaces with constraint-regulated unsupervised intelligence is critical for developing self-calibrating material-sensor intelligence ecosystems to navigate polycrisis.

PMID:42296628 | DOI:10.1016/j.cis.2026.103970

Injury. 2026 Jun 13;57(8):113449. doi: 10.1016/j.injury.2026.113449. Online ahead of print.

ABSTRACT

INTRODUCTION: Urinary tract infection(UTI) is a common complication following hip fracture surgery in elderly patients. Urinary catheterization is frequently used to improve patient comfort during prolonged preoperative immobilization; however, its impact on UTI risk and renal function remains controversial. This prospective randomized study aimed to evaluate the effect of urinary catheter use on postoperative UTI incidence and renal outcomes in geriatric patients undergoing hip fracture surgery.

MATERIALS AND METHODS: This prospective randomized controlled trial included 150 patients aged > 65 years who underwent surgical treatment for proximal femur fractures between December 2022 and May 2025. Patients with UTI at admission, prior indwelling catheter use, high-energy trauma, multiple fractures, or a history of pelvic radiation were excluded. Patients were randomized into two groups: catheterized(n = 75) and non-catheterized(n = 75). Urinary tract infection was defined according to European Association of Urology (EAU) guideline criteria. Renal function was assessed using serum urea and creatinine levels measured preoperatively and on postoperative day 1. Demographic data, comorbidities, fluid intake, and perioperative variables were recorded and compared between groups.

RESULTS: The mean patient age was 79.8±7.2 years, and 61.3% were female. Postoperative UTI occurred in 20 patients (15.2%) overall. UTI was detected in 12 patients (18.5%) in the catheterized group and in 8 patients (11.9%) in the non-catheterized group, with no statistically significant difference between the groups (p = 0.296). Female sex and advanced age were identified as significant risk factors for UTI development. Postoperative creatinine levels were significantly higher in the non-catheterized group (p < 0.01), which was also associated with lower preoperative oral fluid intake. No significant association was found between UTI development and diabetes mellitus, hypertension, or coronary artery disease.

CONCLUSIONS: Indwelling urinary catheterization did not significantly increase postoperative UTI risk in elderly patients undergoing hip fracture surgery. Moreover, catheter use may help prevent dehydration-related renal dysfunction by facilitating adequate oral fluid intake. Careful, short-term catheterization may therefore represent a reasonable strategy in selected geriatric hip fracture patients.

PMID:42296627 | DOI:10.1016/j.injury.2026.113449

J Nutr Health Aging. 2026 Jun 15;30(7):100884. doi: 10.1016/j.jnha.2026.100884. Online ahead of print.

ABSTRACT

OBJECTIVES: This study examined the association between food insecurity (FI) and functional disability (FD) among older adults over time in Ghana and South Africa (SA), and the mediating roles of childhood parental employment (CPE) and adult education (AE) statuses.

METHODS: Data were from 6,569 and 4,663 older adults (60+years) who participated in WHO-SAGE Ghana and SA (Waves 1-3), respectively, between 2007-2019. Multivariable-adjusted logistic mixed effects models were performed to examine the roles of CPE and AE statuses on the associations between FI, in general, and its measures – hunger and food insufficiency – with FD in older adults.

RESULTS: After adjusting for significant covariates, older adults who reported being food insecure (Ghana: aOR = 1.20, 95%CI: 1.03, 1.41, p = 0.024; SA: aOR = 1.98, 95%CI:1.54, 2.56, p < 0.001) and those who reported consuming insufficient food (Ghana: aOR = 1.21, 95%CI: 1.03, 1.42, p = 0.018; SA: aOR = 1.96, 95%CI:1.52, 2.53, p < 0.001) had higher odds of FD over time, compared with those who were food secure. For both Ghana and SA, hunger was associated with higher odds of FD. However, the association remained statistically significant only for SA. CPE and AE statuses proved to be relevant pathways through which FI was associated with increased odds of FD among older adults in Ghana and SA.

CONCLUSION: CPE and AE statuses mediated the associations between FI and FD among older adults in Ghana and SA. This highlights the importance of adopting early–late-life interventions to support the health and economic wellbeing of families to accumulate wealth for food security and functional wellbeing in later life.

PMID:42296619 | DOI:10.1016/j.jnha.2026.100884

Lung Cancer. 2026 Jun 6;218:109486. doi: 10.1016/j.lungcan.2026.109486. Online ahead of print.

ABSTRACT

BACKGROUND: In the phase III LAURA study, osimertinib demonstrated a statistically significant progression-free survival benefit versus placebo, and a generally tolerable safety profile, after definitive chemoradiotherapy (CRT) in unresectable stage III EGFR-mutated non-small cell lung cancer. We report in-depth safety data from LAURA.

PATIENTS AND METHODS: Patients without progression during/after definitive CRT were randomized 2:1 to receive osimertinib or placebo. Safety was assessed at baseline, week 2, week 4, every 4 weeks until week 24, every 8 weeks until week 48, and every 12 weeks until study treatment discontinuation. Adverse events (AEs) of special interest included grouped terms of radiation pneumonitis (RP) and interstitial lung disease (ILD, including pneumonitis).

RESULTS: Overall, 216 patients were randomized (osimertinib, 143; placebo, 73) and received ≥1 dose of study treatment; median exposure 24.0 months (osimertinib), 8.3 months (placebo). Exposure-adjusted rates of grade ≥3 AEs and serious AEs were 18 versus 13 and 20 versus 15/100 patient-years with osimertinib versus placebo, respectively. Exposure-adjusted AEs that occurred at the greatest increased frequency with osimertinib versus placebo were diarrhea and paronychia. AEs led to treatment interruption in 56 % versus 25 % of patients and to discontinuation in 13 % versus 5 % with osimertinib versus placebo, respectively. RP (grouped term) events were numerically higher in the osimertinib (48 %) versus placebo (38 %) arm but were mostly low grade; almost all events were reported by 18 weeks post-randomization. Protocol-mandated toxicity management guidelines effectively managed RP; most patients (60/69; 87 %) continued osimertinib, with or without interruption, and without recurrence (64/69; 93 %). ILD (grouped term) was mainly grade 1-2 and manageable; most events occurred within 20 weeks post-randomization.

CONCLUSIONS: Osimertinib after definitive CRT had an acceptable and manageable safety/tolerability profile, with no new safety findings, supporting osimertinib as the new standard of care in this setting. LAURA clinical trial registration number: NCT03521154.

PMID:42296617 | DOI:10.1016/j.lungcan.2026.109486

Burns. 2026 Jun 3;52(8):108100. doi: 10.1016/j.burns.2026.108100. Online ahead of print.

ABSTRACT

Keloids are benign tumors resulting from pathological scarring and excessive collagen deposition with diverse clinical presentations. The treatment of keloids remains challenging, often leading to recurrences. In this study, we propose an enhanced morphological classification, derived from both previous research and a retrospective analysis of 95 keloids treated surgically in our department with a global recurrence rate of 41.1% over an average follow-up of 3.75 years. We have analyzed the clinical presentation, together with prognosis and recommendations of treatment for the several keloid phenotypes we identified. This analysis enables us to propose a keloid classification defining 5 categories: type I – Acne keloïdalis nuchae (AKN); type II – Nodular outside the ear; type III – Nodular of the ear; type IV – Superficial spreading; type V – Mixed shape. This new clinical classification of keloids was statistically predictive for the risk of recurrence after surgery (p = 0.0158). Of interest, this proposed classification not only captured all keloid presentations but also provided valuable insights for prognosis and treatment. Type I showed a favorable prognosis, with less than 20% recurrence after extralesional excision and wound healing. Types II, III, and IV had moderate recurrence rates (30-50%). Nodular keloids were treated with intralesional excision and suture, followed by corticosteroid injections. Type V, however, had a poor prognosis with a 75% recurrence rate post-surgery. This phenotype-based classification offers a better understanding of keloid pathophysiology and optimization of treatment strategies tailored to specific keloid types.

PMID:42296612 | DOI:10.1016/j.burns.2026.108100

Burns. 2026 May 18;52(8):108071. doi: 10.1016/j.burns.2026.108071. Online ahead of print.

ABSTRACT

INTRODUCTION: American Burn Association (ABA) referral criteria help identify patients to be transferred. Limited data exist on characteristics of patients being transferred and utilization of these criteria at non-burn centers (NBC).

OBJECTIVES: To describe pediatric emergency department (ED) disposition practices at a non-burn center and compare these practices to ABA referral criteria.

DESIGN/METHODS: Retrospective review of electronic records of patients < 18 years old, with discharge diagnosis of burn at a non-burn healthcare system, from December 2016 to June 2022, was performed. Descriptive statistics and multivariable logistic regression was used to analyze transfer rates and determine odds ratios of different factors, comparing transferred and discharged patients.

RESULTS: 1231 cases were identified with 35% transferred. Of the 65% of patients discharged, 52% met ABA referral criteria. For all visits, 64% met at least one ABA criterion, of which 47% were transferred. Infants had greatest odds of transfer (OR 9.62, 95% CI 4.6 – 20.1). Burns to high-risk anatomical zones (OR 5.89, 95% CI 4.1 – 8.4), those with > 20% total body surface area (OR 16.86, 95% CI 4.3 – 66.7) and full/partial thickness burns (OR 11.47, 95% CI 5.5 – 23.9) were also all associated with highest odds of transfer.

CONCLUSION: The majority of visits met ABA criteria for transfer to a burn center; however, only about half those qualified were transferred. Some may have been appropriately discharged. Infants, large burns, burns to high-risk anatomic zones, or full/partial thickness burns were more often transferred indicating appropriate adherence to the established guideline. These data suggest that ABA criteria are very broad for pediatrics and do not have face validity for community physicians. Further work is needed to refine pediatric ABA referral criteria.

PMID:42296607 | DOI:10.1016/j.burns.2026.108071

Burns. 2026 May 27;52(8):108084. doi: 10.1016/j.burns.2026.108084. Online ahead of print.

ABSTRACT

AIM: To study the validity, reliability, standard error of the mean (SEM), minimum detectable change (MDC₉₅), and learning effect of three functional capacity tests in hospitalized burn victims: 5-repetition Sit-to-Stand (STS_5r), 1-minute Sit-to-Stand (STS_1min) and Timed up-and-go (TUG).

METHODS: In a cross-sectional study, 64 subjects were evaluated. The tests were randomly applied by two evaluators in three assessment moments: twice by the same evaluator (intra-rater) with a 1-day interval; and once by a second evaluator after the first assessment (inter-rater). 6-minute walk test (6MWT) and assessment of quadriceps femoris (QF) muscle strength were also performed. For analysis of the learning effect, all tests were repeated two times at each assessment moment.

RESULTS: The TUG showed very strong correlation with the 6MWT (r = -0.90, p < 0.0001), whereas for the STS_5r and STS_1min the correlation was moderate (r = -0.55 and 0.60, respectively; p < 0.0001). As for the QF muscle strength test, there was moderate correlation with the TUG (r = -0.41, p = 0.0008) and rather modest correlations with the STS_5r (r = -0.30, p = 0.013) and the STS_1min (r = 0.21, p = 0.091). Intraclass correlation coefficient values were good to excellent in all intra- and inter-rater tests (0.88-0.97). MDC₉₅ values ranged from 19% to 23%. Moreover, a small but statistically significant learning effect was observed in all tests.

CONCLUSIONS: The STS_5r, STS_1min and TUG tests are valid and reliable to assess functional capacity of hospitalized burn victims, despite a small learning effect indicating the need to perform two tests. SEM and MDC values here described can be used in clinical practice to improve interpretability of the tests’ results.

PMID:42296604 | DOI:10.1016/j.burns.2026.108084

Burns. 2026 May 22;52(8):108076. doi: 10.1016/j.burns.2026.108076. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated the clinical efficacy and safety of amniotic membrane transplantation (AMT) enhanced with a fornix support ring for the treatment of severe acute ocular burns.

METHODS: Eighteen eyes of 15 patients with severe ocular burns (Grades III and IV) were included. Twelve eyes received AMT alone, while six eyes received AMT combined with a fornix support ring. Clinical outcomes, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), and postoperative complications, were monitored over a follow-up period of 3-28 months.

RESULTS: In the Grade III burn group, the addition of a fornix support ring to AMT significantly reduced the incidence of entropion and trichiasis compared to AMT alone (p = 0.018 for both). While the differences in symblepharon, keratitis, BCVA, and IOP changes did not reach statistical significance, clinical improvements were noted. Although statistical significance was not achieved in the Grade IV burn group, the group with the fornix support ring showed a reduced incidence of keratitis and other clinical differences.

CONCLUSIONS: This study demonstrated that the fornix support ring is a reliable and effective option for enhancing surgical outcomes in acute ocular burns. By deepening the fornices, improving amniotic membrane adhesion, and reducing the need for extensive suturing, the ring significantly decreases the occurrence of complications, such as symblepharon, entropion, and trichiasis.

PMID:42296600 | DOI:10.1016/j.burns.2026.108076

Burns. 2026 Jun 1;52(8):108098. doi: 10.1016/j.burns.2026.108098. Online ahead of print.

ABSTRACT

BACKGROUND: Hypothermia is common after major burn injury and may influence both systemic and wound-related outcomes. Although hypothermia has been associated with coagulopathy and higher rates of mortality in the trauma patient cohort, limited literature has examined its effects on the outcomes for patients with burns. The aim of this study was to identify the rate of hypothermia in patients transferred to a specialised burn unit, and to assess the impact on morbidity and mortality.

METHODS: This retrospective, single-centre study examined all burns presentations between 2009-2013. Hypothermia was defined as a core body temperature ≤ 35 °C on arrival. Statistical analysis used logistic regression for binary outcomes and negative binomial models for continuous outcomes. Multivariable logistic regression assessed hypothermia using continuous age, total body surface area burned (TBSA), and their interactions.

RESULTS: Of 268 patients with recorded temperature, 41 (15%) were hypothermic. Hypothermia increased with burn size (11.6% in <20% TBSA vs 35.7% in >50% TBSA; p < 0.01). Hypothermic patients had higher mean age (46.6 vs 41.0 years; p < 0.05) and larger burns (22.8% vs 14.7% TBSA; p < 0.01). Adequate first aid and use of the modified Parkland Formula were less frequently documented in hypothermic patients (75.7% vs 92.3% and 60.7% vs 79.5%, respectively; both p < 0.01). There was no significant difference in burn size across age groups (p = 0.918). On multivariable analysis, increasing TBSA was independently associated with hypothermia, whereas age was not, and no significant age-TBSA interaction was identified (p = 0.647). Hypothermia was associated with higher in-hospital mortality (14.6% vs 3.5%), longer ICU LOS (4.39 vs 2.33 days), and higher sepsis rates (9.8% vs 2.6%); but lower rates of skin grafting (36.6% vs 51.1%) and shorter hospital LOS (17.3 vs 19.7 days). On multivariable analysis, hypothermia independently predicted mortality, LOS, grafting, wound infection and sepsis.

CONCLUSIONS: Hypothermia remains common in burn patients transferred to a tertiary centre in NSW and is associated with larger burns, a higher average age, reduced adherence to early management protocols and poorer systemic outcomes despite reduced grafting rates and shorter hospital admissions.

PMID:42296598 | DOI:10.1016/j.burns.2026.108098

Cancer Radiother. 2026 Jun 15;30(2):104828. doi: 10.1016/j.canrad.2026.104828. Online ahead of print.

ABSTRACT

PURPOSE: Modern adjuvant therapies, including systemic treatments and radiotherapy, have significantly improved outcomes for patients with breast cancer. However, isolated nodal recurrences remain rare, comprising less than 1 % of cases, and pose a therapeutic challenge, with historical 5-year overall survival rates below 50 %. This study evaluated the clinical outcomes of patients with isolated nodal recurrences in the modern era using the Surveillance, Epidemiology, and End Results (SEER) database and examined factors associated with survival.

MATERIALS AND METHODS: We analysed data from 1479 female patients with cT0N+M0 breast cancer diagnosed between 2000 and 2021 in the SEER database. Patients were categorized as having isolated nodal recurrences if they had prior ipsilateral breast cancer or occult primary breast cancer if presenting with a first cancer diagnosis. Demographics, tumour characteristics, and treatments were recorded. Survival outcomes were assessed using Kaplan-Meier and Cox regression models.

RESULTS: Of 1479 patients, 42 (2.8 %) had isolated nodal recurrences, and 1437 (97.2 %) had occult primary breast cancer. Median time to isolated nodal recurrences was 105 months. Most initial tumours were early-stage (T1-T2, 75 %) and node-negative (78.6 %). Five-year overall- and cancer-specific survival rates of patients with isolated nodal recurrences were 72.4 % (95 % confidence interval [CI]: 57.6-91.0 %) and 81.5 % (95 % CI: 67.8-97.9 %), respectively, compared to 80.4 and 86.6 % for patients with occult primary breast cancer. Trends toward improved survival with adjuvant chemotherapy (5-year overall survival rates: 78.0 versus 68.0 %) and radiotherapy (5-year overall survival rates: 83.6 versus 63.2 %) were observed but not statistically significant. No survival benefit was found for total mastectomy in cases of isolated nodal recurrences following breast-conserving surgery.

CONCLUSION: This study showed encouraging survival outcomes for patients with isolated nodal recurrences in the modern era, with 5-year overall survival exceeding historical benchmarks. Comparable survival between patients with isolated nodal recurrences and occult primary breast cancer highlights the potential for curative approaches. Further research is required to refine treatment strategies and identify patient subgroups that may benefit from tailored therapies.

PMID:42296574 | DOI:10.1016/j.canrad.2026.104828