Nevin Manimala

Pain Manag. 2026 Jan 7:1-15. doi: 10.1080/17581869.2025.2608572. Online ahead of print.

ABSTRACT

INTRODUCTION: Effects of Spinal Cord Stimulation (SCS) on physical activity and self-efficacy remain unexplored.

PURPOSE: To evaluate effects of SCS on pain intensity, physical activity, health-related quality of life (HRQL), and self-efficacy among chronic neuropathic pain patients.

METHODS: Randomized controlled trial, the first phase of a 3-part intervention study. Patients >18 years of age underwent SCS implantation after a test trial and were randomized 1:1 to active SCS or conventional medical management (CMM) with the SCS switched off. Data were collected at baseline and 3 months after implantation regarding pain (Numeric Rating Scale; NRS), physical activity (accelerometer), HRQL, and self-efficacy.

RESULTS: Participants implanted with SCS (n=42) were randomized to active SCS (n=21) or CMM (n=21). Nineteen participants crossed over from CMM to active SCS due to lack of pain relief. Neuropathic pain intensity decreased significantly from baseline to 3 months (NRS 6.7 to 4.5; p <0.001) in patients with active SCS. Moderate-to-vigorous physical activity increased by 26 minutes/week (87%), although not statistically significant. Patients reported significant improvements in HRQL and self-efficacy.

CONCLUSION: SCS seems to reduce neuropathic pain intensity which might contribute to improvements in HRQL and self-efficacy. Low physical activity levels in this population should prompt targeted rehabilitation interventions.

CLINICAL TRIAL REGISTRATION: The https://clinicaltrials.gov/ identifier is NCT03740763 and the Västra Götaland Region (VGR) registry (https://www.researchweb.org/is/vgr/) identifier is 216271.

PMID:41503863 | DOI:10.1080/17581869.2025.2608572

Nutr Hosp. 2025 Dec 17. doi: 10.20960/nh.06054. Online ahead of print.

ABSTRACT

INTRODUCTION: pressure injuries (PIs) are chronic wounds of the skin and subcutaneous tissue with multifactorial etiology. They are preventable in 95 % of cases; however, their prevalence reaches up to 33 % among institutionalized individuals. This study comprehensively identified environmental, clinical, nutritional, and functional factors associated with the presence of pressure injuries in institutionalized older adults.

METHODS: observational, cross-sectional, and analytical study conducted in 55 institutionalized older adults selected by non-probabilistic quota sampling. Nutritional status (MNA), body composition (bioimpedance), functional status (Barthel Index), frailty (FRAIL scale), and presence of PIs (NPUAP) were assessed. The analysis included descriptive statistics, bivariate tests (chi-square, Fisher’s exact, Student’s t-test), and multivariate logistic regression with stepwise selection, reporting odds ratios and 95 % confidence intervals.

RESULTS: the majority were women (74.5 %), with a mean age of 86.7 years (SD, 9.8) and a mean institutionalization time of 7.3 years. The prevalence of PIs was 43.6 %. Statistically significant associations were found between PIs and nutritional status (p = 0.027), phase angle (p = 0.007), functional status (p = 0.011), and diaper use (p = 0.001). In multivariate logistic regression analysis, diaper use showed an OR of 24 (IC 95 %, 2.57-223.7, p < 0.005).

CONCLUSION: diaper use is an independent risk indicator for PIs in multivariate analysis. Additionally, systematic use of bioimpedance in institutionalized patients contributes to a comprehensive assessment of older adults, strengthening the management of pressure injuries and their clinical context.

PMID:41503844 | DOI:10.20960/nh.06054

Nutr Hosp. 2025 Dec 17. doi: 10.20960/nh.06008. Online ahead of print.

ABSTRACT

INTRODUCTION: metabolic syndrome (MS) affects approximately 27 % of the global population and represents a growing public health concern. Identifying factors associated with its presence is essential for prevention, early diagnosis, and clinical management.

OBJECTIVE: to evaluate the association between depressive symptomatology (DS) and three IL-18 gene variants-rs360719 (-1297 T>C), rs187238 (-137 G>C), and rs1834481 (+488 C>G)-in individuals with MS.

METHODS: a descriptive, cross-sectional study was conducted between May and June 2023 involving 180 adults (90 with MS and 90 controls), diagnosed according to ALAD criteria. The PHQ-9 questionnaire was used to assess DS. Plasma IL-18 levels were measured using ELISA, and the IL-18 gene variants were genotyped by real-time PCR. The study was approved by the Ethics and Biosafety Committees (CEI-01-2023-02, CBIO-01-2023-02), and informed consent was obtained from all participants.

RESULTS: significant differences in anthropometric, biochemical, and blood pressure parameters were found between groups, confirming a dyslipidemic and inflammatory profile in the MS group. Although no statistically significant association was observed between DS and MS, a higher proportion of moderate to severe DS was noted in the MS group. No significant differences were identified in genotype or allele distributions of the studied variants. However, nonsignificant protective trends were observed for the G allele of rs360719 and rs1834481. Plasma IL-18 levels were significantly higher in participants with MS.

CONCLUSIONS: MS was associated with characteristic clinical and inflammatory alterations. Although no significant association was found with DS, the observed trends suggest a potential proinflammatory role of IL-18 and a possible protective effect of specific gene variants.

PMID:41503842 | DOI:10.20960/nh.06008

J Invest Surg. 2026 Dec;39(1):2560332. doi: 10.1080/08941939.2025.2560332. Epub 2026 Jan 8.

ABSTRACT

BACKGROUND: Abdominal aortic aneurysm (AAA) is a progressive vascular disorder that enlarges irreversibly and may ultimately rupture. Mendelian randomization (MR) provides a powerful approach to uncover biomarkers. We aimed to identify plasma proteins linked to AAA and evaluate their diagnostic potential.

METHODS: We performed a proteome-wide MR analysis using genetic instruments for 2,940 plasma proteins from the UK Biobank Pharma Proteomics Project (UKB-PPP). Summary statistics for AAA were obtained from the Finnish R9 GWAS, comprising 4,083 cases and 420,324 controls.

RESULTS: Eleven proteins showed significant causal associations with AAA risk (FDR < 0.05): seven positively and four negatively associated, highlighting their potential as diagnostic markers.

CONCLUSION: This study provides the first proteome-wide MR evidence linking plasma proteins to AAA, offering candidate biomarkers for diagnosis. As a hypothesis-generating work, further experimental and clinical validation is warranted.

PMID:41503834 | DOI:10.1080/08941939.2025.2560332

Traffic Inj Prev. 2026 Jan 7:1-9. doi: 10.1080/15389588.2025.2592858. Online ahead of print.

ABSTRACT

OBJECTIVES: Motorcyclists, as a vulnerable group of road users, not only suffer from trauma caused by collisions with other vehicles but also from the consequences of their own risky behaviors. As the number of motorcycle crashes has continued to rise in recent years, it is essential to understand trends in motorcyclists’ risky behaviors to enhance their safety. This study investigates the co-occurrence of six risky riding behaviors-speeding, alcohol-impaired riding, helmet nonuse, distraction, fatigue, and anger-and identifies rider characteristics associated with distinct behavioral profiles.

METHODS: This study analyzes data from 4,390 motorcyclists who participated in three annual surveys conducted in Florida between 2021 and 2023. The survey collected information on demographics, riding habits, risky motorcycling behaviors, and the perception that other drivers fail to notice or attend to motorcycles. Descriptive statistics and latent class analysis (LCA) were conducted to identify subgroups of riders based on co-occurring behaviors. A bias-adjusted three-step approach was used to examine associations between class membership and rider characteristics.

RESULTS: Four latent behavioral classes were identified: Very High-risk Riders, Moderate-Risk Riders, Drinking Riders, and Low-risk Riders. Each group exhibited distinct constellations of risky behaviors and demographic or attitudinal profiles. High-risk riders were more likely to be younger, less trained, and not using any safety gear. Alcohol use was especially pronounced among recreational riders regardless of age or gender. Formal motorcycle training was consistently linked to lower-risk classes.

CONCLUSION: This study advances the understanding of motorcyclist safety by demonstrating how risky behaviors cluster and how specific demographic and perceptual factors distinguish rider subgroups. These findings support the development of comprehensive safety interventions that target subgroups of motorcyclists who share similar risky profiles, rather than treating isolated behaviors.

PMID:41503803 | DOI:10.1080/15389588.2025.2592858

Drug Chem Toxicol. 2026 Jan 8:1-12. doi: 10.1080/01480545.2025.2606907. Online ahead of print.

ABSTRACT

The bio-accumulative nature of polychlorinated naphthalenes (PCNs) due to their slow biodegradation raise concerns regarding adverse effects on aquatic organisms and potential human health risks through trophic transfer. The persistent and traditional toxicity assessment of PCNs in aquatic species is constrained by experimental complexity, resource demands, and ethical considerations. Consequently, in silico approaches, particularly QSAR modeling in accordance with OECD guidelines, have emerged as robust alternatives to address data gaps and support hazard evaluation. In the present investigation, a Monte Carlo-based QSAR methodology employing CORAL software was utilized to assess the toxicity of PCNs in aquatic environments. An integrated dataset comprising 225 compounds with toxicity endpoints for green algae, Daphnia magna, and fish was assembled. Molecular structures were encoded using the Simplified Molecular Input Line Entry System (SMILES). Statistical evaluation confirmed the predictive robustness of the models, with Split 4 yielding superior external validation performance (r² = 0.9490, Q² = 0.9453, IIC = 0.9157, CII = 0.9633, CCC = 0.9661, r²_m = 0.8549, MAE = 0.192, S = 0.224, F = 1023). These findings substantiate the reliability of the developed QSAR model, underscoring its applicability in environmental toxicology, potential to design safer drug candidate and early-stage hazard assessment.

PMID:41503800 | DOI:10.1080/01480545.2025.2606907

Glob Public Health. 2026 Dec 31;21(1):2611211. doi: 10.1080/17441692.2025.2611211. Epub 2026 Jan 7.

ABSTRACT

Adequate nutrition plays a vital role in maintaining women’s health and ensuring the healthy growth and development of infants and children. However, during emergencies and displacement, multiple factors can disrupt adequate maternal and child nutrition. The aim of this study was to explore the available literature reporting the prevalence and associated risk factors of undernutrition among displaced pregnant and lactating women. This review follows the PRISMA guidelines for Scoping Reviews. An electronic search was conducted in the PubMed, Web of Science, and Google Scholar databases. The Emergency Nutrition Network and ReliefWeb websites were also explored for grey literature. The prevalence of wasting among pregnant and lactating women varied widely, reaching 77% in Tigray internally displaced person (IDP) camps. The underweight prevalence ranged from 9.3% in a Nigerian IDP camp to 26.7% in a refugee camp in Bangladesh. Anemia was common, affecting up to 44.7% of pregnant Syrian refugees in Jordan. Maternal age, family size, childbirth interval, family income, and lack of education were the main factors associated with undernutrition among displaced pregnant and lactating women. Acknowledging the burden of undernutrition and identifying the most frequent risk factors, should inform the development of relevant nutrition interventions in different displacement settings.

PMID:41503795 | DOI:10.1080/17441692.2025.2611211

Environ Technol. 2026 Jan 7:1-20. doi: 10.1080/09593330.2025.2610518. Online ahead of print.

ABSTRACT

Polyhydroxyalkanoates (PHAs) are eco-friendly, biodegradable thermoplastics that have the potential to replace conventional plastics with sustainable biopolymers for several applications. This study aimed to isolate and identify halotolerant strains and to optimise the parameters influencing PHA production using response surface methodology. Furthermore, enhancing PHA production and evaluating the effects of low-dose gamma irradiation on Halomonas mongoliensis AL-ARS. Fifteen bacterial isolates were screened using Sudan Black B for PHA production. The most efficient isolate was Halomonas mongoliensis AL-ARS, identified through morphological, biochemical, and molecular techniques. Response surface methodology using Plackett-Burman and central composite design models is used to optimise factors influencing PHA synthesising. Additionally, the effect of low-dose gamma irradiation was examined. The purified PHA polymer was structurally characterised using FTIR, XRD, and ¹H-NMR. Glucose was the optimal carbon source, while minimal salt media was the most suitable media for PHA production. The best production conditions (10 g/L glucose, 40.5°C, 6.5 days, 2.5% inoculum) yielded 0.0960 g/L of PHA. Remarkably, gamma irradiation at 0.5 kGy significantly increased PHA production by 76%, confirming its role as a stress-inducing factor and highlighting irradiation’s potential to overcome production bottlenecks. Structural analyses confirmed the purified polymer as a standard PHA. This work is the first study highlighting the integration of gamma irradiation with a statistical optimisation to boost PHA biosynthesis using Halomonas mongoliensis AL-ARS, a halophilic strain with no previous study on PHA improvement, presenting a scalable strategy for sustainable, eco-friendly, cost-effective bioplastic production, and bridging the gap between lab-scale and industrial application.

PMID:41503788 | DOI:10.1080/09593330.2025.2610518

Med Teach. 2026 Jan 7:1-8. doi: 10.1080/0142159X.2025.2607517. Online ahead of print.

ABSTRACT

OBJECTIVES: This study evaluated the effectiveness of three retrieval practice strategies: re-solving virtual patient (VP) cases, answering multiple-choice questions (MCQs), and answering short answer questions (SAQs), on long-term memory retention of medical students using a VP simulation platform.

METHODS: Eighty fifth-year medical students participated in a stratified randomized trial conducted in three phases. In the initial learning phase, participants completed a 14-item baseline test (seven MCQs and seven SAQs) to assess prior knowledge and enable stratified randomization. They then engaged with two clinical cases using the Paciente 360^® VP platform. One week later, participants were randomly assigned to one of three retrieval practice conditions: re-solving the original VP cases, answering 24 related MCQs, or answering 24 related SAQs. Six weeks after the intervention, participants completed a 40-item retention test (20 MCQs and 20 SAQs), which included both previously encountered and novel questions to assess long-term retention and transfer of learning.

RESULTS: Participants in the SAQ condition demonstrated a statistically significant improvement in performance over time, while those in the re-solving the virtual case and MCQ conditions maintained their knowledge levels. No significant differences were observed between performance on repeated versus novel questions or between MCQs and SAQs.

CONCLUSIONS: Retrieval practice using VP simulations supports knowledge retention, with SAQs yielding the greatest improvement from baseline. Comparable performance on repeated and novel questions suggests that retrieval practice may also promote transfer of learning to new clinical scenarios.

PMID:41503782 | DOI:10.1080/0142159X.2025.2607517

Hum Vaccin Immunother. 2025 Dec;21(1):2476332. doi: 10.1080/21645515.2025.2476332. Epub 2025 Mar 18.

ABSTRACT

With the gradual improvement in tumor immunotherapy, the incidence of immune-related adverse events (irAEs) has increased. However, according to current research, the relationship between irAEs and prognosis remains a contentious issue. This study used bibliometrics research to investigate hotspots and future trends on the relationship between irAEs and prognosis and to serve as a resource for researchers in this field. In the core literature database of Web of Science, the keywords immune checkpoint inhibitors(ICIs), immune-related adverse events, prognosis were used to search for the articles and reviews in the field of irAEs and prognosis. Set the time parameter to January 2007 to December 2023. Visualization analysis software CiteSpace 6.1.R6, VOSviewer1.6.18 and Carrots2 were used to conduct quantitative statistical and visual research on the author, institution, country, keyword, publication, cited literature, research status, research hotspots and development trends of the relevant research. The analytic research was based on original articles and reviews. 724 articles from 308 countries led by China(147)，the United States(131), and Japan(105) were included. The most popular tumor type is melanoma, small-cell lung cancer, and renal cell carcinoma. The focus topics in this field encompass “Myasthenia gravis,” “neurotoxicity,” “liver damage,” “head and neck adverse events,” “colitis,” and “skin adverse events.” This study has provided a valuable reference for future research in this field. Combination therapy, predictive biomarkers, patients’ preexisting conditions, glucocorticoids, prognostic indicators, ICI rechallenge, and other topics could become research hotspots which will help us to identify useful information from complex big data and provide a basis for precise medicine for immune checkpoint inhibitor therapy.

PMID:41503777 | DOI:10.1080/21645515.2025.2476332