Nevin Manimala

Adv Mater. 2026 May 2:e18756. doi: 10.1002/adma.202518756. Online ahead of print.

ABSTRACT

Sequence-controlled polymers, such as polypeptides, offer a versatile platform for tuning the microenvironment of catalytic centers, drawing inspiration from enzymes while enabling a larger design space, structural flexibility, automated synthesis, and compatibility with closed-loop optimization. Here, we designed an artificial oxidase system by immobilizing Fe(III)-protoporphyrin IX onto a lysine residue in synthetic decapeptides via amide linkage. Using hydrogen peroxide as the oxidant and acetophenone as a model substrate, we used an active-learning-guided closed-loop workflow to prioritize peptide sequences across 233 variants over 20 rounds. Statistical analysis revealed that sulfur-containing residues-cysteine and methionine-consistently enhanced activity when positioned adjacent to the coordination site. Notably, although sequence optimization began from random inputs, the algorithm quickly converged on cysteine-containing motifs, consistent with features found in natural oxidases. Thioether-containing methionine was also found to promote catalysis, extending the relevance of sulfur-based coordination beyond naturally occurring systems. These findings demonstrate the application of data-driven sequence design for developing tunable, enzyme-inspired catalysts with simplified architectures.

PMID:42068197 | DOI:10.1002/adma.202518756

J Psychopharmacol. 2026 May 2:2698811261443696. doi: 10.1177/02698811261443696. Online ahead of print.

ABSTRACT

INTRODUCTION: Serotonergic psychedelics are being investigated in the treatment of various disorders and in the improvement of well-being. Evidence suggests that their subjective effects may play a role in long-term behavioral outcomes. The subjective effects are mediated by 5-HT_2A receptor agonism, but the 5-HT_1A receptor may also play a role in the subjective effects. This study elucidates the effects of 5-HT_1A receptor blockade using pindolol pre-treatment on the subjective effects induced by N,N-dimethyltryptamine (DMT).

METHODS: In a double-blind, randomized, placebo-controlled within-subjects design, 12 (10 males, 2 females) experienced hallucinogen-using participants received a sub-hallucinogenic dose of intravenous DMT fumarate, 0.1 mg/kg, after pre-treatment with 30 mg oral racemic pindolol. Subjective effects were measured using the Hallucinogen Rating Scale.

RESULTS: Pindolol pre-treatment increased DMT-induced subjective effects with a moderate effect size (M = 0.514). Blood pressure and mean arterial pressure also increased with pindolol pre-treatment at 2 minutes following DMT administration, but heart rate was not affected.

CONCLUSIONS: 5-HT_1A receptor blockade results in a global intensification of DMT-induced subjective effects, suggesting a functional role of 5-HT_1A receptor action in the mechanism of psychedelic-induced subjective effects.

PMID:42068196 | DOI:10.1177/02698811261443696

J Interpers Violence. 2026 May 2:8862605261441201. doi: 10.1177/08862605261441201. Online ahead of print.

ABSTRACT

Intimate partner violence (IPV) represents a public health crisis in the United States. Experiencing IPV is associated with various adverse health outcomes and injuries, including traumatic brain injury (TBI). Improving screening and care for individuals affected by concurrent IPV and traumatic brain injury (IPV-TBI) requires understanding its incidence, sociodemographics, risk factors, and clinical outcomes. Using standardized multicenter data from the US National Trauma Data Bank years 2018 to 2022, this study aimed to answer the following questions: (a) What is the incidence of IPV-TBI among female patients treated for TBI at US trauma facilities? (b) Are there sociodemographic and clinical differences between female IPV-TBI and female non-IPV-TBI patients? (c) What hospital outcomes (length of stay [LOS], emergency department discharge disposition, hospital discharge disposition) are associated with IPV-TBI, based on TBI severity. Statistical differences were examined using Welch’s t-test and analysis of variance, Pearson’s chi-squared test with post hoc Bonferroni-corrected z-tests, and multivariate logistic and linear regressions. Our findings indicate that most female trauma center patients with assault-related TBI experienced IPV (76.8%), often inflicted by male partners (97.9%). Compared to those with non-IPV TBI, IPV survivors who experienced TBI were younger (mean 37.9 ± 12.5 years vs. non-IPV: 48.0 ± 12.4; p < .001) and more commonly insured by Medicaid (47.0% vs. 36.5%, p < .001). IPV-TBI was associated with significantly higher odds of discharge to home in female patients (aOR = 1.31 [95% CI: 1.01, 1.69]), and IPV-TBI patients were likely to have shorter hospital LOS than those with TBI from non-IPV assault (4.3 ± 6.8 days vs. 5.9 ± 9.8; p < .001). Our findings underscore the critical importance of screening TBI patients for IPV, given that the social and medicolegal contexts surrounding their injury and recovery may be substantially different from TBI patients without IPV, and being discharged home may present significant safety risks.

PMID:42068181 | DOI:10.1177/08862605261441201

J Nurs Scholarsh. 2026 May;58(3):e70096. doi: 10.1111/jnu.70096.

ABSTRACT

BACKGROUND: Patient safety is a global priority, as adverse events represent the 14th leading cause of morbidity and mortality worldwide. Among the most common complications in hospitalized adults are functional decline, pressure injuries, and falls, all of which increase hospital stays, healthcare costs, and mortality. Although these risks are typically assessed independently, their interaction has been scarcely explored, and the identification of integrated patient risk profiles could better guide nursing care.

OBJECTIVE: To establish profiles of adult inpatients based simultaneously on their level of functional capacity, risk of pressure injuries, and risk of falls.

DESIGN: Cross-sectional observational study.

PARTICIPANTS: A total of 2.666 patients were admitted to adult inpatient units in a Spanish hospital.

METHODS: Data from the Barthel, Braden, and Downton scales collected within 24 h of admission were analyzed. A hierarchical cluster analysis followed by the k-means method was used to classify patients. Relationship between profiles and clinical variables were explored through multiple correspondence analysis, and predictors for each profile were identified using multinomial logistic regression.

RESULTS: Three patient profiles were identified: profile 1 (low risk), minor dependency, low risk of pressure injuries and falls (68.5%); profile 2 (moderate risk), moderate dependency and intermediate risk (15.4%); and profile 3 (high risk), severe dependency with high risk of pressure injuries and falls (16.1%). Older age, female sex, and higher comorbidity were significantly associated with higher-risk profiles (p < 0.001).

CONCLUSIONS: Hospitalized adults can be reliably classified into risk profiles based on functional capacity and the risk of pressure injuries and falls.

IMPLICATIONS: The identification of combined risk profiles may potentially guide nursing strategies to enhance patient safety, support individualized care planning, and contribute to optimizing resource distribution in hospital settings.

IMPACT: Loss of functional capacity, pressure injuries, and falls are key nursing-sensitive indicators of care quality. Profile-based stratification offers a new framework for personalized, data-driven, and safety-oriented nursing care.

CLINICAL RELEVANCE: The identification of integrated risk profiles based on functional capacity, pressure injury risk, and fall risk may support more comprehensive nursing assessment in hospitalized adults. These profiles may help inform care prioritization, facilitate early identification of vulnerable patients, and contribute to more efficient allocation of nursing resources. Incorporating multidimensional risk stratification into clinical practice may enhance coordinated and patient-centered care planning.

PMID:42068180 | DOI:10.1111/jnu.70096

J Nurs Scholarsh. 2026 May;58(3):e70095. doi: 10.1111/jnu.70095.

ABSTRACT

BACKGROUND: The new Universal Health Insurance (UHI) reforms aim to improve equity and quality of healthcare delivery; however, their sustainability depends on engagement and retention of the nursing workforce. Psychological empowerment has been identified as a key factor influencing nurses’ attitudes and work-related behaviors, yet the evidence on how it relates to job embeddedness among nurses working in the early phase of UHI implementation in Egypt remains underexplored.

AIM: This study aimed to assess the association between psychological empowerment and job embeddedness among nurses under the umbrella of the new Universal Health Insurance in Egypt.

METHODS: A descriptive cross-sectional design was employed from August 2025 to November 2025. A total of 213 nurses working at Aswan Specialized Hospital, affiliated with the UHI system in Upper Egypt, were recruited. Data were collected using a demographic questionnaire, and psychological empowerment was measured using the Psychological Empowerment Scale, and job embeddedness was assessed using the Global Job Embeddedness Scale. Descriptive statistics, Pearson correlation analysis, and hierarchical linear regression were used for data analysis.

RESULTS: Among 213 nurses, the mean score of psychological empowerment was reported at high overall levels of 5.75 (SD = 0.77), particularly in the dimensions of competence and meaning, alongside moderately high levels of job embeddedness, with a mean score of 4.76 (SD = 0.89). Psychological empowerment showed a significant positive correlation with job embeddedness (r = 0.512, p < 0.001). In hierarchical regression analysis adjusting for demographic and professional covariates, psychological empowerment emerged as a strong and independent predictor of job embeddedness (β = 0.55, 95% CI: 0.398-0.701, p < 0.001), explaining an additional 16.5% of the variance after controlling for covariates (ΔR² = 0.165). In adjusted analyses, the covariates were not independently associated with job embeddedness.

CONCLUSION: Psychological empowerment was positively associated with nurses’ job embeddedness in the UHI implementation setting. Higher levels of empowerment-related factors were positively associated with greater embeddedness, suggesting their relevance to workforce engagement and retention during health system reform.

CLINICAL RELEVANCE: Our study findings highlight that psychological empowerment plays a crucial role in fostering nurses’ job embeddedness, which is critical for sustaining workforce retention and stability. Enhancing supportive leadership and nurses’ involvement in decision-making is critical, especially during the early phase implementation of the universal health insurance system reform.

PMID:42068169 | DOI:10.1111/jnu.70095

J Clin Lab Anal. 2026 May 2:e70247. doi: 10.1002/jcla.70247. Online ahead of print.

ABSTRACT

BACKGROUND: Anemia represents a frequent complication in patients with chronic kidney disease (CKD) on hemodialysis. Inflammation results in disruption of erythropoiesis and establishment of less effective responses to erythropoiesis-stimulating agents (ESAs).

OBJECTIVE: This study investigated how systemic inflammation, which C-reactive protein (CRP) measured, relates to anemia severity and erythropoietin (EPO) responsiveness among patients with chronic kidney disease who undergo maintenance hemodialysis.

METHODS: Cross-sectional study design involving 120 CKD patients. Participants were classified into high inflammation group for CRP levels at or above 10 mg/L and low inflammation group for CRP levels below 10 mg/L. Hematological parameters and iron status indices were analyzed, and weekly EPO doses were recorded. Pearson correlation and multivariable linear regression analyses were done while controlling for age, sex, comorbidities, and dialysis duration.

RESULTS: High inflammation group displayed hematocrit level of 29.6% ± 4.8% while the control group showed a level of 34.2% ± 5.2% which produced a statistically significant difference (p < 0.001). CRP exhibited a negative correlation with hematocrit (r = -0.42, p < 0.001) and transferrin saturation (r = -0.36, p < 0.001) but showed a positive correlation with EPO dose (r = 0.48, p < 0.001). CRP established an independent relationship with hematocrit (β = -0.43, 95% CI: -0.58 to -0.28) and EPO dosage (β = 401, 95% CI: 210 to 592) during the multivariable analysis.

LIMITATIONS: Cross-sectional design restricts causal relationships while the research team evaluated CRP as the only inflammatory marker.

CONCLUSIONS: Systemic inflammation establishes a significant connection to anemia severity and EPO resistance, which affects CKD patients.

PMID:42068154 | DOI:10.1002/jcla.70247

Stat Med. 2026 May;45(10-12):e70578. doi: 10.1002/sim.70578.

ABSTRACT

A generalization of the classical concordance correlation coefficient (CCC) is considered under a three-level design where multiple raters rate every subject over time, and each rater is rating every subject multiple times at each measuring time point. The ratings can be discrete or continuous. A methodology is developed for the interval estimation of the CCC based on a suitable linearization of the model along with an adaptation of the fiducial inference approach. The resulting confidence intervals have satisfactory coverage probabilities and shorter expected widths compared to the interval based on Fisher’s Z-transformation, even under moderate sample sizes. Two real applications available in the literature are discussed. The first application is based on a clinical trial to determine if various treatments are more effective than a placebo for treating knee pain associated with osteoarthritis. The CCC was used to assess agreement among the manual measurements of the joint space widths on plain radiographs by two raters, and the computer-generated measurements of digitalized radiographs. The second example is on a corticospinal tractography and the CCC was once again applied in order to evaluate the agreement between a well-trained technologist and a neuroradiologist regarding the measurements of fiber number in both the right and left corticospinal tracts. Other relevant applications of our general approach are highlighted in many areas including artificial intelligence.

PMID:42068150 | DOI:10.1002/sim.70578

Aust J Rural Health. 2026 Jun;34(3):e70202. doi: 10.1111/ajr.70202.

ABSTRACT

INTRODUCTION: Indigenous peoples experience significant health inequities compared to non-Indigenous peoples. The reasons for this are multi-faceted. Access to healthcare for marginalised Indigenous peoples is made more difficult by living rurally; urban counterparts have improved healthcare access and health outcomes.

OBJECTIVE: This review aimed to further understand the healthcare experiences of rural Indigenous peoples residing in New Zealand (Aotearoa), Australia, Canada or the United States of America (USA).

INCLUSION CRITERIA: Participants were required to self-identify as Indigenous consumers of healthcare aged 18 years or older, with personal or family experiences of receiving healthcare. Contextually, rural healthcare service access in any healthcare setting was chosen. The countries chosen for inclusion were New Zealand, Australia, Canada, and the USA. Exclusion criteria included studies with non-Indigenous participants with healthcare experiences that were unable to be isolated and extracted, as well as studies involving both rural and urban healthcare experiences where the urban experiences were unable to be isolated and removed.

METHODS: The electronic databases Scopus (Elsevier), CINAHL Complete (EBSCOhost) and Medline (OVID) were searched. Articles were screened by one author (TC) to identify primary research studies that reported patient lived experiences and included Indigenous participants who live rurally. Searches were completed in June 2024 and limited to full text, English language and date limited to 2004-2024. Articles were then analysed via thematic analysis.

FINDINGS: Seven articles were analysed. The articles were located in Aotearoa, Australia, and Canada. No suitable studies from the USA were identified or included. Five themes were identified as having impacted the healthcare experiences of Indigenous peoples: distance to care; quality of care and racism; support from and impact on, whānau (family); health professional communication and knowledge sharing; and Indigenous solutions and holistic care.

CONCLUSION: Ensuring that patient-centred care also involves wider family members has been shown to be beneficial, as has the engagement of Indigenous health professionals and health workers in providing culturally inclusive healthcare. Health professionals should consider language and communication techniques when engaging with people seeking healthcare and not make assumptions, for example around health knowledge.

PMID:42068139 | DOI:10.1111/ajr.70202

J Sep Sci. 2026 May;49(5):e70429. doi: 10.1002/jssc.70429.

ABSTRACT

A micellar electrokinetic chromatography method was developed for the simultaneous separation of the phosphodiesterase-5 inhibitors sildenafil and tadalafil, two therapeutic agents used in the treatment of erectile dysfunction that are frequently identified as illicit adulterants in dietary supplements marketed for sexual enhancement. Method development was supported by a design of experiments strategy. An initial fractional factorial screening design was used to evaluate the influence of selected experimental parameters on resolution (R_s) and migration time. Pareto analysis of standardized effects indicated that cyclodextrin (CD) concentration, methanol (MeOH) content, and separation voltage significantly affected the separation, whereas pH, sodium dodecyl sulfate (SDS) concentration, and temperature did not show a statistically significant impact within the studied range. Based on the screening results, a Box-Behnken response surface design was employed to optimize the significant factors. Optimized separation conditions consisted of a 50 mM phosphate buffer (pH 2.5) containing 50 mM SDS, 10% MeOH, and 5 mM hydroxypropyl-β-CD, with a separation voltage of -20 kV and a capillary temperature of 20°C. Under these conditions, baseline separation was achieved with a R_s of 4.75 and migration times below 6 min. The method was validated in terms of precision, linearity, accuracy, and robustness, showing satisfactory analytical performance. Application to pharmaceutical formulations and dietary supplement samples confirmed the suitability of the proposed method for routine screening and quality control purposes.

PMID:42068125 | DOI:10.1002/jssc.70429

Cult Health Sex. 2026 May 2:1-14. doi: 10.1080/13691058.2026.2663055. Online ahead of print.

ABSTRACT

This pilot study examined the use of a participatory approach to co-create and prioritise menstrual health actions and interventions with university students in Ecuador. Despite growing recognition of the importance of menstrual health, university students continue to face unmet needs that can affect academic participation and daily life. Between October and November 2023, three in-person workshops engaged a total of 37 students in a structured co-creation process. The first workshop involved collaborative brainstorming, generating 31 proposed actions and interventions organised into four participant-derived categories: resources, support, infrastructure, and education. The second workshop involved thr independent ranking of the actions and interventions using a structured worksheet, with descriptive statistics used to identify a subset of highly prioritised options. The third workshop focused on refining these priorities through guided group discussion. The highest-ranked actions and interventions identified from the participatory process included institutional flexibility for chronic menstrual conditions, education-based initiatives, improved toilet/bathroom access, and student-led support. Rather than providing generalisable evidence of intervention effectiveness or population-level need, this study highlights how participatory, process-oriented methods can help generate a context-specific, student-informed response. Findings highlight the value of participatory approaches in surfacing nuanced, actionable insights in menstrual health research.

PMID:42068113 | DOI:10.1080/13691058.2026.2663055