Category: Nevin Manimala

Eur J Surg Oncol. 2026 Feb 27;52(4):111515. doi: 10.1016/j.ejso.2026.111515. Online ahead of print.

ABSTRACT

BACKGROUND: Pelvic exenteration (PE) performed for locally advanced or recurrent pelvic malignancies often required urinary reconstruction but associated with high postoperative morbidity (POM). The influence of urinary diversion type on outcomes remains uncertain.

METHODS: This retrospective cohort study included 90 patients who underwent PE with urinary reconstruction between 2016 and 2023. Urinary diversions were classified as ileal conduit and alternative reconstructions (vesico-urethral anastomosis, Mitrofanoff procedure, ureteral implantation and enterocystoplasty). POM, quality of life (QoL; EQ-5D-5L questionnaire), bowel dysfunction (LARS and Wexner scores), and overall (OS) and disease-free survival (DFS) were analyzed. Statistical analyses compared outcomes between groups.

RESULTS: Sixty-two patients (69%) underwent an ileal conduit and 28 (31%) an alternative urinary reconstruction.The POM rate occurred in 66% of cases, including 34% experiencing major complications with no difference between groups (p = 0.86). Urologic complications were observed in 13% of patients, mainly urinary tract infections (10%); urine leaks (5%) occurred only after ileal conduit. Severe bowel dysfunction (major LARS) affected 30% and significant fecal incontinence (Wexner >10) 35% of patients, with a trend toward worse outcomes in the alternative reconstruction group. QoL was similar across most domains, except for the “usual activities” category, which were more limited after alternative reconstructions(p = 0.046). OS and DFS were comparable while primary cancer had significantly better outcomes than recurrent cancers (p < 0.001).

CONCLUSION: Ileal conduit remains the predominant urinary diversion following PE. Alternative reconstructions do not significantly impact morbidity, survival or QoL, except for a modest limitation in “usual activities”. Shared decision-making is essential given the high morbidity and complex functional sequelae of PE.

PMID:41774974 | DOI:10.1016/j.ejso.2026.111515

J Psychiatr Res. 2026 Feb 12;197:107-117. doi: 10.1016/j.jpsychires.2026.02.025. Online ahead of print.

ABSTRACT

PURPOSE: Increased social demands during adolescence and early adulthood pose specific challenges for individuals with autism spectrum disorder (ASD) without accompanying intellectual impairment. Targeted group-based social competence trainings are effective interventions. This work evaluates the Zurich social competence training (KOMPASS), a manualized program for adolescents and young adults (12-25 years) with ASD.

METHODS: In this quasi-experimental longitudinal study with a naturalistic waiting period and follow-up, we assessed participants of the KOMPASS intervention (N = 108) at our clinic through parent-, teacher- and self-reports along with a computerized task. A subset of participants (N = 65) was additionally assessed during a waiting period prior to intervention, allowing within-subject comparison of change before and during treatment. One-year follow-up data for the KOMPASS intervention group were collected (N = 62). Furthermore, we analyzed pre- and post-data from 35 individuals who completed KOMPASS at external clinics using the KOMPASS- manual without prior introduction to the method. Critically, we used Bayesian statistics to show evidence for stability of effects and comparable outcomes across settings.

RESULTS: Compared to the waitlist period, the KOMPASS training period showed a significant decrease in social and behavioral difficulties associated with ASD and improvements in social competences, which were sustained one year after training. General psychiatric symptoms also improved post-intervention in the KOMPASS training period. Participants from external clinics demonstrated similar significant improvements, affirming the manual’s effectiveness in external settings. No significant gender or age moderation effects were observed for the primary outcomes. Participants and caregivers expressed satisfaction with the training.

CONCLUSION: KOMPASS demonstrates significant effects in improving social functioning and reducing ASD-related difficulties in adolescents and young adults. The study benefits from a large sample, a naturalistic waiting-period comparison, a one-year follow-up, multi-informant assessment, and external validation. Limitations include the quasi-experimental design, the lack of formal fidelity monitoring, and reliance on some older assessment measures.

PMID:41774970 | DOI:10.1016/j.jpsychires.2026.02.025

Waste Manag. 2026 Mar 2;215:115426. doi: 10.1016/j.wasman.2026.115426. Online ahead of print.

ABSTRACT

Food waste in schools presents significant environmental, economic, and social challenges. This large-scale study investigates the effectiveness of an awareness-raising campaign aimed at reducing food waste in schools. The intervention included printed materials, campaign videos, and an online food waste tracker to inform students about the consequences of food waste and encourage behaviour change. The study employed a three-phase methodology: initial food waste measurement, an awareness campaign combined with a questionnaire survey, and post-intervention food waste assessment. The survey was conducted across 10 schools, where data were collected on food waste generated from a total of 52,421 prepared lunch menus. Food waste was measured during two separate 10-day survey periods in consecutive years; in the second year, an awareness-raising campaign was implemented in the selected schools. In addition, students’ attitudes towards food waste were assessed through a questionnaire survey, yielding 1,480 responses. Data were analysed using statistical methods (Student’s t-test, Pearson’s correlation). On average, consumers left 103 g of food on their plates from each course, which accounted for 32% of the served meal. Although our hypothesis assumed that the campaign would reduce the amount of waste generated, the results did not support this expectation. The findings indicate that while students recognize the importance of reducing food waste, the campaign did not lead to a measurable reduction. This suggests that simply increasing awareness may not be sufficient to drive behavioural change, highlighting the need for alternative strategies.

PMID:41774966 | DOI:10.1016/j.wasman.2026.115426

Mar Pollut Bull. 2026 Mar 2;227:119456. doi: 10.1016/j.marpolbul.2026.119456. Online ahead of print.

ABSTRACT

Marine debris entanglement is a growing threat to pinnipeds, with acute consequences including injury, restricted movement, and increased energy expenditure now well documented. The use of drones to monitor populations and estimate entanglement prevalence is growing. Drone-borne colour (RGB) cameras enhance detection of conspicuous debris, but thin or transparent materials such as fishing line are often missed. Thermal infrared (TIR) imaging may improve detection by highlighting heat from wounds or disrupted fur caused by entanglement. We assessed the efficacy of drone-borne RGB and TIR imaging for detecting entanglements in Australian fur seals (Arctocephalus pusillus doriferus) at Seal Rocks, south-eastern Australia. Across 54 drone surveys using representative commercial RGB + TIR sensors and concurrent handheld imaging, we captured imagery of entangled and non-entangled individuals. The resultant orthomosaic images and videos were classified by reviewers with relevant experience, and reviewer performance was assessed using generalised linear mixed models to estimate recall and precision. Entanglements were clearly visible in handheld TIR via elevated heat signatures. Similar thermal anomalies were visible in 81% of RGB + TIR drone detections of marine debris entanglements, with 95% reviewer agreement. RGB + TIR videos achieved the highest estimates and most reliable balance of recall and precision, followed closely by RGB alone, though differences were not always statistically significant. Importantly, fishing line was effectively detected in dual RGB + TIR drone imagery. This study presents the first use of drone-borne TIR imaging to detect marine debris entanglements and demonstrates that combining RGB and TIR video maximises detection performance.

PMID:41774946 | DOI:10.1016/j.marpolbul.2026.119456

J Spec Oper Med. 2026 Mar 3:J.Spec.Oper.Med.2026.R9KS-GFTU. doi: 10.55460/J.Spec.Oper.Med.2026.R9KS-GFTU. Online ahead of print.

ABSTRACT

BACKGROUND: Police Tactical Group (PTG) officers, in general, are older than their general duties counterparts. The nature of the occupational role scope demands a high level of fitness; thus, physical assessments are essential. This research investigated the relationship between officer age and completion times for an occupationally relevant physical fitness assessment in specialist police officers.

METHODS: Retrospective data were collected from 34 male PTG officers (age 37.8 [SD 6.5] y); height 181.6 [SD 6.7] cm; body mass 91.5 [SD 10.9] kg) and 18 male PTG candidates (age 32.1 [SD 5.0] y; height 183.7 [SD 5.8] cm; body mass 89.4 [SD 8.7] kg) competing in the RUSH assessment. The RUSH consisted of alternating directional sprints, crawls, 80kg mannequin drags (10-20m), and adopting shooting positions. Operational personal protective equipment (PPE; 22.2 [SD 4.90] kg) was worn.

RESULTS: PTG officers were significantly older (P=.002) and carried significantly lighter PPE loads (P<.001). There were no significant differences in mean RUSH times between PTG officers (105.1 seconds [SD 14.6s]) and candidates (111.7 (SD 9.2) s, P=.056). Correlations and a backward stepwise regression model were consistent in indicating that neither age nor group was a statistically significant predictor of RUSH time. PPE weight was not significantly predictive of RUSH time when entered alone in a regression model.

CONCLUSION: Age was not a significant predictor of RUSH times; as such, the RUSH can be used for initial candidates and for older qualified personnel. Ongoing physical strength and conditioning practices undertaken by PTG officers may mitigate age-related fitness loss.

PMID:41774931 | DOI:10.55460/J.Spec.Oper.Med.2026.R9KS-GFTU

JMIR Hum Factors. 2026 Mar 3;13:e75263. doi: 10.2196/75263.

ABSTRACT

BACKGROUND: The rising number of refugees and migrants has created growing mental health needs that health care systems struggle to address. Providing assessment and treatment for mental health problems in a digital format could help increase access to care and facilitate the provision of adapted interventions. Psychologists are key stakeholders in the delivery and influence of clinical services within routine care settings, but there are limited data on their perspectives regarding the use of digital solutions to assess and treat common mental health problems in refugees and migrants.

OBJECTIVE: This study aimed to examine psychologists’ usage, knowledge, and attitudes toward digital mental health solutions for assessing and treating common mental health problems in refugees and migrants within the Swedish health care system.

METHODS: A cross-sectional online survey was conducted among psychologists in Sweden between December 2023 and February 2024. Responses included Likert-scale items and categorical variables, which were analyzed using descriptive statistics, independent samples t tests, and Fisher exact test to explore differences between subgroups.

RESULTS: A total of 81 psychologists responded to the survey. Among them, 58 (72%) were women, and nearly half (40/81, 49%) worked in a public health care region. Respondents showed the highest acceptance for guided internet-based cognitive behavioral therapy (ICBT), blended treatment, and videoconferencing therapy. Only 20% (16/81) reported using digital solutions for refugees or migrants with mental health problems. Most respondents had low or very low knowledge of digital assessment and screening (61/81, 75%) and digital treatment (58/81, 72%) for these groups. Those using digital formats for refugees and migrants, or working in a setting that did so, had significantly higher ratings on all 5 knowledge items compared to those that did not (P<.001 to P=.01). Respondents emphasized the importance of digital solutions being provided in refugees’ and migrants’ native languages (70/81, 86%) and being culturally adapted (56/81, 69%). Those using digital formats for refugees and migrants considered cultural adaptation less necessary (P=.05). The preferred implementation approach was through specialized or decentralized units in primary care (66/81, 81%).

CONCLUSIONS: While psychologists recognize the potential of digital mental health solutions, significant barriers remain, including limited knowledge and experience with using digital formats for refugees and migrants. Psychologists prefer digital solutions in the native language of refugees and migrants that are implemented at the primary care level. The need for cultural adaptation should be further explored. Addressing psychologists’ preferences could facilitate the future integration and implementation of digital formats for refugees and migrants in routine care settings.

PMID:41774913 | DOI:10.2196/75263

Ecol Evol Physiol. 2026 Jan-Feb;99(1):33-42. doi: 10.1086/739792. Epub 2026 Jan 20.

ABSTRACT

AbstractFitness of interspecific hybrids can be higher or lower than that of their parental genotypes, with major ramifications for evolution and conservation. A recent study found that hybrid tiger salamanders had higher metabolic rates than their parental forms. Specifically, the ratio of resting metabolic rate to water loss, which was used as a measure of performance, was greater in hybrids. Recent genetic research showed that over half of the experimental subjects in that study were genetically pure California tiger salamanders (Ambystoma californiense) misclassified as hybrids. We reanalyzed the data using the corrected identification of hybrids and parentals. As expected, updating the classification revealed even stronger evidence for differences between hybrids and parentals. Hybrids had higher resting metabolic rates and greater water loss than parentals. The ratio of resting metabolic rate to water loss was also higher in hybrids. However, we suggest that this ratio might not be a positive measure of salamander performance. Higher metabolic rate means higher energy expenditure, and higher water loss suggests increased risk of desiccation. Both are major challenges for terrestrial amphibians, especially salamanders, which are hypothesized to be low-energy, low-water-loss specialists. Under this hypothesis, the ratio of energy expenditure to water loss is a ratio of two costs rather than a ratio of benefit to cost. While our analyses corroborate and strengthen the previous statistical results, we suggest that high resting metabolic rate is better interpreted as hybrid dysfunction, not vigor. Both hypotheses are speculative, and specific research on the fitness effects of these physiological differences is needed to resolve this important ecological question.

PMID:41774889 | DOI:10.1086/739792

JCO Clin Cancer Inform. 2026 Mar;10:e2500173. doi: 10.1200/CCI-25-00173. Epub 2026 Mar 3.

ABSTRACT

PURPOSE: Early-stage breast cancer (ESBC) in women younger than 50 years often presents with tumor features, including grade and hormone receptor and human epidermal growth factor receptor 2 (HER2) status different from older women. Machine learning clustering techniques can reveal underlying patterns in the inter-relationships of these features and provide novel insights to inform and guide decision making by patients and providers.

METHODS: Partitioning around medoids (PAM) was applied to SEER data from 67,746 women age 18-49 years diagnosed with ESBC. PAM clustering based on tumor size (T), nodal status (N), grade, and receptor status identified 10 distinct clusters. The PAM clusters and American Joint Committee on Cancer (AJCC) anatomic and prognostic stages were compared in terms of their tumor features and their association with chemotherapy and survival.

RESULTS: AJCC anatomic and prognostic stages are primarily defined by T and N. PAM clusters were primarily defined by receptor status and grade. PAM clusters align closely with luminal A, luminal B, triple-negative, or HER2-overexpressing treatment-related subtypes. PAM clusters better discriminated chemotherapy treatment, with C-statistic 0.839 (95% CI, 0.836 to 0.842), than either anatomic, with C-statistic 0.770 (95% CI, 0.767 to 0.773), or prognostic staging, with C-statistic 0.796 (95% CI, 0.794 to 0.800). PAM clusters were better predictors of 5-year overall survival, with C-statistic 0.733 (95% CI, 0.727 to 0.739), than anatomic stages, with C-statistic 0.721 (95% CI, 0.715 to 728), but not as predictive as prognostic stages, with C-statistic 0.759 (95% CI, 0.753 to 0.764).

CONCLUSION: Data-driven PAM clusters provide novel insights into the inter-relationship of tumor features and their association with hormonal, targeted, and chemotherapy treatment and with survival outcomes in women younger than 50 years with ESBC. An online application was created so that the PAM clusters could be used as alternatives or in addition to traditional AJCC staging to inform and guide patients and providers.

PMID:41774882 | DOI:10.1200/CCI-25-00173

Rev Med Inst Mex Seguro Soc. 2026 Mar 3;64(2):e6878. doi: 10.5281/zenodo.17537296.

ABSTRACT

Delaying the measurement of a complete blood count (CBC) for 6 to 24 hours after red blood cell transfusion remains a common practice in hospitals worldwide, despite the absence of strong physiological or empirical justification. This narrative review summarizes the available clinical evidence comparing early versus delayed post-transfusion evaluation of hemoglobin (Hb) and hematocrit (Hct) levels in adult patients. Studies conducted in the United States, Spain, Colombia, and Thailand, including more than 290 hemodynamically stable, non-bleeding adults, assessed Hb and Hct levels at different intervals ranging from 15 minutes to 24 hours after transfusion. Across all studies, early post-transfusion measurements showed no statistically significant differences when compared with delayed testing, demonstrating that Hb and Hct values stabilize rapidly within 15 to 60 minutes following transfusion. These findings refute the traditional assumption that several hours are required for equilibration. Implementing early CBC testing provides accurate results, enables prompt assessment of transfusion efficacy, reduces unnecessary delays in clinical decision-making, and improves hospital workflow efficiency. Therefore, early measurement of Hb and Hct is safe, reliable, and cost-effective in stable adult patients.

PMID:41774859 | DOI:10.5281/zenodo.17537296

Rev Med Inst Mex Seguro Soc. 2026 Mar 3;64(2):e6801. doi: 10.5281/zenodo.17537340.

ABSTRACT

Graphs used in scientific articles help improve the understanding of results. One of the most widely used graphs in recent scientific literature is the forest plot. Its growing popularity is related to its versatility. Although it was initially employed to present results of meta-analyses, it is now used to display findings from individual studies, for both qualitative and quantitative variables, as long as a confidence interval -most commonly the 95% CI- can be calculated. This graph not only allows the presentation of results from univariate analyses but also from multivariable analyses, making it applicable to diverse fields of scientific knowledge. In this article, we present, in addition to the history of the forest plot, a description of its components -its anatomy- and a tutorial on how to create one using statistical software.

PMID:41774848 | DOI:10.5281/zenodo.17537340