Category: Nevin Manimala

Int J Speech Lang Pathol. 2026 Apr 7:1-20. doi: 10.1080/17549507.2026.2645784. Online ahead of print.

ABSTRACT

PURPOSE: Youth offenders disproportionately come from low socioeconomic status backgrounds and are more likely to present with a language disorder than their non-offending peers. Literature on the presence of socioeconomic status-related risk factors among youth offenders with language disorders is limited, despite its important role in both language development and youth offending behaviour.

METHOD: A scoping review protocol was developed using the PRISMA-ScR protocol and executed across five electronic databases. Data sources were deduplicated, screened, charted, and appraised. Synthesis was conducted using descriptive statistics and qualitative content analysis. Initially, 787 sources were identified, of which 16 (1993-2024) were analysed.

RESULT: Thirteen sources (81.3%) that investigated language disorders among incarcerated youth offenders and discussed result related to socioeconomic status factors were identified. Eleven risk factors were identified, with the most frequent being illicit substance use (n = 6, 46.2%), dropping out of school (n = 4, 30.8%), and coming from low-income communities (n = 3, 23.1%).

CONCLUSION: Despite significant variability and inconsistency in measurement, a number of socioeconomic status-related risk factors were identified. A dearth in literature on diverse contexts and demographics were observed. The need for further research on socioeconomic status risk factors among youth offenders with language disorders is evident.

PMID:41945387 | DOI:10.1080/17549507.2026.2645784

J Patient Saf. 2026 Apr 7. doi: 10.1097/PTS.0000000000001505. Online ahead of print.

ABSTRACT

OBJECTIVES: Medically ill patients, especially those with psychiatric comorbidities, may exhibit behavioral disturbance while hospitalized. Restlessness, removing medical devices, or wandering may lead to sentinel events such as falls, elopements, or violence. An interdisciplinary behavioral intervention team (BIT) was implemented to address and anticipate the need for behavioral health support on medical units. A retrospective review was conducted to evaluate the effects of BIT interventions on patient safety events.

METHODS: Two psychiatric nurses were embedded on medical/surgical units as part of medical and psychiatric interdisciplinary teams. A retrospective review was conducted to evaluate outcomes. Two time periods were examined: 6 months with early-BIT efforts and 6 months with expanded-BIT efforts. Medical records and safety reports were reviewed, and statistical analysis was conducted in SAS Enterprise Guide 8.3. Statistical significance was based on associated P-values (P<0.05).

RESULTS: Of admitted patients during the study period (N=1413), pre-existing psychiatric diagnoses were present in 58% of cases, with mood, anxiety, and neurocognitive disorders being most common. A majority of patients were on psychotropic medications during both study periods; however, there was a significant decrease in the use of psychotropic medications with expanded-BIT efforts (71.2% versus 61.3%, P<0.001). In comparing early-BIT efforts to expanded-BIT efforts, significant reductions in workplace aggression (6.7% versus 2.3%, P<0.001), use of restraints (5.8% versus 3.4%, P=0.034), and need for security officers (4.2% versus 0.8%, P<0.001) were observed.

CONCLUSIONS: Engaging BIT significantly reduced aggression, restraint use, and security officer interventions. An interdisciplinary BIT is feasible and effective in reducing negative outcomes.

PMID:41945363 | DOI:10.1097/PTS.0000000000001505

JAMA Netw Open. 2026 Apr 1;9(4):e265439. doi: 10.1001/jamanetworkopen.2026.5439.

ABSTRACT

IMPORTANCE: Financial and geographic barriers are associated with worse cardiovascular outcomes, underscoring the need to improve access to cardiovascular care. Medicare Advantage (MA) plans offer reduced cost-sharing for cardiologists, potentially mitigating financial barriers to cardiovascular care through minimizing out-of-pocket costs.

OBJECTIVES: To determine how availability of Medicare Advantage plans with reduced cost-sharing for cardiologists has changed over time, whether plans offer reduced cost-sharing to beneficiaries in communities with more or less cardiologist supply or cardiovascular care infrastructure, and whether such benefits are offered by high-quality plans.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study of MA benefit design related to cardiovascular care used plan benefits package and MA enrollment data from December 31, 2022, to December 31, 2024. Participants were MA beneficiaries. Data were analyzed from March 1 to May 23, 2025.

EXPOSURES: MA plans with reduced cost-sharing for cardiologists.

MAIN OUTCOMES AND MEASURES: The primary outcomes were (1) enrollment patterns in MA plans offering reduced-cost sharing for cardiologists (measured as quarterly enrollment in such plans from 2022 to 2024), (2) number of MA plans with reduced cost-sharing for cardiologists mapped to county-level cardiologist supply (measured as the number of cardiologists per 1000 MA beneficiaries) and cardiovascular care infrastructure (measured via individual measures and a composite index of 3 county-level measures), and (3) quality of these plans vs other MA plans (measured via 3 metrics of cardiovascular care-related quality from the Healthcare Effectiveness Data and Information Set).

RESULTS: Among 2993 plans with reduced cost-sharing for cardiologists and 3143 counties, the number of plans offering reduced cost-sharing for cardiologists (from 134 of 6448 [2.1%] in 2022 to 158 of 6808 [2.3%] in 2024) and enrollment in such plans (1.4 million in 2022 to 1.5 million in 2024) increased during the study period. Across counties, the number of MA plans with reduced cost-sharing for cardiologists varied considerably compared with cardiologist supply and cardiovascular care infrastructure. Reduced cost-sharing plans had greater care quality compared with other MA plans (116 of 158 [73.4%] with reduced cost-sharing for cardiologists being high quality vs 2508 of 6650 [37.7%]; P < .001).

CONCLUSIONS AND RELEVANCE: In this cross-sectional study of plans with reduced cost-sharing for cardiologists, the number of plans increased over time and tended to be higher quality compared with other MA plans. However, persistent geographic variability in number of plans offered, cardiologist supply, and cardiovascular care infrastructure underscore the need for additional strategies to minimize financial and geographic barriers for cardiovascular care.

PMID:41945346 | DOI:10.1001/jamanetworkopen.2026.5439

JAMA Netw Open. 2026 Apr 1;9(4):e265528. doi: 10.1001/jamanetworkopen.2026.5528.

ABSTRACT

IMPORTANCE: The prevalence of childhood obesity has tripled between 1999 and 2021, and the greatest increases have been observed in Asia. Ultraprocessed foods are considered a major risk factor for obesity; however, trends in ultraprocessed food consumption among Korean youths remain understudied.

OBJECTIVE: To examine 18-year trends in ultraprocessed food consumption stratified by obesity and demographic characteristics among Korean youths.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study used 24-hour dietary recall data from 6 cycles of the Korea National Health and Nutrition Examination Survey from 2007 to 2024. Participants included Korean youths aged 1 to 18 years.

EXPOSURE: Survey cycles.

MAIN OUTCOMES AND MEASURES: The percentage of energy intake from ultraprocessed foods based on the Nova food classification system was estimated across survey cycles.

RESULTS: Among the 24 518 youths included, the weighted mean (SD) age of participants was 10.2 (5.1) years, of whom 12 797 (52.2%) were boys. From the 2007-2009 to 2022-2024 cycles, the percentage of energy from ultraprocessed foods increased from 24.6% (SE, 0.5%) to 33.0% (SE, 0.5%) (P < .001 for trend), while the percentage of energy from unprocessed or minimally processed foods decreased from 64.8% (SE, 0.5%) to 51.8% (SE, 0.4%) (P < .001 for trend). There was a greater increase in ultraprocessed food consumption among school-aged children (from 22.9% [SE, 0.6%] to 34.0% [SE, 0.6%]) and adolescents (from 28.7% [SE, 0.8%] to 36.9% [SE, 0.7%]) than among preschool-aged children (from 23.5% [SE, 0.6%] to 26.4% [SE, 0.9%]) and among youths without obesity (from 24.7% [SE, 0.5%] to 33.5% [SE, 0.5%]) than those with obesity (from 24.9% [SE, 0.8%] to 30.9% [SE, 1.1%]) (P ≤ .001 for interaction).

CONCLUSIONS AND RELEVANCE: In this cross-sectional study of Korean youths, the estimated proportion of energy intake from ultraprocessed foods increased from 2007 to 2024, indicating that ultraprocessed foods became a more dominant part of Korean youths’ diets, especially among older youths and those without obesity. These findings suggest the need for monitoring and preventive strategies to reduce intake.

PMID:41945345 | DOI:10.1001/jamanetworkopen.2026.5528

JAMA Netw Open. 2026 Apr 1;9(4):e265585. doi: 10.1001/jamanetworkopen.2026.5585.

ABSTRACT

IMPORTANCE: Life-prolonging targeted therapies are available based on alterations detected on next-generation sequencing (NGS); however, clinical data on NGS adoption are limited.

OBJECTIVE: To assess trends and disparities in NGS among patients with common advanced or metastatic cancers.

DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 280 US-based cancer clinics (approximately 800 sites of care) using electronic health record-derived deidentified information from Flatiron Health Research Database. Participants were patients diagnosed with metastatic breast (mBC), metastatic prostate (mPC), advanced non-small cell lung (aNSCLC), metastatic colorectal (mCRC), and metastatic pancreatic (mPanC) cancers between January 1, 2018, and December 30, 2022. Data were analyzed from April 2024 to December 2025.

MAIN OUTCOMES AND MEASURES: Time to NGS from diagnosis, considering death as competing risk. Multivariable cause-specific Weibull accelerated failure time models evaluated association of socioeconomic status (SES), race and ethnicity, insurance type, practice setting, and sex with time to NGS.

RESULTS: Overall, 63 294 patients with advanced or metastatic cancer who underwent NGS were eligible and included: 12 085 with mBC (19.1%), 4341 with mPC (6.9%), 27 050 with aNSCLC (42.7%), 13 648 with mCRC (21.6%), and 6170 with mPanC (9.7%). The median (IQR) age was 68 (60-76) years and 33 975 patients (53.7%) were female; 1703 (2.7%) were Asian, 6551 (10.0%) were Black, 3772 (6.0%) were Hispanic, 38 318 (61.0%) were White, and 12 950 (20.3%) were other races and ethnicities. One-year cumulative incidence of NGS increased in patients diagnosed in 2022 compared with 2018 across all cancer types. Significantly longer time to NGS (time ratio [TR]) was observed in those with mBC with low SES (1, lowest: TR, 1.3; 95% CI, 1.1-1.6; 2: TR, 1.3; 95% CI, 1.1-1.5), those who were Hispanic (TR, 1.4; 95% CI, 1.2-1.7), or those on Medicare (TR, 1.5; 95% CI, 1.3-1.8). Longer TRs were also observed in those with mPC and Hispanic ethnicity (TR, 1.6; 95% CI, 1.3-2.1), those on Medicaid (TR, 2.0; 95% CI, 1.2-3.5), those with aNSCLC with low SES (1, lowest: TR, 1.6; 95% CI, 1.5-1.8; 2: TR, 1.4; 95% CI, 1.3-1.6; 3: TR, 1.2; 95% CI, 1.1-1.3), Black patients (TR, 1.4; 95% CI, 1.2-1.5), and those on Medicare (TR, 1.4; 95% CI, 1.3-1.5). For mCRC, TRs were elevated for those with low SES (1, lowest: TR, 1.3; 95% CI, 1.1-1.5; 2: TR, 1.1; 95% CI, 1.0-1.3), Black patients (TR, 1.4; 95% CI, 1.2-1.6), Hispanic patients (TR, 1.4; 95% CI, 1.2-1.6), and those on Medicare (TR, 1.4; 95% CI, 1.3-1.6). Elevated TRs were also observed for mPanC in Black patients (TR, 1.5; 95% CI, 1.2-1.8) and those on Medicare (TR, 1.3; 95% CI, 1.1-1.5).

CONCLUSIONS AND RELEVANCE: In this cohort study, most patients with advanced or metastatic cancers did not undergo tumor genomic testing. Low SES, Black race or Hispanic ethnicity, and Medicaid or Medicare coverage were associated with significantly longer time to NGS, highlighting the need for awareness and health care policies aimed at bridging these gaps.

PMID:41945343 | DOI:10.1001/jamanetworkopen.2026.5585

Anatol J Cardiol. 2026 Apr 3. doi: 10.14744/AnatolJCardiol.2026.5770. Online ahead of print.

ABSTRACT

BACKGROUND: Premature ventricular complexes (PVCs) arising from the right and left ventricular outflow tracts (RVOT and LVOT) require accurate localization for successful ablation. Existing electrocardiographic (ECG) algorithms are limited by anatomical variability. This study aimed to develop a supervised learning approach model based on logistic regression using validated ECG parameters and to compare its diagnostic performance with 7 established algorithms.

METHODS: A retrospective cohort of 116 patients with idiopathic outflow tract PVCs who underwent successful ablation between 2015 and 2020 was analyzed. Four ECG parameters were selected through backward stepwise logistic regression. The performance of the model and 7 published algorithms was assessed using receiver-operating characteristic (ROC) curve analysis, Youden index, and accuracy metrics. Subgroup analysis was performed in patients with V3 precordial transition.

RESULTS: The supervised learning model achieved the highest diagnostic accuracy with an area under the ROC curve of 0.942 in the overall cohort and 0.878 in the V3 transition subgroup, significantly outperforming all comparator algorithms (P < .001). The model demonstrated a Youden index of 0.66, sensitivity of 82.7%, and specificity of 84.4%.

CONCLUSION: The supervised learning approach model outperformed existing rule-based ECG algorithms in differentiating RVOT from LVOT PVCs. By integrating validated ECG features into a statistically optimized and interpretable framework, it provides a reliable noninvasive tool to support ablation planning. Larger multicenter validation studies are warranted.

PMID:41945340 | DOI:10.14744/AnatolJCardiol.2026.5770

J Craniofac Surg. 2026 Apr 7. doi: 10.1097/SCS.0000000000012600. Online ahead of print.

ABSTRACT

To investigate the difference between the 3-dimensional structure of the cavity in patients with isolated cleft palate and Pierre-Robin syndrome with cleft palate. Retrospective measurements of high need ratio (NR), velopharyngeal gap (VPG), soft palate length (SPL), and long velopharyngeal depth (VPD) were taken from lateral and anteroposterior (AP) cephalometric radiographs of isolated cleft palate and PRS with cleft palate. A total of 29 isolated cleft palate and 18 PRS patients with cleft palate were included. The VPG, SPL, and VPD of cleft palate were higher than those in the PRS group. But there is no statistically significant difference of the NR values between the 2 groups (P=0.509). NR and long VPD were contributing factors to velopharyngeal insufficiency (VPI) occurrence. The higher VPD in isolated cleft palate patients compared with PRS may reflect age-related assessment variability. However, the 2 groups show no significant difference in NR values, suggesting comparable velopharyngeal insufficiency between PRS and isolated cleft palate patients.

PMID:41945325 | DOI:10.1097/SCS.0000000000012600

Sports Med Open. 2026 Apr 7;12(1):40. doi: 10.1186/s40798-026-00993-3.

ABSTRACT

BACKGROUND: Exercise-induced muscle damage (EIMD) is known to impair neuromuscular performance, provoke inflammation, and delay recovery. Tart cherry (TC) juice, a polyphenol-rich nutritional product, has been proposed as a strategy to support recovery in athletes; however, findings across studies remain inconsistent.

OBJECTIVE: The aim was to conduct a systematic review combined with a meta-analysis and corroborate the certainty of evidence underpinning the effects of TC juice supplementation on physical, biochemical, and perceptual recovery markers following EIMD in trained athletes.

METHODS: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. PubMed, ScienceDirect, Web of Science and SPORTDiscus were searched from inception to 25 December 2025.

RESULTS: Nineteen trials were included. Our results revealed TC juice supplementation significantly improved MVC recovery in the main analysis across all time points (post: ES = 0.63; 24 h: ES = 1.12; 48 h: ES = 1.29; 72 h: ES = 2.14; 96 h: ES = 4.82), with substantial heterogeneity (I² 69-93%). CMJ showed no significant effects post-exercise or at 24h but improved at 48 h (ES = 1.41; I² = 72%). TC juice significantly reduced CRP post-exercise and up to 48 h (post: ES = -0.46; 24 h: ES = -0.73; 48 h: ES = -0.68), whereas no significant pooled effects were found for muscle soreness, CK, IL-6, TNF-α, ROM, or most subgroup time points. Subgroup analyses suggested model-specific responses (e.g., MVC improvements at 24-48 h in whole-body protocols and at 72 h in isolated protocols). Sensitivity analyses indicated that statistical significance at selected time points (MVC post and 72 h; CMJ 48 h; CRP 24-48 h) was influenced by individual studies. Certainty of evidence ranged from very low to moderate.

CONCLUSIONS: TC juice supplementation may support recovery of selected functional and inflammatory markers following exercise-induced muscle damage in trained athletes; however, findings are heterogeneous and supported by low-to-moderate certainty of evidence, warranting cautious interpretation.

PMID:41945263 | DOI:10.1186/s40798-026-00993-3

Adv Clin Exp Med. 2026 Apr 7. doi: 10.17219/acem/208614. Online ahead of print.

ABSTRACT

BACKGROUND: No comprehensive comparative research has been conducted to evaluate open Bankart (OB), arthroscopic Bankart (AB), open Latarjet (OL), and arthroscopic Latarjet (AL) simultaneously across all relevant clinical outcomes and parameters.

OBJECTIVES: To compare the efficacy of OB, AB, OL, and AL procedures in the treatment of shoulder dislocation.

MATERIAL AND METHODS: The databases PubMed, Embase, the Cochrane Library, and Web of Science were utilized for the literature search. The study evaluated recurrent instability, re-dislocation, apprehension, functional outcomes, and postoperative pain. The results were visually represented through network diagrams, forest plots, league tables, and rank probability plots to provide a comprehensive understanding of each outcome.

RESULTS: Overall, 37 studies were included in the analysis. Individuals who underwent OL experienced a notably reduced risk of recurrent instability compared with those who underwent AB (random-effects model pooled relative risk (RR) = 0.34, 95% credible interval (95% CrI): 0.24-0.48) and OB (random-effects model pooled RR = 0.51, 95% CrI: 0.31-0.85). The risk of re-dislocation was also significantly lower for patients treated with OL compared with AB (pooled RR = 0.15, 95% CrI: 0.04-0.45). While not statistically significant, the OL procedure tended to have the lowest risk of apprehension and the highest Subjective Shoulder Value (SSV) score. Regarding postoperative pain, patients who underwent OB had the highest likelihood of attaining the lowest scores on the visual analogue scale (VAS). In addition, OL was associated with the highest probability of complications.

CONCLUSION: The open Latarjet procedure appears to offer superior shoulder stability; however, while functional outcomes for patients undergoing OL are likely to be non-inferior, the procedure is not significantly associated with reduced postoperative pain as measured with the VAS score. Additionally, the OL procedure is associated with an increased likelihood of complications. Consequently, it is essential to implement preventive measures to manage postoperative pain and address potential complications following OL procedure.

PMID:41945260 | DOI:10.17219/acem/208614

Int J Clin Pharm. 2026 Apr 7. doi: 10.1007/s11096-026-02134-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Medication non-adherence is common in patients with acute coronary syndrome (ACS) and may increase the risk of cardiac readmissions and mortality.

AIM: To evaluate the effect of a clinical pharmacist-led, behavioural theory-based discharge service designed to promote medication adherence on 30-day cardiac readmissions (primary outcome) and on clinical, humanistic, and healthcare utilisation outcomes over 360 days in patients with ACS.

METHOD: In this single-centre, parallel-group randomised controlled trial, adult patients hospitalised with ACS were assigned by permuted block randomisation (block size 8) to the intervention or control group. The intervention comprised a clinical pharmacist-led, behavioural theory-based discharge service to promote medication adherence. The intervention consisted of medication reconciliation, medication review and patient counselling based on components of the behaviour change technique taxonomy and Health Belief Model. The primary outcome was 30-day hospital readmission for cardiac reasons. Secondary outcomes included all-cause and cardiac readmissions, emergency department visits, all-cause and cardiac mortality, medication adherence, LDL (low-density lipoprotein) target attainment, and quality of life over 360 days.

RESULTS: A total of 167 patients were analysed (intervention: n = 80; control: n = 87). The primary outcome occurred in 0/80 (0.0%) in the intervention group versus 5/87 (5.7%) in the control group (risk difference – 5.7%, 95% CI – 12.8 to 2.1%; p >0.050). Over 360 days, the control group had higher adjusted odds of cardiac readmission (aOR 4.4; 95% CI 1.2-16.0; p = 0.027), all-cause readmission (aOR 3.7; 95% CI 1.1-11.7; p = 0.029), and non-adherence at 30 days (aOR 2.4; 95% CI 1.1-5.2; p = 0.028). At 180 days, the control group had lower adjusted odds of LDL target attainment (aOR 0.4; 95% CI 0.2-0.9; p = 0.038).

CONCLUSION: This intervention reduced 30-day cardiac readmission, but the effect was not statistically significant. According to findings of secondary outcomes, this behavioural theory-based discharge service at discharge might be effective in reducing healthcare utilisation in the long term and improving the short-term target for medication adherence in patients with acute coronary syndrome.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05153707.

PMID:41945242 | DOI:10.1007/s11096-026-02134-y