Category: Nevin Manimala

Top Stroke Rehabil. 2026 May 4:1-11. doi: 10.1080/10749357.2026.2664222. Online ahead of print.

ABSTRACT

BACKGROUND: Spasticity is a common condition among stroke survivors, and previous studies have explored the effects of whole-body vibration therapy for its benefits. However, the findings regarding lower limb spasticity remain inconsistent. Thus, the aim of this study was to determine the effect of eight-week whole-body vibration exercise on lower limb spasticity for stroke survivors.

METHODS: This is a single-blind randomized controlled trial. The 40 participants were eligible to participate the study and were allocated randomly to either an intervention group or control group. The intervention group implemented as 40 min of conventional therapy sessions and whole-body vibration training daily, five times a week for eight weeks; the control group implemented the same movements on a vibration platform without vibration with daily habitual living styles. The measurements were assessed at baseline, week four, and week eight. Primary outcomes were measured using the Modified Ashworth Scale and surface electromyography to measure spasticity. The Fugl-Meyer assessment was measured as a secondary outcome.

RESULTS: In the intervention group, spasticity of the triceps surae decreased by a mean of 0.45 points on the Modified Ashworth Scale from baseline to mid-intervention, and the same mean reduction was maintained at post-intervention. However, the statistical between-group differences were not observed at either mid-intervention or post-intervention. No significant between-group or within-group differences were observed in surface electromyography outcomes or Fugl-Meyer Assessment scores in either the intervention or control group.

CONCLUSION: Whole-body vibration therapy may contribute to improvements in lower-limb spasticity in stroke survivors and demonstrates some moderate effect sizes. These findings suggest that whole-body vibration may have potential benefits as a long-term adjunct therapy in stroke rehabilitation.Trial registrationThe registration number is ChiCTR1900026439.

PMID:42077180 | DOI:10.1080/10749357.2026.2664222

Am J Sports Med. 2026 May 4:3635465261439048. doi: 10.1177/03635465261439048. Online ahead of print.

ABSTRACT

BACKGROUND: Hip arthroscopy for femoroacetabular impingement (FAI) in professional athletes is associated with significant improvements in postoperative pain and function and a return-to-sport (RTS) rate >80%. However, RTS rate after hip arthroscopy for FAI in professional athletes with borderline dysplasia is unknown.

PURPOSE: To assess RTS rates exclusively in professional athletes with borderline dysplasia after hip arthroscopy for treatment of FAI.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: A total of 40 professional and Olympic athletes (42 hips) with borderline dysplasia (lateral center edge angle [LCEA] 18°-25°) underwent hip arthroscopy for FAI between 2005 and 2022. RTS was defined as competing in a single professional game at an equal level after surgery. Data were retrospectively obtained for each athlete from publicly available sport-specific data sources.

RESULTS: The study included 42 hips. Patients undergoing primary hip arthroscopy demonstrated a 79% RTS rate, whereas patients undergoing revision hip arthroscopy demonstrated a 25% RTS rate (P = .006). Among athletes who successfully returned, RTS occurred at a median of 7.5 months (range, 3.1-24.3 months) after surgery. The mean age at the time of surgery was 28.9 years (range, 18-53.5 years). In total, 21 hips (50%) had an Outerbridge grade 3 or 4 defect at the time of surgery, and 10 (24%) underwent a microfracture procedure. Older age (P = .041) and history of previous hip arthroscopy (P = .008) were associated with a lower likelihood of return to professional sport. No statistically significant association was found between femoral version, LCEA, alpha angle, the presence of Outerbridge grade 3 or 4 defect, or minimum joint space and RTS.

CONCLUSION: In the primary setting, professional athletes with borderline hip dysplasia who underwent hip arthroscopy for FAI demonstrated a 79% RTS rate. The mean time to return was 7.5 months, with older age and a history of prior hip arthroscopy predictive of a lower likelihood of RTS (25% RTS among revision cases). Hip arthroscopy for FAI in professional athletes with borderline dysplasia was effective for returning the majority of these athletes to their preoperative level, especially in the primary setting.

PMID:42077177 | DOI:10.1177/03635465261439048

Clin Nurs Res. 2026 May 4:10547738261441460. doi: 10.1177/10547738261441460. Online ahead of print.

ABSTRACT

Inadequate nutritional knowledge among hemodialysis (HD) patients can lead to poor fluid and dietary adherence, increasing the risk of complications. This study aimed to evaluate the effects of a nurse-led, animated video-based nutrition education program on dietary knowledge and fluid-diet adherence in individuals receiving HD. This experimental study employed a pretest-posttest control group design and included 107 HD patients, 48 in the intervention group and 59 in the control group. Data were collected using a patient information form, a nutritional knowledge survey, and the Dialysis Diet and Fluid Non-Adherence Questionnaire. Descriptive statistics and initial data entry were conducted using SPSS 24.0. The difference-in-differences (DiD) analysis was performed in Stata 18.0. The intervention group received nurse-led nutrition education supported by a 10-min animated video. Measurements were taken at baseline and 12 weeks after the intervention. There were no significant differences between groups in baseline nutritional knowledge or fluid-diet adherence scores. However, at week 12, the intervention group demonstrated a significant increase in nutritional knowledge and a decrease in fluid-diet nonadherence compared to the control group (p < .05). A DiD analysis revealed that the educational intervention resulted in a 4.4-point increase in knowledge scores, which was statistically significant (p < .05). Nurse-led animated video education significantly improved nutritional knowledge and fluid-diet adherence among HD patients. This approach may be an effective tool for supporting patient education and self-management of chronic kidney disease.

PMID:42077174 | DOI:10.1177/10547738261441460

Am J Health Promot. 2026 May 4:8901171261447644. doi: 10.1177/08901171261447644. Online ahead of print.

ABSTRACT

PurposeThe rapid growth of semaglutide use for weight loss has been accompanied by a proliferation of patient-shared experiences and non-evidence-based claims on video platforms. This unchecked information environment poses significant risks to public health, including potential self-medication and misunderstanding of treatment risks, underscoring the urgent need to evaluate the quality of semaglutide-related video content to safeguard digital health literacy. This study assesses the quality, reliability, and user engagement of semaglutide-related short videos on TikTok and Bilibili.ApproachThis cross-sectional study analyzed the top 100 semaglutide-related videos from TikTok and Bilibili, using keyword searches. Videos were evaluated using JAMA benchmark criteria, Global Quality Scale (GQS), and DISCERN tools.SettingRetrieving top 100 videos from TikTok (Mar 4, 2025) and Bilibili (Mar 8, 2025) using “” (Semaglutide) as the search keyword.Participants200 videos and their characteristics.ResultsAmong 200 videos, no statistically significant inter-platform differences in JAMA, GQS or DISCERN scores were observed. Non-professional organizations achieved higher JAMA scores than individual creators (P < .01). Medical information videos scored higher than personal experience content (P < .0001). Engagement metrics (likes) correlated weakly with quality (r = 0.151, P < .05), while longer videos were associated with higher DISCERN scores (r = 0.273, P < .001) but not increased engagement.ConclusionsSemaglutide-related videos on TikTok and Bilibili show moderate quality, with medical professionals and institutions producing more reliable content. However, user engagement remains a poor indicator of quality. These findings call for platform governance to algorithmically promote evidence-based content and verify credible creators, while public health efforts should steer user attention from popularity to credibility, thereby protecting informed decision-making.

PMID:42077173 | DOI:10.1177/08901171261447644

Public Health Nutr. 2026 May 4:1-41. doi: 10.1017/S1368980026102584. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine and synthesize data on the environmental impact of diet in Latin America.

DESIGN: A systematic review was conducted in April 2024, using Medline, Embase, Web of Science and Scopus databases, and updated in March 2025. We synthesized the evidence on the most reported environmental impact indicators. Meta-analysis was conducted to derive pooled estimates for individual countries of the mean dietary carbon and water footprints per person/per day; crude and energy-standardised (to 8,368 kJ (2,000 kcal)) values and stratified by dietary assessment method (DAM) and sociodemographic variables.

SETTING: Latin America.

PARTICIPANTS: Latin American populations.

RESULTS: Of the 4,266 studies screened, 31 were included. Data on environmental impact of diet were reported for eight Latin American countries, with most coming from Brazil. Dietary water footprint ranged from 2,078 in Chile to 3,215 L/person/day/8,368 kJ in Brazil. Dietary carbon footprint ranged from 2.1 to 7.3 kgCO₂-equivalents/person/day/8,368 kJ, in Peru and Argentina, respectively. The pooled standardised carbon footprint mean was 4.1 (95% CI 2.6-5.5, I²=100%) kgCO₂-equivalents/person/day/8,368 kJ with no significant differences between DAM (p=0.86). A higher carbon footprint was observed in individuals with higher education level and urban residence (p<0.05).

CONCLUSION: The available evidence suggested a wide variation in dietary environmental impact between Latin American countries, but a paucity of studies conducted in countries other than Brazil. Standardised approach to estimate the environmental impact of diet across the region, and analytical perspectives in further research would support the development of country-relevant evidence-based public policies for sustainable diets in Latin America.

PMID:42077150 | DOI:10.1017/S1368980026102584

Biol Rev Camb Philos Soc. 2026 May 4. doi: 10.1002/brv.70176. Online ahead of print.

ABSTRACT

The impact of plastic pollution on ecosystems and marine fauna is well documented, although research into its effects on waders (also known as shorebirds) remains limited. Given that waders are exposed to coastal marine litter, this exposure could be a significant factor in the decline of their populations. This study aims to assess the global distribution of plastic ingestion in waders and investigate regional differences in their exposure. Our analysis included 30 studies, examining 316 digestive tracts and 1114 faecal samples. Only four studies analysed plastic in wader nests or entanglements. Eastern Asia exhibited the highest prevalence of plastic ingestion in waders, although no significant differences were detected among coastal regions. Descriptive patterns suggest that this trend may be influenced by intensive industrial activity, high population density, and pollution along migratory flyways. Southern Asia had the highest prevalence of plastics in faecal samples. No statistically significant differences were observed across wader families; however, descriptive results indicated elevated ingestion frequencies in Haematopodidae and Scolopacidae, while Recurvirostridae and Haematopodidae tended to show higher plastic prevalence in faecal samples. This study highlights the need for standardised sampling protocols and continued research on the effects of plastic on wader populations, which could contribute to their conservation.

PMID:42077149 | DOI:10.1002/brv.70176

J Biopharm Stat. 2026 May 4:1-22. doi: 10.1080/10543406.2026.2663458. Online ahead of print.

ABSTRACT

Randomized controlled trials with co-primary endpoints refer to trials that are designed to evaluate if the intervention is superior to the control on each endpoint. Data analysis and sample size estimation can be complicated when the endpoints are of different scales. In contrast to trials with multiple primary endpoints, where multiplicity is a concern, multiple co-primary endpoints could cause substantial power/efficiency reduction. We propose a rank-based approach to data analysis and sample size estimation for such studies. For each endpoint, we quantify the treatment effect using the win probability (WinP) that a subject in the treatment group has a better score than (or a win over) a subject in the control group. Inference for the endpoint-specific WinPs is carried out by using multivariate linear mixed models with a unstructured variance-covariance matrix for win fractions, which are derived from (mid)ranks and shown to be asymptotically uncorrelated. We focus on confidence intervals (CIs) for WinPs and testing null hypothesis based on whether all lower limits of the CIs are above 0.50. Sample size formulae are derived with the focus on determining the sample size required to guarantee with a pre-specified assurance probability that the lower limit of CI for each endpoint is above 0.50. Results from a simulation study based on a published trial on ulcerative colitis suggest that our approach performed well in terms of CI coverage and assurance probability. The results also show that baseline adjustments can result in a gain in efficiency, but dichotomizing data can decrease efficiency substantially.

PMID:42077142 | DOI:10.1080/10543406.2026.2663458

Acta Obstet Gynecol Scand. 2026 May 4. doi: 10.1111/aogs.70241. Online ahead of print.

ABSTRACT

INTRODUCTION: Topical vaginal estrogens have been used in the management of postmenopausal vulvovaginal atrophy for some time, locally reintroducing exogenous estrogens to the estrogen-receptive tissues of the female urogenital tract following a decline in systemic levels. The postpartum period is similarly a state of relative estrogen depletion due to the antagonistic effect from raised prolactin levels throughout pregnancy and lactation; this is thought to contribute to post-delivery pelvic floor dysfunction and vaginal atrophy. Given the similar etiology, there may be a role for topical vaginal estrogens in postpartum women.

MATERIAL AND METHODS: A systematic review was performed evaluating the use of topical vaginal estrogens in postpartum women. This was performed as per PRISMA guidelines, with articles screened from online databases from their inception to October 2025.

RESULTS: Three studies were identified that met the inclusion criteria, including a total of 85 women. Two studies focused on the molecular and cellular composition of tissues from postpartum women using topical vaginal estrogens, and one double-blind randomized placebo-controlled trial primarily evaluated postpartum atrophy in the presence and absence of vaginal estrogens. Tissues exposed to estrogen appeared to have increased cellular proliferation, while the Vulval Assessment Score (VuAS), a patient-subjective validated scoring system for vaginal atrophy, was found to be lower in those using vaginal estrogen cream for 12 weeks. No statistically significant difference in bladder, bowel, or sexual function was noted. No serious adverse outcomes were reported, and the use of vaginal estrogens appeared acceptable to women.

CONCLUSIONS: There is a paucity of data currently available regarding the use of topical vaginal estrogens in the post-partum period. Although likely safe for use, further evidence is required to be able to make firm conclusions about their efficacy for postpartum vaginal atrophy, and further high-quality trials are required in the future.

PMID:42077139 | DOI:10.1111/aogs.70241

Health Serv Res. 2026 Jun;61(3):e70123. doi: 10.1111/1475-6773.70123.

ABSTRACT

OBJECTIVE: To evaluate the association between Prescription Drug Monitoring Programs (PDMPs) and postpartum opioid prescribing from 2007 to 2015, prior to the 2016 Centers for Disease Control and Prevention opioid prescribing guidelines, and to assess differences between low- and high-risk populations.

STUDY SETTING AND DESIGN: This cross-sectional study captures delivery episodes across the United States, primarily from commercially insured patients. The exposure was the implementation of PDMPs at the state level from 2007 to 2015, with states classified by whether implementation occurred before or after 2016. We used a difference-in-difference design for analysis. The primary outcome included: (1) morphine milligram equivalents (MME) per day; (2) pills dispensed; (3) average days’ supply, and (4) total number of prescriptions filled during the postpartum period (42 days after delivery).

DATA SOURCES AND ANALYTIC SAMPLE: We analyzed secondary data from IQVIA PharMetrics, an administrative claims database from 2006 to 2015. We identified reproductive-age patients (ages 12-59) with a documented delivery and stratified them into low and high-risk groups by postpartum prescribing and pre-delivery opioid exposure.

PRINCIPAL FINDINGS: Among 361,165 delivery episodes (9.9% cesarean, 90.1% vaginal), PDMP implementation was not associated with changes in postpartum opioid prescribing. In an age-and comorbidity-adjusted analysis by risk groups, PDMP implementation was not associated with statistically significant changes in MME per day per delivery in either low-risk (-0.35; 95% CI, -3.27 to 2.57) or high-risk groups (1.11; 95% CI, -7.46 to 9.68) in the implementation year, and results for pills dispensed, days’ supply, and total prescriptions were similarly null, with confidence intervals spanning zero.

CONCLUSION: State-level PDMP implementation was not associated with changes in postpartum opioid prescribing. These findings suggest PDMPs alone may be insufficient to influence postpartum prescribing, highlighting the need for alternative strategies to optimize pain management and reduce opioid-related risks.

PMID:42077138 | DOI:10.1111/1475-6773.70123

Acta Obstet Gynecol Scand. 2026 May 4. doi: 10.1111/aogs.70238. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to evaluate the role of radiomic analysis applied to ultrasound images in predicting postpartum blood loss at birth in women affected by low-lying placenta or placenta previa.

MATERIAL AND METHODS: In this retrospective, single-center study, we analyzed singleton pregnancies with placenta previa or a low-lying placenta, initially diagnosed at the second-trimester ultrasound examination. Data were collected from ultrasound examinations conducted in the second and third trimesters, along with birth outcomes. Radiomic analysis was conducted on archival ultrasound images to extract quantitative features. Predictive models were constructed utilizing multivariable generalized linear modeling (Gamma regression with a log link), encompassing radiomics-only, clinical/sonographic-only, and an integrated model.

RESULTS: In the final analysis of 107 women, 51 exhibited postpartum blood loss exceeding 500 mL. A prior cesarean delivery was recognized as a notable clinical risk factor. Multiple radiomic features identified in second- and third-trimester ultrasound scans correlated with a heightened risk of significant blood loss during birth. The integrated predictive model exhibited superior accuracy for blood loss exceeding 500 mL, achieving an AUC of 82.32% (95% CI: 74.18%-90.45%). This performance surpassed that of the clinical ultrasound model, which had an AUC of 71.27% (95% CI: 62.27%-80.27%), with a statistically significant difference (p = 0.001). Additionally, it demonstrated a nonsignificant improvement over the radiomics-only model, which recorded an AUC of 77.17% (95% CI: 68.25%-86.09%).

CONCLUSIONS: Radiomic analysis of ultrasound images enhances risk prediction for postpartum major blood loss in pregnancies affected by placenta previa and low-lying placenta. Integrating radiomics with clinical and sonographic data improves predictive accuracy, offering a promising tool for personalized obstetric risk assessment and management.

PMID:42077135 | DOI:10.1111/aogs.70238