Category: Nevin Manimala

J Wound Care. 2026 Jan 2;35(1):68-74. doi: 10.12968/jowc.2023.0112.

ABSTRACT

OBJECTIVE: To evaluate the use of negative pressure wound therapy (NPWT) in healing closed spinal incisions following scoliosis deformity surgery in a paediatric cohort.

METHOD: A retrospective review of patients <21 years of age who underwent posterior spinal instrumentation and fusion for severe scoliosis between 2019-2022. Patients were divided into two groups. The first comprised patients with idiopathic scoliosis (IS) treated with 3M Prevena (SolventumUS) application (Group P-IS). They were compared against a matched group who received standard dressings (Group S-IS). The second group comprised patients with non-idiopathic scoliosis (NIS) treated with 3M Prevena application (Group P-NIS), and who were compared against a matched group who received standard dressings (Group S-NIS).

RESULTS: The first group had a total of 31 patients (Group P-IS) who were compared to 35 patients (Group S-IS). Seroma formation, wound dehiscence, surgical site infections (SSIs), duration of hospitalisation and the number of visits until complete wound healing was higher in Group S-IS, although statistical significance (p<0.05) was not reached. In the second group, a total of 17 patients (Group P-NIS) were compared against 13 patients (Group S-NIS). Seroma formation, duration of hospitalisation and number of visits until complete wound healing was higher in Group S-NIS.

CONCLUSION: In this study, NPWT following primary closure in scoliosis surgery resulted in reduced seroma formation, wound dehiscence and SSIs in patients with IS, and reduced seroma formation in NIS patients. NPWT was beneficial in augmenting wound healing following paediatric spinal surgery and should be further examined in larger-scale prospective studies.

PMID:41528794 | DOI:10.12968/jowc.2023.0112

J Wound Care. 2026 Jan 2;35(1):100-109. doi: 10.12968/jowc.2024.0452.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the effects of the interleukin (IL)-17A inhibitor secukinumab in conjunction with a modified nourishing blood and moisturising decoction (NBMD) on superficial fungal infections in patients with psoriasis with blood-dryness pattern (a traditional Chinese medicine (TCM) subtype characterised by dry, scaly skin and pruritus; the approximate Western clinical equivalent being mild-to-moderate chronic plaque psoriasis with xerotic (dry-type) features).

METHOD: A cohort of patients diagnosed with psoriasis with blood-dryness pattern were enrolled and randomised into three treatment groups: one receiving secukinumab monotherapy (control group); a matched group receiving tumour necrosis factor (TNF)-α inhibitor (etanercept) plus NBMD therapy (match group), and a third group receiving combination therapy with secukinumab and NBMD therapy (study group). Clinical efficacy was assessed using the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). Peripheral blood Th17 cells and serum levels of IL-17A and IL-22 were measured before and after 12 weeks of treatment. The incidence of superficial fungal infections was recorded at three, six and 12 months. Statistical analysis was performed using SPSS version 22.0, employing Chi-squared tests and repeated measures analysis of variance. Absolute risk reduction was calculated to quantify infection risk differences.

RESULTS: A total of 216 patients were included in the study, 72 in each of the three groups. Compared with the control group, both the study group and the match group demonstrated superior clinical outcomes. At the 12-month follow-up, PASI 90 (≥90% reduction) response rates were significantly higher in the study group (76.39%) and match group (73.61%) than in the control group (51.39%). Quality of life measures (DLQI) and TCM symptom scores also showed significantly greater improvements in the combination groups (Cohen’s d=0.85 for DLQI and 0.76 for TCM symptom scores, representing large and medium-to-large effects, respectively; p<0.001). Immunological analyses revealed that both the study group and match group exhibited more pronounced reductions in Th17 cells, IL-17A and IL-22 levels compared with the control group, indicating enhanced modulation of the IL-17 inflammatory pathway. Notably, the 12-month incidence of superficial fungal infections was markedly lower in the study group (12.5%) and match group (13.9%) than in the control group (30.6%). The adjusted hazard ratios were 0.41 (p<0.01) for the study group and 0.45 (p<0.01) for the match group, demonstrating a significantly reduced risk with combination therapy.

CONCLUSION: In this study, combining secukinumab with a modified nourishing and moisturising TCM regimen yielded superior clinical outcomes, including greater symptom relief, improved quality of life, and a reduced risk of superficial fungal infections compared with biologic monotherapy.

PMID:41528783 | DOI:10.12968/jowc.2024.0452

Expert Opin Biol Ther. 2026 Jan 13. doi: 10.1080/14712598.2026.2617294. Online ahead of print.

ABSTRACT

BACKGROUND: Axial spondyloarthritis (axSpA) leads to significant impairments in quality of life (QoL) and work productivity. While infliximab is effective in treating axSpA, its impact in patients with concomitant extra-skeletal manifestations is limited, particularly in the Greek population.

AIMS: To evaluate intravenous infliximab’s impact on disease activity, QoL, and work productivity in Greek patients with axSpA, and to compare treatment effects in subgroups with and without concomitant psoriasis and inflammatory bowel disease.

METHODS: 39 patients with axSpA participated in a prospective, observational study and assessed at baseline, 6 and 12 months. Disease activity was measured using ASDAS and BASDAI, QoL was assessed via EQ VAS and HAQ, and work productivity was evaluated with WPAI.

RESULTS: Infliximab resulted in significant reductions in ASDAS and BASDAI. QoL improved (HAQ decreased and EQ VAS increased). Work productivity also significantly improved, with decreases in absenteeism, presenteeism, activity impairment, and work productivity loss. Importantly, no significant differences were observed between subgroups.

CONCLUSION: This study provides real-world evidence that infliximab improved disease activity, quality of life, and work productivity in all patient groups. Although subgroup differences were not statistically significant, these findings suggest consistent therapeutic benefits across diverse clinical presentations of axSpA.

PMID:41528782 | DOI:10.1080/14712598.2026.2617294

J Health Psychol. 2026 Jan 13:13591053251398259. doi: 10.1177/13591053251398259. Online ahead of print.

ABSTRACT

We examined the measurement of mindful screen time and whether it moderated links between screen-related psychological needs (satisfaction and frustration) and well-being. University students (N = 770, M_age = 19.96) completed a questionnaire online. A unidimensional structure of mindful screen time had an adequate fit (CFI = 0.97, RMSEA = 0.08) and composite reliability (0.79). Correlations between mindful screen time and well-being (rs = |0.08-0.26|) showed evidence of validity based on relations to other variables. Path analysis indicated two of the eight moderated associations were statistically significant but counter to hypotheses: higher mindful screen time increased the negative influence of need frustration on negative affect and diminished the positive influence of need satisfaction on flourishing. Screen-related psychological need satisfaction and frustration were key factors influencing well-being. Effect sizes were small-to-moderate (R² = 0.21-0.48). Overall, we found that that mindful screen time is not a robust moderator. More research is needed to better understand the role of mindful screen time on well-being.

PMID:41528779 | DOI:10.1177/13591053251398259

J Public Health Manag Pract. 2026 Jan 13. doi: 10.1097/PHH.0000000000002279. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematized review aimed to identify the most common methods used to prioritize health needs among 501(c)(3) nonprofit hospital systems in the US since the implementation of the Affordable Care Act.

INTRODUCTION: Of the approximately 6000 hospitals in the US, 50% are 501(c)(3) nonprofits. These 501(c)(3)s are tax-exempt with surplus revenue serving their communities and must meet the community benefit standard provided by Internal Revenue Code (IRC) section 501(c)(3) and Revenue Ruling 69-545. Additionally, the Patient Protection and Affordable Care Act (ACA) (2010) requires all 501(c)(3) nonprofit hospitals to conduct a Community Health Needs Assessment (CHNA) every 3 taxable years. The Internal Revenue Service (IRS) provides broad guidelines for these needs assessments, but no guidance on prioritizing the needs identified.

METHODS: A systematized review was utilized to review commonly used methods in CHNAs. The PubMed database was utilized to find recent, peer-reviewed articles. A librarian was consulted for the generation of Boolean search terms. Filters included articles in English, peer-reviewed, and time-bound from 2010 to 2025. Data extracted focused on the type of prioritization method used by CHNAs.

RESULTS: Out of 1076 records initially identified, 37 peer-reviewed studies met the final inclusion criteria. Three broad categorical approaches of prioritizing needs were identified: community-driven approaches, structured prioritization frameworks, and a combination of approaches. Prioritization methods include the nominal grouping technique, multivoting technique, community-based participatory research, concept mapping, the Delphi technique, descriptive statistics & regressions, and the Hanlon method.

DISCUSSION: There are many evidence-based methods for prioritizing health needs. Some are better suited to specific situations and communities than others. Aggregating the examples of prioritization methods in CHNAs will aid hospitals and communities in selecting the right method to best serve their community. Ultimately, this research provides guidance to communities creating a useful CHNA and a healthier equitable community. Future research should investigate the effect of these prioritization methods on health outcomes and quantifying subsequent community benefit.

PMID:41528769 | DOI:10.1097/PHH.0000000000002279

Fam Pract. 2025 Dec 9;43(1):cmaf112. doi: 10.1093/fampra/cmaf112.

ABSTRACT

BACKGROUND: Unnecessary vitamin tests are among the most frequently mentioned low-value care practices among Dutch general practitioners (GPs). Understanding drivers for vitamin testing from a GP’s perspective is key for developing effective interventions.

OBJECTIVES: This study explored GPs’ perspectives on drivers of vitamin D and B12 testing, focusing on potential differences between GPs in practices with high and low testing rates, using the Capability, Opportunity, and Motivation Model of Behaviour (COM-B) behavioural science framework.

METHODS: Laboratory data from 57 primary care centres (PCCs) in the South of the Netherlands (2016-2019) identified the 15 PCCs with the lowest and highest vitamin testing rates. Thirty GPs, one per PCC, were purposively sampled to ensure variation in testing rate and background. Semi-structured interviews (May-July 2020) covered general perceptions, as well as social, cognitive, and motivational factors. Interviews were analysed by mapping factors driving vitamin testing to the COM-B model.

RESULTS: Several medical and non-medical factors affecting vitamin D and B12 test ordering in general practice were identified, which could be linked to all three COM-B components at the GP (e.g. education), patient (e.g. informational material), and service level (e.g. laboratory forms).

CONCLUSION: Education, feedback on testing behaviour, evidence-based patient informational material, clear evidence-based guidelines, and modification of laboratory request forms by adding test costs and indications of at-risk groups were identified by participants as promising strategies to reduce unnecessary vitamin testing.

PMID:41528763 | DOI:10.1093/fampra/cmaf112

Pain Med. 2025 Dec 4:pnaf170. doi: 10.1093/pm/pnaf170. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the effectiveness of ultrasound-guided percutaneous electrolysis and peripheral nerve stimulation in reducing pain, improving functional capacity, and modifying mechanosensitivity responses in patients with carpal tunnel syndrome compared to a sham intervention.

DESIGN: A multicenter, randomized controlled clinical trial.

SETTINGS: Double center pain clinic.

SUBJECTS: In brief, 46 patients diagnosed, with carpal tunnel syndrome, assigned to an intervention group or a sham group.

METHODS: Both groups received 3 sessions over 4 weeks. Primary outcomes included mean and worst pain intensity. Secondary outcomes assessed functional status and symptoms severity; Boston Carpal Tunnel Questionnaire, Upper Limb Neurodynamic Test 1, grip and pinch strength, two-point discrimination, sensory thresholds, pressure pain threshold and Global Rating of Change Scale. Follow-ups were conducted at 4, 12, and 24 weeks.

RESULTS: Statistically significant intergroup differences were observed for all evaluated variables across follow-ups, except for grip and pinch strength. The intervention group demonstrated significantly greater improvements in pain intensity, functional disability, sensory thresholds, and neural mobility, with large effect sizes ranging from 0.64 to 2.09. Notably, the improvements in pain and function were sustained at 6 months.

CONCLUSIONS: Ultrasound-guided percutaneous electrolysis and peripheral nerve stimulation significantly reduce pain and improve function in carpal tunnel syndrome, offering a promising minimally invasive alternative to standard care.

CLINICAL TRIAL REGISTRATION NUMBER: Effectiveness of an Invasive Physical Therapy Protocol in Carpal Tunnel Syndrome: Randomized Controlled Clinical Trial. Registration number: NCT05527743. Link to full trial record: https://clinicaltrials.gov/ct2/show/NCT05527743 Patient enrollment began on: April 1, 2023.

PMID:41528761 | DOI:10.1093/pm/pnaf170

J Health Psychol. 2026 Jan 13:13591053251395856. doi: 10.1177/13591053251395856. Online ahead of print.

ABSTRACT

Studying class stigma in the context of diabetes and socioeconomic inequalities may shed light on the societal factors influencing diabetes. Data from 1947 participants aged 49-88 who participated in the second phase of The Maastricht Study were used. SEP (education, income, occupation) and a six-item classism scale were measured through self-reported questionnaires. Prediabetes and T2D were defined through an oral glucose tolerance test. We conducted multinomial logistic regression analyses to investigate the associations between SEP, classism, and diabetes. About 20.9% (N = 406) of the study sample had T2D (Mean_age = 69.8 ± 6.8; 31.3% women). People with low SEP had T2D (e.g. income OR = 2.13, 95% CI: 1.54-2.82) and reported perceived classism (e.g. education OR = 2.07, 95% CI: 1.33-3.21) more often than people with high SEP. Classism was not statistically significantly associated with T2D. Social health inequalities are apparent in T2D; however, our results suggest that class stigma might not be a major factor in the underlying processes. Further research should investigate chronic stress and the intersection of stigmas.

PMID:41528758 | DOI:10.1177/13591053251395856

Psychol Rep. 2026 Jan 13:332941251415313. doi: 10.1177/00332941251415313. Online ahead of print.

ABSTRACT

Researchers have found that psychological well-being is independently correlated with both optimism and flow. Although the flow-optimism-well-being structure has been studied empirically, there hasn’t been much concentrated synthesis on optimism’s particular mediating mechanism. This review conducts a thorough analysis of peer-reviewed research on optimism as a specific mediator between flow and psychological health in adults between the ages of 18 and 65. PRISMA 2020 guidelines were adhered to in this systematic review. To find studies published between 2015 and 2025, six databases were searched: PsycINFO, Scopus, PubMed, Google Scholar, ScienceDirect, and ERIC. The following criteria must be met for inclusion: statistical mediation analysis of optimism between flow and well-being, adult samples, empirical research, and English language proficiency. To evaluate quality, the Mixed Methods Appraisal Tool (MMAT) was employed. All of the updated inclusion criteria were met by three studies. However, generalizability is constrained by measurement and design heterogeneity. With indirect effects ranging from .15 to.23, these studies consistently showed that optimism serves as a mediator in the relationship between flow and psychological well-being particularly. Although the majority of the included studies used cross-sectional designs, the evidence was especially strong in longitudinal and daily diary designs. Hence, the review reveals a consistent but moderate mediation effect where optimism acts as a significant psychological mechanism through which flow experiences enhance well-being.

PMID:41528755 | DOI:10.1177/00332941251415313

JAMA Netw Open. 2026 Jan 2;9(1):e2551734. doi: 10.1001/jamanetworkopen.2025.51734.

ABSTRACT

IMPORTANCE: Over 1 million pulmonary nodules are discovered each year in the US, and many of these undergo molecular imaging-guided surgery to obtain a diagnosis. Locating a small nodule and determining its malignant potential is technically challenging and is prone to human error.

OBJECTIVE: To demonstrate use of a machine learning (ML) algorithm with molecular imaging to analyze imaging data during lung cancer surgery to determine malignant potential of nodules.

DESIGN, SETTING, AND PARTICIPANTS: Data were retrospectively analyzed from a prospectively collected database. Between 2014 and 2021, patients at the hospital of the University of Pennsylvania with lung nodules were included in the study. Patients in the model development set were randomly allocated into training and validation sets in an 8:2 ratio. Data were analyzed from January 2014 and December 2021.

MAIN OUTCOMES AND MEASURES: Algorithmic tumor to background ratio (TBR) detection was implemented for individual images using Image Processing Toolkit. Developed nomogram and artificial intelligence (AI) image analyzer were combined as an optical biopsy algorithm and tested prospectively between 2021 and 2024.

RESULTS: A total of 322 patients with lung nodules were included in the study, of whom 279 had complete clinical data for data analysis (175 [62.7%] female). The nomograms and image segmentation technology were developed using a large database of IMI videos (1014 video sequences) and demonstrated an area under the curve of 0.865 to 0.893 for malignant nodule assessment. On multivariate logistic regression analysis, patient smoking history of greater than 5 pack-years (patient pack-years [PPY] >5), ex vivo back table TBR greater than 2.0, ex vivo bisected tumor lesions TBR greater than 2.4, and in situ (inside the chest) fluorescence were found to have statistically significant associations with malignancy on final pathology. Prospective testing in an independent set of 61 consecutive patients during IMI-guided cancer surgery demonstrated a sensitivity of 93.8%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 71%. The study algorithm determined malignant potential of the lesion in less than 2 minutes (mean [SD], 1.8 [0.17] minutes) compared with a mean (SD) of 34 (11) minutes with frozen section analysis.

CONCLUSION: In this cohort study of patients with indeterminate lung nodules, intraoperative imaging data analyzed by AI accurately determined if a nodule was malignant. This has the potential to improve the diagnostic challenges that occur at the time of surgery.

PMID:41528749 | DOI:10.1001/jamanetworkopen.2025.51734