Category: Nevin Manimala

BMC Geriatr. 2026 Feb 27. doi: 10.1186/s12877-026-07037-1. Online ahead of print.

NO ABSTRACT

PMID:41761125 | DOI:10.1186/s12877-026-07037-1

Int J Emerg Med. 2026 Feb 27. doi: 10.1186/s12245-026-01154-9. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the association between recent nonsteroidal anti-inflammatory drug (NSAID) use and clinical presentation and in-hospital outcomes among patients presenting to the emergency department with acute decompensated heart failure.

METHODS: This prospective, single-center, observational study was conducted between October 20, 2023, and May 21, 2025, in the Emergency Medicine Department of a University Hospital. A total of 400 patients diagnosed with decompensated heart failure were included. For statistical analyses, differences between patients who used NSAIDs and those who did not were compared using Pearson’s Chi-Square Test, while Fisher’s Exact Test was applied when appropriate.

RESULTS: Among the 400 participants, 54.3% were female, and 54.0% were aged ≥ 80 years. NSAID use within the preceding 10 days was observed in 27.8% of patients. A substantial proportion of patients presented with advanced heart failure, with the majority classified as NYHA Class III or IV, and 44.0% required intensive care unit admission during hospitalization. NSAID use was more frequently observed among older patients and in those presenting with clinical features such as hypertension and tachypnea. However, no consistent or statistically significant associations were identified between recent NSAID exposure and in-hospital mortality or intensive care unit admission. These findings should be interpreted in the context of the study’s observational design and the presence of multiple clinical confounders.

CONCLUSION: Recent NSAID use was common among patients presenting to the emergency department with acute decompensated heart failure. In this cohort, NSAID exposure was not clearly associated with differences in in-hospital outcomes, and further analyses adjusting for clinical confounders are warranted.

PMID:41761062 | DOI:10.1186/s12245-026-01154-9

Obes Surg. 2026 Feb 28. doi: 10.1007/s11695-026-08543-2. Online ahead of print.

NO ABSTRACT

PMID:41761036 | DOI:10.1007/s11695-026-08543-2

J Gen Intern Med. 2026 Feb 27. doi: 10.1007/s11606-026-10276-y. Online ahead of print.

ABSTRACT

BACKGROUND: Although fall prevention programs in real-world clinical settings often generate recommendations to reduce fall risk factors, evidence that they improve clinical outcomes remains limited. To better understand this gap, we examined implementation rates of recommendations.

METHODS: This retrospective cohort study evaluated patients who received care at an interdisciplinary (nurse, physical therapist, geriatrician) fall prevention consultation clinic from November 2020 to December 2022. Data were collected on patient demographics, screening assessments (including self-reported falls, fracture risk, visual acuity, cognition, and orthostatic blood pressure), physical therapy evaluations, and implementation of recommendations. Fall- and fracture-related ED visits and hospitalizations in the year before and after the clinic visit were compared.

RESULTS: Ninety-four patients seen with a mean age of 79 years (SD = 8.4, range 63-101); 71% were women, 60% self-identified as non-Hispanic White, 39% needed help with ≥ 1 activity of daily living, and 62% needed help with ≥ 2 instrumental activities of daily living. Patients screened positive for a self-reported fall in the last year (81%), increased fracture risk (67%), vision impairment (43%), cognitive concerns (27%), and orthostatic hypotension (12%). Implementation of recommendations occurred most often for home (58%) and outpatient (46%) physical therapy, bisphosphonate recommendations or orders (50%), ophthalmology (43%), and medication adjustment recommendations (36%). Referrals to podiatry (30%), clinical pharmacy (29%) for fall risk-increasing drugs, osteoporosis clinic (23%), and memory clinic (12%) were implemented least frequently. There were no statistically significant differences in fall- or fracture-related ED visits (IRR 0.61, 95% CI 0.33-1.15) or hospitalizations (IRR 0.75, 95% CI 0.32-1.72) 1-year pre- and post-clinic evaluation.

CONCLUSIONS: Although this consultative fall prevention clinic generated actionable recommendations, their implementation was sub-optimal. The study identified key areas for process improvement, particularly enhancing adherence to high-impact recommendations such as physical therapy and bone health.

PMID:41761018 | DOI:10.1007/s11606-026-10276-y

Eur Radiol. 2026 Feb 28. doi: 10.1007/s00330-026-12446-2. Online ahead of print.

NO ABSTRACT

PMID:41761002 | DOI:10.1007/s00330-026-12446-2

Int J Inj Contr Saf Promot. 2026 Feb 27:1-9. doi: 10.1080/17457300.2026.2635100. Online ahead of print.

ABSTRACT

Ghana is losing too many lives on the road, and the numbers continue to rise. This study examined road traffic fatalities in Ghana from 1991 to 2024, identified their major causes and compared Ghana’s situation with that of selected African countries. Data were obtained from credible sources, including the National Road Safety Authority, the World Health Organisation, the Ghana Highway Authority and relevant local studies. The findings show that more than 46,000 people died in road crashes between 1991 and 2018, with an additional 2,494 deaths recorded in 2024 alone. The leading causes were poor road infrastructure, driver error and vehicle defects. Comparative analysis revealed that Ghana’s road fatality rate is higher than that of Rwanda and Nigeria, despite Ghana having a smaller vehicle population. Using a statistical projection based on historical trends, the study indicates that Ghana could record more than 2,800 road deaths in a single year by 2030 if current conditions persist. This trajectory suggests that the country is unlikely to achieve the Sustainable Development Goal target of halving road traffic deaths. These findings highlight a crisis that has become normalised in everyday life, where road travel is often perceived as a gamble. Urgent and coordinated action is therefore required, including improved road infrastructure, expansion of dual carriageways, stricter enforcement of traffic regulations and sustained public education. Road safety in Ghana has become a national public health and development priority rather than a transport issue alone.

PMID:41758544 | DOI:10.1080/17457300.2026.2635100

Soft Matter. 2026 Feb 27. doi: 10.1039/d5sm01268f. Online ahead of print.

ABSTRACT

This work presents a compact, general model that predicts static contact angles and upper bounds on contact angle hysteresis for random or periodic local surface topography by accounting for arbitrary fractions of localized air entrapment and liquid infiltration within micro/nanoscale topographic features adjacent to the contact line. The proposed model recovers classical wetting limits (Wenzel, Cassie-Baxter, and hemiwicking), accounts for intermediate states (e.g., impregnating Cassie), and highlights a fourth limiting state with potential realizability and practical implications: a bulk Cassie state with an ambient liquid film, termed the inverse Wenzel state. The model predictions provide actionable guidance for the rational design of micro- and nanostructured surfaces to modulate contact angle hysteresis, under real-world operating conditions that are often uncontrolled and unpredictable due to local variations of the surface topography, fouling or contamination at the liquid-solid and liquid-vapor interfaces, chemical aging, kinetic constraints, and fluctuations of the ambient relative humidity and temperature.

PMID:41758538 | DOI:10.1039/d5sm01268f

JAMA Health Forum. 2026 Feb 6;7(2):e256872. doi: 10.1001/jamahealthforum.2025.6872.

ABSTRACT

IMPORTANCE: In 2020, all US states adopted the Families First Coronavirus Response Act Medicaid continuous coverage requirement (CCR), which prevented disenrollment from Medicaid. This policy effectively extended pregnancy-related Medicaid eligibility beyond the previous end date of 60 days post partum.

OBJECTIVE: To determine whether the CCR was associated with a change in postpartum hospitalization rates for mothers covered by Medicaid during their delivery.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted from December 2023 to March 2025 at all nonfederal acute care hospitals in 20 states using data from the Healthcare Cost and Utilization Project’s State Inpatient Databases from 2018 through 2021. Participants included mothers aged 18 to 55 years who had Medicaid-paid deliveries (based on the primary expected payer) from January 2018 to June 2021; they were followed up for 180 days post partum.

EXPOSURES: State-level postpartum uninsured rate among mothers with Medicaid-paid deliveries that occurred from 2018 to 2019 (before the CCR was implemented in 2020). Residency in states with an uninsured rate above the median was considered to be high exposure (ie, a greater share of the state population had the potential to benefit from the CCR) and residency in states with a preperiod uninsured rate below the median was considered low exposure.

MAIN OUTCOMES AND MEASURES: Probability of a mother being hospitalized 1 to 60 days post partum (covered under previous Medicaid eligibility rules) and 61 to 180 days post partum (newly covered under the CCR).

RESULTS: A total of 2 024 214 mothers (mean age, 27.5 [95% CI, 27.5-27.5] years) with Medicaid-paid deliveries were identified. The sample included 550 881 deliveries by Hispanic mothers (27.2%), 490 586 deliveries by non-Hispanic Black mothers (24.2%), 744 945 deliveries by non-Hispanic White mothers (36.8%), 200 639 deliveries by mothers of other races and ethnicities (9.9%), and 37 163 deliveries by mothers with missing race and ethnicity data (1.8%). Among the full sample, 931 452 mothers (mean age, 27.1 [95% CI, 27.71-27.2] years) resided in high-exposure states and 1 092 762 mothers (mean age, 27.8 [95% CI, 27.8-27.8] years) resided in low-exposure states. In adjusted difference-in-differences models, the rate of hospitalization per 1000 Medicaid-paid deliveries at 61 to 180 days post partum decreased (adjusted β coefficient, -1.4; 95% CI, -2.5 to -0.3) in high-exposure states compared with low-exposure states, a 10.9% decrease relative to the preperiod mean (12.9; 95% CI, 12.6 to 13.2) in high-exposure states. The analogous estimate for the hospitalization rates 1 to 60 days post partum was not statistically significant (-0.7 [95% CI, -2.0 to 0.5] per 1000 Medicaid-paid deliveries).

CONCLUSIONS AND RELEVANCE: Findings of this study suggest that residency in high-exposure states was associated with a reduction in hospitalizations for mothers 61 to 180 days post partum (the period newly covered by extended Medicaid coverage). Extended Medicaid coverage may help to improve postpartum health and reduce adverse events among mothers with low income.

PMID:41758525 | DOI:10.1001/jamahealthforum.2025.6872

JAMA Netw Open. 2026 Feb 2;9(2):e2559863. doi: 10.1001/jamanetworkopen.2025.59863.

ABSTRACT

IMPORTANCE: Overdose prevention centers (OPCs) are interventions to reduce overdose mortality and support health care engagement. In the US, concerns have been raised that OPCs may be associated with reduced economic activity in their surrounding neighborhoods.

OBJECTIVE: To evaluate changes in the local economic activity in New York City (NYC), measured by neighborhood-level foot traffic and consumer spending, following the opening of the first 2 publicly recognized OPCs in the US.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used anonymized mobility and spending data from June 1, 2021, to June 13, 2022, for the areas surrounding the East Harlem and Washington Heights OPCs in NYC. These neighborhoods were defined using 5-minute and 10-minute walking buffers and Business Improvement Districts (BIDs). Synthetic control donors included walking buffers and BIDs around syringe service programs without OPCs and opioid treatment programs that were operational as of OPCs’ opening. Analyses were conducted from February to July 2025.

EXPOSURES: Opening of the 2 NYC OPCs on November 30, 2021.

MAIN OUTCOMES AND MEASURES: Primary outcomes were foot traffic and in-person consumer spending within 10-minute walking buffers. Secondary analyses considered 5-minute walking buffers and BIDs. Augmented synthetic control models were adjusted for neighborhood-level demographic and socioeconomic features, with fit assessed using root mean squared error before OPC opening. Permutation tests and conformal inference were used to assess significance.

RESULTS: A total of 27 biweekly observations (13 in pre-OPC and 14 in post-OPC periods) were analyzed. The 10-minute walking buffer analyses captured 1259 consumer spending sites and 7816 foot traffic sites across 2 treated buffers and 56 donor buffers. In East Harlem, the average treatment effect on the treated (ATT) estimate (SE) was -$21.96 ($40.53) for consumer spending (P = .16) and 1.28 (5.40) visits for foot traffic (P = .19). In Washington Heights, ATT (SE) estimates were $14.94 ($37.38) for consumer spending (P = .13) and 0.44 (3.54) visits for foot traffic (P = .97). Secondary analyses produced consistent results. No statistically significant results were observed at any post-OPC time point.

CONCLUSIONS AND RELEVANCE: This cohort study found that OPC opening was not associated with significant changes in local economic activity. Given the absence of observed economic harms, policy debates should instead focus on the public health implications of OPCs.

PMID:41758519 | DOI:10.1001/jamanetworkopen.2025.59863

JAMA Netw Open. 2026 Feb 2;9(2):e2560084. doi: 10.1001/jamanetworkopen.2025.60084.

ABSTRACT

IMPORTANCE: In an effort to increase access to care, the US Department of Veterans Affairs (VA) has created 2 additional pathways for veterans to receive mental health (MH) services: regional VA Clinical Resource Hubs (CRHs) and VA-purchased community care (CC). Previous studies have found that veterans rate their satisfaction with VA MH care, including via CRHs, higher than CC. It is unclear whether increased CRH use decreases referrals to CC.

OBJECTIVE: To determine whether clinics with higher CRH utilization have fewer CC referrals or, alternatively, whether clinics with local care shortages rely on both CRH and CC at similar levels to ensure adequate access to MH care.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study included all veterans with at least 1 outpatient MH encounter between 2018 and 2019 in 1149 MH clinics within the VA. The study evaluated changes in CC referral rates at clinics with and without CRH visits between baseline and post-CRH implementation (October 1, 2017, through September 30, 2023). In addition, CC referral rates at clinics with higher use of CRH were compared with clinics with lower CRH utilization. Data were analyzed from August 20, 2024, to July 25, 2025.

EXPOSURES: Clinics were classified based on whether they had any CRH utilization, as well as whether their per-patient rate of CRH visits fell in the top 25% (high penetration) or bottom 25% (low penetration).

MAIN OUTCOMES AND MEASURES: The main outcome was the number of CC referrals per 1000 patients. Difference-in-differences (DID) analyses were used.

RESULTS: The sample included 1 120 250 patients (mean [SD] age, 60.04 [15.38] years; 15.99% female). Clinics with any CRH utilization showed a slight but statistically significant increase in CC referrals in the post-CRH implementation period compared with clinics with no CRH utilization (DID, 0.525; 95% CI, 0.181-0.868; P = .003). However, clinics with high penetration of CRH had fewer CC referrals per month compared with low-penetration clinics at the end of the CRH implementation period (DID, -20.00 referrals; 95% CI, -21.90 to -18.20; P < .001).

CONCLUSIONS AND RELEVANCE: In this cohort study of VA MH clinics, successful CRH implementation was associated with fewer CC referrals, suggesting that clinics with higher CRH utilization were less reliant on VA-purchased CC. Results underscore the importance of developing strong CRH infrastructures to ensure veteran access to high-quality MH care.

PMID:41758516 | DOI:10.1001/jamanetworkopen.2025.60084