Category: Nevin Manimala

Harm Reduct J. 2026 Jan 17. doi: 10.1186/s12954-026-01399-w. Online ahead of print.

ABSTRACT

The study examines whether tetrahydrocannabinol (THC) use alone affected sustainability of weekly take-home methadone medication among a small sample of 33 patients attending a single opioid treatment program, under special exception by state and federal governments during the Covid-19 pandemic. Kaplan Meier analyses of survival rates in months of eligibility for take-home methadone showed that the majority of patients with continuing THC use remained eligible for 10 months despite continued THC use. Majority were employed, insured, and housed stably, but Log Rank Tests on these predictor variables showed no statistical significance. The socioeconomic stability of the cohort may indicate THC use alone may be less important in restricting take-home methadone and warrants further research.

PMID:41547863 | DOI:10.1186/s12954-026-01399-w

Ann Gen Psychiatry. 2026 Jan 17. doi: 10.1186/s12991-026-00629-6. Online ahead of print.

ABSTRACT

BACKGROUND: Depression, characterized by significant psychological and physiological alterations, has been proved to tightly associate with insulin resistance (IR) and hallmarks of biological aging. Phenotypic Age Acceleration (PhenoAgeAccel), which quantifies the discrepancy between biological and chronological age, serves as a robust indicator of accelerated aging. However, the interplay between depression, IR, and accelerated aging remains unclear. This study aims to explore the relationship between depression and PhenoAgeAccel, and the potential mediating role of IR in this association.

METHODS: A total of 4,555 adults participants from the National Health and Nutrition Examination Survey (NHANES) database with complete data on depression, PhenoAgeAccel, and other essential covariates were included in this study. Depression severity was assessed by the nine-item Patient Health Questionnaire (PHQ-9), with a PHQ-9 score ≥ 10 used to define depression. Four indicators, including triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), TyG-waist height ratio (TyG-WHTR), and metabolic score for insulin resistance (METS-IR), were used to assess IR. Weighted multivariable linear regression analyses were performed to identify the association of depression/PHQ-9 score with PhenoAgeAccel. Moreover, subgroup analyses, interaction tests, and adjusted restricted cubic spline (RCS) analyses were employed to explore the robustness, stability, and potential nonlinearity of the associations between PHQ-9/depression and PhenoAgeAccel. Additionally, mediation analysis was conducted to investigate the mediating role of IR biomarkers in the association between PHQ-9 score and PhenoAgeAccel.

RESULTS: In the fully-adjusted model, being depressive and one-unit increment in PHQ-9 score were associated with a 1.93-year (95% CI: 0.95-2.92) and 0.14-year (95% CI: 0.07-0.21) increase in PhenoAgeAccel, respectively. A positive linear dose-response relationship between PHQ-9 score and PhenoAgeAccel was identified via RCS analysis (P for overall = 0.001, P_{non-linearity}=0.867). Subgroup analyses and interaction tests revealed a more pronounced association between depression/PHQ-9 and PhenoAgeAccel in subgroups with diabetes, moderate-to-heavy alcohol consumption, and higher education levels (all P_interaction<0.05). IR biomarkers were observed to mediated 3.6-8.4% of the total effect, with METS-IR showing the highest mediation (8.4%, 95% CI: 0.024-0.222).

CONCLUSIONS: Depression was associated with accelerated PhenoAgeAccel, with insulin resistance acting as a partial mediator. In depression management, interventions targeting metabolic issues like insulin resistance should also be considered to mitigate depression-associated aging.

PMID:41547857 | DOI:10.1186/s12991-026-00629-6

Harm Reduct J. 2026 Jan 18. doi: 10.1186/s12954-026-01397-y. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, Boston has attempted to increase housing options and reduce overdose risk through the implementation of harm reduction housing (HRH) sites. Despite numerous harm reduction resources available to HRH residents, drug checking services are absent. Studies suggest that drug checking may prevent negative experiences associated with unexpected adulterants. Drug checking offers a window into concerning supply shiftsand helps monitor disruptions in the supply due to environmental changes, such as encampment clearings. Few studies have explored drug checking’s application in housing programs. The establishment of the Massachusetts Drug Supply Data Stream, a statewide community drug checking program, allowed us to pilot real-time drug checking at HRH sites.

METHODS: From September 2023 to February 2024, we administered surveys to 106 HRH residents. From September 2023 to March 2025, we conducted longitudinal interviews (baseline, 3-month, 6-month) with a subset of 28 survey respondents. In response to drug supply shifts and resident demand, starting on May 20, 2024, we implemented real-time drug checking services at three HRH sites located in Boston. Residents were asked to provide approximately 5 mg of their remnant substance in order to receive immediate test results using FTIR spectroscopy and immunoassay test strips. Survey responses pertaining to drug checking provision and real-time, on-site drug checking sample results were analyzed using descriptive and bivariate statistics. Longitudinal interviews and field notes collected during real-time, on-site service provision were analyzed to further contextualize resident experiences.

RESULTS: Resident engagement with drug checking services was considerable, with fifty-five drug samples collected across nine site visits over three months. The services generated an increase in xylazine awareness among residents and provided chances to address concerns about the changing drug market amid heavy policing. Engagement with residents confirmed the need for on-site drug checking alongside other provided harm reduction services, and a consensus vocalized concerns with the local drug supply.

CONCLUSIONS: Real-time, on-site drug checking in low-barrier housing programs is a promising harm reduction approach for detecting shifts in the drug supply and can complement transitional housing interventions. Residents engage with these services with the intention of intervening upon personal, community, and market-level norms.

PMID:41547849 | DOI:10.1186/s12954-026-01397-y

BMC Health Serv Res. 2026 Jan 17. doi: 10.1186/s12913-025-13998-7. Online ahead of print.

ABSTRACT

BACKGROUND: Patient decisions in healthcare services are increasingly shaped by interpersonal communication and shared experiences. Word-of-mouth communication is among the most influential non-commercial information sources guiding hospital preference, yet the mechanism through which this communication affects patient choice requires further investigation. This study aims to examine the direct effect of word-of-mouth communication on hospital preference and to determine whether physician branding has a mediating role in this relationship.

METHODS: The study was conducted using a cross-sectional survey design. Data were collected from 1,636 adults residing in Türkiye who had previously received healthcare services. A convenience sampling approach was used due to accessibility considerations. Validated measurement tools assessing word-of-mouth communication, physician branding, and hospital preference were administered. Statistical analyses were performed using structural equation modeling to evaluate both direct and indirect effects. Reliability, construct validity, and normal distribution assumptions were tested prior to inferential analyses. Mediation significance was examined using the bootstrapping technique with 5,000 repeated samples and a 95% confidence interval.

RESULTS: Word-of-mouth demonstrated significant positive effects on both physician branding (β = 0.47, p < .001) and hospital preference (β = 0.40, p < .001). Physician branding strongly predicted hospital preference (β = 0.73, p < .001) and significantly mediated the WOM-hospital preference relationship (indirect effect: β = 0.341, 95% CI: 0.288-0.393). The final mediation model showed excellent fit (CFI = 0.950; RMSEA = 0.038).

CONCLUSIONS: Word-of-mouth communication influences hospital preference both directly and through the enhancement of physician brand value. Healthcare organizations should develop strategies to increase the visibility and credibility of physicians, strengthen communication-based trust, and promote positive patient experiences through digital and interpersonal channels. These managerial implications provide valuable insights for healthcare providers aiming to improve competitive positioning in regulated healthcare markets where traditional marketing activities are limited.

PMID:41547845 | DOI:10.1186/s12913-025-13998-7

Eur J Med Res. 2026 Jan 17. doi: 10.1186/s40001-026-03870-7. Online ahead of print.

ABSTRACT

BACKGROUND: Lung cancer is a leading cause of cancer-related mortality globally, yet its association with physical exercise remains incompletely understood. This study employed Mendelian randomization (MR) and bioinformatics to investigate the causal link between physical exercise and lung cancer, further validating potential molecular mediators through experimental analysis.

METHODS: We applied a two-sample MR framework, using genetic variants as instrumental variables, to examine the causal associations between five distinct exercise modalities-recreational walking, strenuous sports, miscellaneous activities, light do-it-yourself (DIY) activities, and heavy DIY activities-and lung cancer risk. This analysis was conducted using data from the UK Biobank and the Genome-Wide Association Studies (GWAS) consortia. To ensure the robustness of our results, we performed sensitivity analyses including MR-Egger, weighted median, and MR-PRESSO. Furthermore, we investigated potential mediators such as lipids, immune cells, inflammatory cytokines, and metabolites through MR. Bioinformatics analyses, specifically GEPIA, were employed to identify candidate genes and key molecules, and the expression level of the key molecule SULT1A1 was further validated by Qpcr, Western blot and immunofluorescence.

RESULTS: The findings indicated that participation in activities such as swimming, cycling, fitness training, bowling (ebi-a-GCST90018875: P = 0.017, OR = 0.086;ieu-b-4954: P = 0.004, OR = 0.972; ieu-b-4955: P = 0.003, OR = 0.972), and walking (ebi-a-GCST90018875: P = 0.021, OR = 0.170; ieu-b-4954, P = 0.025, OR = 0.980; ieu-b-4955: P = 0.016, OR = 0.978) was associated with a decreased risk of lung cancer. Our analysis found significant causal relationships between lung cancer and 21 lipids, 7 immune cell subtypes, 4 inflammatory markers, and 16 metabolites, but no statistically significant regulatory effect of physical activity on them. Bioinformatics analysis revealed that SULT1A1 expression was significantly lower in lung tumors, specifically in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), and was correlated with improved prognosis (hazard ratio [HR] = 0.67 for LUAD, P = 0.0083). In murine models, exercise led to a reduction in tumor growth, volume, and Ki-67 + cell proliferation, while concurrently increasing SULT1A1 mRNA and protein expression levels (P < 0.05).

CONCLUSION: This study offers causal evidence supporting the protective effects of exercise against lung cancer, potentially through pathways dependent on SULT1A1.

PMID:41547836 | DOI:10.1186/s40001-026-03870-7

BMC Psychol. 2026 Jan 17. doi: 10.1186/s40359-025-03863-x. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence, recurrence rate, and mortality rate of adolescent depression are at a high level, necessitating a rigorous assessment tool to screen the actual level of self-management in adolescents with depressive disorders. In order to provide personalized and targeted self-management support for them, this study aims to develop and validate a self-management scale for adolescents with depressive disorders.

MATERIALS AND METHODS: We developed and validated a Self-Management Scale for Adolescents with Depressive Disorders (SSADD). The study involved two phases: scale development and validation. In the scale development phase, a pool of scale items was initially formed through a literature review. Two rounds of expert consultations and pre-pilot investigation were conducted to refine the scale and evaluate its validity. The scale was tested on 356 participants using item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), test-retest reliability and internal consistency evaluation.

RESULTS: The scale consists of three factors and twenty-four items. Following two rounds of expert correspondence, the I-CVI of the items ranged from 0.83 to 1.00, While the S-CVI/Ave was 0.94, indicating a high level of content validity. The Cronbach’s alpha value of Medical Management is 0.807; the Emotional Management is 0.786; the Role Management is 0.969, and the total scale is 0.912, showed good internal consistency. The retest reliability coefficient was 0.802, which was found to be statistically significant (p < 0.01), indicating that the scale demonstrates good stability over time.

CONCLUSION: The SSADD is valid and reliable. It can serve as a valuable tool for self-management assessment in adolescent patients with depressive disorders, enabling timely identification of issues in self-management during the treatment process.

PMID:41547830 | DOI:10.1186/s40359-025-03863-x

BMC Endocr Disord. 2026 Jan 17. doi: 10.1186/s12902-026-02168-3. Online ahead of print.

NO ABSTRACT

PMID:41547824 | DOI:10.1186/s12902-026-02168-3

Cardiovasc Diabetol. 2026 Jan 17. doi: 10.1186/s12933-026-03079-2. Online ahead of print.

NO ABSTRACT

PMID:41547820 | DOI:10.1186/s12933-026-03079-2

Perioper Med (Lond). 2026 Jan 17. doi: 10.1186/s13741-026-00643-y. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to compare thromboembolic (TE) complications between intravenous and epidural analgesia after unilateral total knee arthroplasty (TKA) under neuraxial anesthesia.

METHODS: In this retrospective study, patients who received spinal anesthesia (SA) and intravenous patient-controlled analgesia (IV-PCA) were allocated to the SA-IV group, and those who received combined spinal-epidural (CSE) anesthesia and epidural PCA were allocated to the CSE-E group. Primary outcome was composite incidence of in-hospital TE events defined as myocardial infarction, stroke, peripheral artery occlusion, pulmonary embolism, or deep vein thrombosis. Secondary outcomes were general complications and pain score. After propensity score matching, outcomes were compared using generalized estimating equation.

RESULTS: Among 1,244 cases from 2016 to 2022 at a tertiary hospital, 321 patients in SA-IV and 214 patients in CSE-E were analyzed after matching. The incidence of TE complications was comparable between SA-IV and CSE-E groups [0.9% (n = 3) vs. 2.8% (n = 6); odds ratio (OR) 1.88, 95% confidence interval (CI) 0.89-10.57; p = 0.08]. There were no differences in general complications, delirium, falls, or bedsores. In the CSE-E group, transient motor weakness was more frequent (OR 2.70, 95% CI 9.27-451.78; p < 0.001), and the number of days to joint exercise initiation was higher. However, pain score after TKA was significantly lower in the CSE-E group [5(3-6) vs. 3(2-5); p < 0.001].

CONCLUSION: In this retrospective analysis, the incidence of TE complications after TKA under neuraxial anesthesia was not significantly different between intravenous and epidural analgesia. Epidural analgesia was associated with lower pain intensity, higher incidence of motor weakness, and late initiation of exercise.

PMID:41547811 | DOI:10.1186/s13741-026-00643-y

BMC Med Educ. 2026 Jan 17. doi: 10.1186/s12909-026-08621-0. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, advancements in artificial intelligence (AI) have led to the widespread integration of large language models and their chatbot applications into various fields, including dental education. This study aimed to evaluate the accuracy of ChatGPT-4 Omni (ChatGPT-4o) and Gemini Advanced in answering multiple-choice questions from the Turkish Dentistry Specialization Exams (DUS) across various disciplines.

METHODS: A total of 1,504 multiple-choice questions from 10 years of DUS exams were analyzed to compare the accuracy of ChatGPT-4o and Gemini Advanced. The questions were categorized into Fundamental Medical Sciences (n = 514) and Clinical Dental Sciences (n = 990). Each question was submitted to both chatbots, resulting in 3,008 responses. Accuracy was assessed using the official answer keys. Chi-square tests and Bonferroni post-hoc analyses were used to compare accuracy across disciplines and examine year-based variations.

RESULTS: ChatGPT-4o achieved an overall accuracy rate of 84%, while Gemini Advanced achieved 81.8% (p = 0.110). For the Fundamental Medical Sciences questions, no statistically significant differences were observed across sub-disciplines, with overall accuracies of 92.6% for ChatGPT-4o and 93.4% for Gemini Advanced. For the Clinical Dental Sciences questions, ChatGPT-4o outperformed Gemini Advanced in Prosthetic Dentistry (p = 0.013) and Dentomaxillofacial Radiology (p = 0.001), whereas Gemini Advanced showed higher accuracy in Pediatric Dentistry (p = 0.008). Across all Clinical Dental Sciences questions, ChatGPT-4o achieved an accuracy of 79.5%, compared to 75.8% for Gemini Advanced, and this difference was statistically significant (p = 0.046).

CONCLUSIONS: AI-based chatbots demonstrate strong potential in answering multiple-choice dentistry questions. However, variations in performance across disciplines were observed, indicating differences in accuracy depending on the subject area. These findings highlight the potential educational implications of integrating AI into dental curricula, particularly as supplementary tools for exam preparation and knowledge reinforcement. Nevertheless, cautious integration is required to ensure that AI supports, rather than replaces, critical thinking and professional expertise.

PMID:41547810 | DOI:10.1186/s12909-026-08621-0