Category: Nevin Manimala

J Orthop. 2026 Feb 4;75:163-167. doi: 10.1016/j.jor.2026.02.021. eCollection 2026 May.

ABSTRACT

BACKGROUND: While two-stage revision is considered the gold standard, single-stage revision continues to gain popularity for the treatment of chronic periprosthetic joint infections. In this single-provider, single-protocol study, the outcomes between the two approaches were compared.

METHODS: This was a retrospective study that included 63 consecutive adult patients who underwent single-stage or two-stage total hip revision arthroplasty for chronic periprosthetic joint infection between 2009 and 2020. Only the two-stage approach was performed between 2009 and 2014, while only single stage was performed between 2015 and 2020. Infections were classified using the Delphi-based consensus criteria. Three major outcomes were compared between the revision approaches: the rates of postoperative complications, reinfections, and reoperations.

RESULTS: There were 43 (68.3%) single-stage and 20 (31.8%) two-stage revisions. The mean age was 59.5 ± 13 years with 35 (55.6%) women. The mean body mass index was 35.8 ± 9.1 kg/m². At the mean follow-up rate of 6.9 years (range, 2.1-10.8 years), the rate of no recurrence of infection was 81.4% in the single-stage cohort compared to 80.0% in the two-stage cohort (p = 1.000). Reoperation rate for single-stage revision due to a non-infectious reason was higher than two-stage (20.9% versus 15.0%; p = 0.7367). No statistically significant differences were noted for other postoperative complications.

CONCLUSION: Single-stage revision is as effective as two-stage revision for the treatment of chronic periprosthetic hip joint infections in patients with limited exclusion criteria.

PMID:41732787 | PMC:PMC12925240 | DOI:10.1016/j.jor.2026.02.021

Indian J Psychol Med. 2026 Feb 21:02537176261421806. doi: 10.1177/02537176261421806. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to study the prevalence of behavioral problems among school-going children, the factors affecting them, and to establish normative scores for the Strengths and Difficulties Questionnaire (SDQ) parent form.

METHODS: A cross-sectional questionnaire-based study was conducted among schoolchildren aged 6-11 years from two primary schools in South India. Parents of children included in the study were asked to fill out the Kannada/English version of the SDQ Parent Form.

RESULTS: The SDQ parent report forms were filled by parents of 671 children, of which 49.8% (n = 334) were boys with a M: F ratio of 1:1.01. There was an equal distribution across different age groups. The comparison of scores between boys and girls showed no statistically significant difference in all scales except for the hyperactivity subscale, where the boys had a higher score with a median (IQR) of 4 (2,5) compared to the girls’ score of 3 (1,4) (p = .001). Regarding age, although the total difficulties score, conduct problems score, hyperactivity score, and internalizing score were higher in the 9-11-year-old group than in the 6-8-year-old group, the p value was not significant. Children of fathers with higher educational status scored better in the peer problems and prosocial scores. The newer cut-off scores have been generated and are divided into four bands, similar to the 4-band categorization on the SDQ scoring site.

CONCLUSIONS: Boys had higher scores on the hyperactivity subscale than girls. Normative data for Indian children aged 6-11 years have been generated and are similar to UK data.

PMID:41732772 | PMC:PMC12924766 | DOI:10.1177/02537176261421806

Innov Aging. 2026 Jan 16;10(3):igaf149. doi: 10.1093/geroni/igaf149. eCollection 2026.

ABSTRACT

BACKGROUND AND OBJECTIVES: To better inform service provision and social services, Australia has long needed a comprehensive national ageing study that is comparable with international ageing studies and eligible to join the register of harmonized cross-national studies of ageing. We conducted a pilot study to fill this gap in Australia’s social and health data collection on ageing.

RESEARCH DESIGN AND METHODS: We utilized online computer-assisted web interviewing (CAWI) and a follow-up Telephone Interview for Cognitive Status (TICS) screening. Participants were drawn from a Roy Morgan Consumer Panel using random probability sampling. Data collected were compared with the national Census data.

RESULTS: Among 1172 online CAWI survey participants (mean age: 65.8 years; 51.0% female), 46.8% had a chronic health condition or disability, 26.1% were full-time employed, and 46.8% were fully or partially retired. Compared with 2021 Australian Census data, the sample was broadly representative by age, sex, geographic region, and health, but respondents tended to have higher education levels (66% reported completing secondary schooling vs 42% in the Census) and underrepresented culturally and linguistically diverse backgrounds (21% born overseas vs 39%; 4% speak a language other than English at home vs 23%); 804 respondents completed TICS (mean[SD] = 33.6[2.8]; range: 22-41), with 71.4% classified as cognitively normal, 27.7% ambiguous, and 1.1% cognitively impaired.

DISCUSSION AND IMPLICATIONS: This pilot demonstrated the feasibility of online and telephone-based data collection with cognitive screening to capture demographic and health profiles of older Australians, providing a strong foundation for future large-scale national ageing studies.

PMID:41732765 | PMC:PMC12924878 | DOI:10.1093/geroni/igaf149

Kidney Int Rep. 2026 Jan 21;11(4):103789. doi: 10.1016/j.ekir.2026.103789. eCollection 2026 Apr.

ABSTRACT

INTRODUCTION: In the AWARD-7 clinical trial participants with type 2 diabetes mellitus (T2D) and moderate-to-severe chronic kidney disease (CKD), a once-weekly treatment with dulaglutide slowed kidney function decline compared with insulin glargine. This post hoc study evaluated dulaglutide’s effect on 6-month changes in plasma concentrations of 21 Joslin Kidney Panel (JKP) proteins, which were previously associated with end-stage kidney disease (ESKD) risk.

METHODS: Plasma concentrations of JKP proteins in participants treated with dulaglutide (n = 124) and insulin glargine (n = 125) were measured using a customized Joslin OLINK proteomic platform. Changes in circulating JKP protein concentrations from baseline to 6 months were determined.

RESULTS: Baseline JKP protein concentrations were similar between groups. After 6 months, 14 JKP proteins increased in the insulin glargine group and decreased in the dulaglutide group with statistically significant between-group differences. The most significant differences were observed for 8 tumor necrosis factor (TNF)-receptors (TNF-R1, -R2, -R3, -R4, -R6B, -R7, -R19L, and -R27), key mediators of inflammatory and apoptotic pathways. In addition, CD160, WFDC2, DLL1, LAYN, SYND1, and EPHA2 were significantly different between treatments, although to a lesser degree, and 7 other proteins remained unaffected. Kidney injury molecule 1 (KIM1), a marker of proximal tubule stress, declined in both groups without significant differences. Treatment effects were more pronounced in participants with lower baseline estimated glomerular filtration rate or higher baseline urinary albumin-to-creatinine ratio, hemoglobin A1c, or body mass index.

CONCLUSION: Six months of dulaglutide treatment significantly lowered concentrations of 14 JKP proteins, particularly those involved in inflammatory and fibrotic pathways. These findings provide insight into biological mechanisms that may underlie the reno-protective effects of dulaglutide.

PMID:41732754 | PMC:PMC12925400 | DOI:10.1016/j.ekir.2026.103789

Int J Cardiol Heart Vasc. 2026 Feb 14;63:101886. doi: 10.1016/j.ijcha.2026.101886. eCollection 2026 Apr.

ABSTRACT

Background: With the growing popularity of amateur endurance sports, including marathon running, it is crucial to recognize transient myocardial changes induced by prolonged physical exertion and to evaluate potential predictors of cardiac fatigue. Methods: A total of 105 runners participating in the 2023 Silesia Marathon (half-marathon, marathon, and ultramarathon) were studied. Transthoracic echocardiography was performed at baseline (1-4 days pre-race), immediately after the race, and 14 days later. Parameters of left and right ventricular function were assessed, including left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LV GLS), right ventricular global longitudinal strain (RV GLS), right ventricular free wall strain (RV FWS), tricuspid annular plane systolic excursion (TAPSE), as well as left and right atrial strain. Regression analyses were conducted to explore demographic- and training-related predictors of exercise-induced functional changes. Results: Immediately post-race, LVEF decreased slightly but remained within the normal range, while LV GLS was significantly reduced in marathon and ultramarathon runners compared with baseline (p = 0.008). RV GLS and RV FWS showed smaller, non-significant declines, and TAPSE demonstrated a non-significant reduction. Atrial strain parameters were transiently decreased but normalized at follow-up. All ventricular and atrial parameters returned to baseline within two weeks, confirming the reversibility of the observed changes. Between-group comparisons revealed no significant differences in cardiac response according to race distance. Regression analyses did not identify consistent predictors of functional decline. Trends suggested that higher weekly training volume may attenuate reductions in LVEF and TAPSE, whereas older age may predispose individuals to a greater decline in TAPSE; however, these associations did not reach statistical significance. Conclusion: Long-distance running induces mild, transient, and reversible changes in ventricular and atrial function in amateur runners. These alterations appear largely independent of race distance and cannot be reliably predicted by simple demographic or training-related indices.

PMID:41732747 | PMC:PMC12924757 | DOI:10.1016/j.ijcha.2026.101886

Phys Imaging Radiat Oncol. 2026 Feb 11;37:100923. doi: 10.1016/j.phro.2026.100923. eCollection 2026 Jan.

ABSTRACT

BACKGROUND AND PURPOSE: Adaptive radiotherapy (ART) manages anatomical variations through real-time plan adjustments. Herein, we aimed to evaluate the efficacy of ART in improving target coverage and reducing organ-at-risk (OAR) irradiation doses in cervical cancer.

MATERIALS AND METHODS: A prospective single-arm study enrolled 15 patients with cervical cancer. Participants received definitive chemoradiotherapy (45-50 Gy/25Fractions) using cone-beam computed tomography-guided online ART workflow. Endpoints included geometric miss volume (target volume underdosed), planning target volume (PTV) coverage (V_100%), OAR sparing (generalized equivalent uniform dose [gEUD] and normal tissue complication probability [NTCP]), and dose homogeneity/conformity parameters (coefficient of variation [CV], Paddick Index [PI]). Mixed-effects models compared ART and simulated image-guided radiotherapy (IGRT) plans, with Wilcoxon signed-rank and Mann-Whitney U tests for statistical analysis.

RESULTS: Among 375 adaptive sessions, ART outperformed IGRT, reduced geometric miss volume by 85.1% (0.28 cm³ vs. 1.88 cm³; P < 0.001) and achieved V_100% ≥ 99% in 99.2% of fractions (vs. 75.0% with IGRT; P < 0.001). ART improved PTV dose homogeneity (median CV: -0.29% vs. 3.89%; P < 0.001) and conformity (median PI: 0.75 vs. 0.60; P < 0.001). Additionally, ART reduced rectum gEUD by 4.39% (P < 0.001) and NTCP by 52.27% (P < 0.001), with similar benefits for other OARs (P < 0.001). ART maintained robustness against intrafractional anatomical changes, with minimal target coverage loss and stable OAR doses despite bladder/rectum volume fluctuations. Patients exhibited 100% complete response and mild acute side effects (no grade ≥ 3 enteritis; no cystitis).

CONCLUSIONS: Online ART with 3-mm isotropic margins is feasibile for cervical cancer, achieved high target coverage while reduced OAR doses and NTCP.

PMID:41732733 | PMC:PMC12925179 | DOI:10.1016/j.phro.2026.100923

PeerJ. 2026 Feb 19;14:e20779. doi: 10.7717/peerj.20779. eCollection 2026.

ABSTRACT

BACKGROUND: Mexico has high levels of adolescent obesity (40.4%), with an increase from 17.6 to 18.1% between 2020 and 2023. Technological advancement and early access to electronic devices and video games after the COVID-19 pandemic, along with morbid lifestyles, contribute to this problem.

OBJECTIVE: To determine the association between video game use, lifestyle, and obesity in adolescents.

METHODS: A cross-sectional, analytical study was conducted. Subjects with and without video game use and percentiles >5 and <95 were included. Those with metabolic, hormonal, neurological, and autoimmune diseases were excluded. Questionnaires were administered regarding lifestyle and video game use. A multiple binary logistic regression model including the variables male sex, morbid lifestyle, video game use, and physical inactivity was developed, yielding exponential B coefficients, 95% CI, and p-values.

RESULTS: Of 272 subjects, males predominated with 51.8%, and obesity of 75.7%. The use of video games and morbid lifestyle showed an OR 10.67 (95% CI [5.33-20.58]) and 3.55 (95% CI [1.99-6.36]), respectively. In the adjusted model, the use of video games and physical inactivity obtained an exponential of B of 6.89 (95% CI [3.17-14.94]) and B of 3.12 (95% CI [1.49-6.50]).

CONCLUSIONS: The importance of family physician intervention on obesogenic factors in adolescents and their families to reduce the risk of harmful behaviours by promoting physical activity and a healthy lifestyle.

PMID:41732729 | PMC:PMC12925410 | DOI:10.7717/peerj.20779

PeerJ. 2026 Feb 19;14:e20554. doi: 10.7717/peerj.20554. eCollection 2026.

ABSTRACT

The way people perceive health risks is often assumed to influence how they adopt precautionary measures. However, people’s assessment of a given phenomenon’s risk may vary over time, and the relationship between perceived risk and compliance with protective measures may be dynamic and bi-directional. We measured the perceived risk of COVID-19 and compliance with infection control measures for a large representative sample at four time-points during the first year of the COVID-19 pandemic in Norway. We employed a cross-lagged panel analysis to investigate both the cross-sectional and the temporal association between perceived risk and compliance. We found cross-sectional associations between perceived risk and compliance at one of the time points. There were no temporal associations between risk at one time-point and compliance at the subsequent time-point. Neither was compliance associated with risk at the subsequent time-point. The results suggest that the relationship between perceived risk and compliance with COVID-19 infection control measures is negligible and stable over time. A multiverse analysis showed that the absence of a relationship between perceived risk and compliance was robust to different operationalizations of perceived risk. This highlights the need for a nuanced understanding of how risk perceptions impact behavior during a pandemic.

PMID:41732725 | PMC:PMC12925416 | DOI:10.7717/peerj.20554

Crit Care. 2026 Feb 23. doi: 10.1186/s13054-026-05867-4. Online ahead of print.

ABSTRACT

BACKGROUND: The role of Enterococcus spp. and the need for specific anti-Enterococcus therapy in Intensive Care Unit (ICU) patients with peritonitis remain debated.

METHODS: We conducted a retrospective multicentre cohort study including all consecutive adults admitted to the ICUs of four hospitals in western France with peritonitis between 2020 and 2022. Outcomes were compared according to Enterococcus spp. isolation and, among Enterococcus-positive cases, according to early administration (< 48 h) of active antimicrobial therapy. Propensity-weighted Cox models were used to estimate 90-day survival.

RESULTS: Among 392 patients, Enterococcus spp. were isolated in 161 (41.1%). Enterococcus-positive patients were older and more frequently had postoperative and diffuse peritonitis. ICU mortality rates were 29.8% vs 28.1% in patients with and without Enterococcus infection (p = 0.805). In multivariable analysis, postoperative peritonitis (aOR 2.56 [1.67-3.95], p < 0.001), diffuse peritonitis (aOR 1.78 [1.10-2.89], p = 0.020) and solid organ transplantation (aOR 5.82 [1.18-28.76]; p = 0.031) were independently associated with Enterococcus isolation. Among the 155 patients with documented Enterococcus peritonitis and available antimicrobial treatment data, 95 (61%) received early active therapy. Early anti-Enterococcus treatment was not associated with improved 90-day survival either in the raw population (HR 0.71 [95% CI 0.39-1.27]; p = 0.241) or after weighted Cox regression (HR 0.66 [95% CI 0.37-1.18]; p = 0.160).

CONCLUSIONS: Enterococcus spp. isolation appears common in ICU peritonitis but not independently associated with higher mortality. Early targeted antimicrobial therapy was not associated with a statistically significant improvement in outcomes.

PMID:41731517 | DOI:10.1186/s13054-026-05867-4

BMC Med. 2026 Feb 24. doi: 10.1186/s12916-026-04700-7. Online ahead of print.

ABSTRACT

BACKGROUND: Older adults (> 65 years) residing in long-term care facilities (LTCFs) are at elevated risk of severe outcomes from respiratory infections. Infections often remain undetected or present atypically in this population, leading to underdiagnosis. Our study aimed to estimate the respiratory virus infection burden, independent of symptom presentation, among older adults in Swedish LTCFs in the post-pandemic period (2021-2024).

METHODS: We leveraged capillary blood samples and coupled national registry data from 1622 LTCF residents (median age = 87). A multiplex platform was used to quantify antigen-specific IgG and IgM responses to RSV (pre-/post-F, strain A-specific G-protein), influenza-A (H1N1 and H3N2 HA), influenza-B (HA) and SARS-CoV-2 (spike). Linear mixed-effects models were used to demonstrate the dynamics of antibody levels over time, adjusted for age, sex and comorbidities.

RESULTS: RSV-specific antibody responses peaked in spring 2022 (p < 0.001), suggesting an impact of relaxed COVID-19-related restrictions on RSV exposure at LTCFs. RSV-specific antibodies subsequently declined over time until an increase during autumn 2023 (p < 0.001). Geographic variation in pre-F antibody levels suggested localised RSV outbreaks. The total estimated RSV burden at LTCFs was markedly higher than official reports of the Swedish Public Health Agency. Influenza antibody dynamics reflected seasonal trends and were strongly influenced by annual vaccination. A random forest classifier incorporating serological profiles with demographics, location and comorbidities significantly outperformed a model without serological data (AUC-ROC = 0.67 vs. 0.58), although discriminatory performance remained modest. Higher levels of RSV pre-F antibodies in autumn 2021 were associated with increased one-year mortality in logistic regression (OR = 1.43, p = 0.024). Exploratory survival analysis indicated a trend that elevated levels of RSV pre-F antibodies during low population immunity may confer a transiently elevated early hazard of death, although this did not reach statistical significance (HR = 4.50, p = 0.087).

CONCLUSIONS: We observed substantial respiratory virus circulation among older adults in Swedish LTCFs and show that RSV burden is under-reported. The results highlight a need for further research into the role of RSV pre-F antibody levels in preventing severe outcomes, potentially via vaccination of LTCF residents. Our scalable serological surveillance system is a valuable approach to detect respiratory infections in LTCFs, independent of symptom presentation or healthcare-seeking behaviour.

PMID:41731510 | DOI:10.1186/s12916-026-04700-7