Category: Nevin Manimala

J Int Med Res. 2026 Jun;54(6):3000605261463455. doi: 10.1177/03000605261463455. Epub 2026 Jun 27.

ABSTRACT

ObjectiveHip and femur fractures in older adults are linked to high morbidity, mortality, and socioeconomic costs. This meta-analysis compares regional anesthesia and general anesthesia for these surgeries, focusing on perioperative safety and outcomes.MethodsFifteen studies (6829 participants) from 2009 to 2024 were analyzed. Primary outcomes included 30-day mortality, postoperative delirium, and cardiovascular events; secondary outcomes covered intraoperative blood loss, hospital stay, and pain. Pooled effect sizes were calculated using random-effects models with odds ratios and 95% confidence intervals. Heterogeneity was assessed using the I² statistic. Risk of bias was evaluated with Risk of Bias 2.0 (randomized controlled trials) and Risk Of Bias In Nonrandomized Studies of Interventions (observational studies). Certainty of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation approach.ResultsPooled analysis showed no significant difference in 30-day mortality between regional anesthesia and general anesthesia (odds ratio = 0.89 (0.72-1.10), p = 0.28, I² = 34%). Regional anesthesia was associated with significantly lower hypotension rates (odds ratio = 0.28 (0.18-0.43), p < 0.001, I² = 52%). There was a nonsignificant trend toward lower postoperative delirium with regional anesthesia (odds ratio = 0.78 (0.60-1.01), p = 0.06, I² = 46%). Pain management favored general anesthesia in one large trial (severe pain: 28.8% vs. 42.3%, p < 0.01), but other studies showed no difference. No significant differences were found in long-term mortality or functional recovery (p > 0.05 for all). Substantial heterogeneity (I² > 50%) was noted for some outcomes because of variations in age, fracture type, and study design.ConclusionRegional anesthesia may offer perioperative benefits, including reduced hypotension and a possible (but not statistically confirmed) reduction in postoperative delirium. General anesthesia provides better early pain control in some patients and remains suitable for complex cases. Individualized anesthesia plans are recommended. Future research should prioritize standardized outcomes and larger trials.

PMID:42363795 | DOI:10.1177/03000605261463455

J Nurs Manag. 2026;2026(1):e3436144. doi: 10.1155/jonm/3436144.

ABSTRACT

BACKGROUND: Nurses in resource-limited settings like Jordan require strong leadership and clinical judgment. Job rotation is believed to improve adaptability and self-efficacy, but its effect on clinical decision-making is unclear.

PURPOSE: This study aimed to examine whether job rotation mediates the relationship between clinical leadership skills and clinical decision-making among nurses.

METHODS: A cross-sectional correlational study was conducted among 395 registered nurses employed in Jordanian governmental hospitals. Participants were recruited using a proportional random sampling technique. Data were collected using validated questionnaires assessing clinical leadership skills, job rotation, and clinical decision-making. Statistical analyses, including ANOVA and regression analysis, were performed to examine relationships among the study variables. Structural equation modeling (SEM) was additionally used to assess mediation effects.

FINDINGS: The results showed significant differences between clinical decision-making and gender, marital status, and educational level. Clinical leadership significantly predicted decision-making (β = 0.433, 95% CI [0.331, 0.535], t = 8.226, p < 0.001). In contrast, job rotation indicated no significant direct effect (β = 0.000, 95% CI [-0.052, 0.051], t = -0.010, p = 0.992) and did not mediate the relationship between leadership and decision-making (β = 0.008, 95% CI [-0.041, 0.057], t = 0.325, p = 0.745).

CONCLUSION: Leadership skills were significantly associated with nurses’ clinical decision-making, and leadership development may play a more substantial role in clinical decision-making than job rotation within this sample.

IMPLICATION FOR NURSING MANAGEMENT: Job rotation implementation has to be intentional, by putting real effort into structured training, mentoring, and embedding workplace learning into daily routines, which improves decision-making quality, increases professional confidence, and ultimately enhances patient outcomes.

PMID:42363792 | DOI:10.1155/jonm/3436144

Nucleic Acids Res. 2026 Jun 27:gkag420. doi: 10.1093/nar/gkag420. Online ahead of print.

ABSTRACT

Computational methods are central to the life sciences. The rapid growth and diversification of software tools and databases make it difficult to find, compare, and reuse methods for a given task. bio.tools is a community-driven registry designed to improve the visibility of research software and allow researchers to simplify access to the software ecosystem through structured, interoperable, and accessible metadata. Tools are annotated using the EDAM ontology and additional controlled vocabularies, enabling users to search and filter by scientific topics, operations, input/output data types, and data formats. bio.tools supports interactive exploration via rich tool landing pages and provides programmatic access through a documented API for search, retrieval, and registry statistics. The registry has expanded to almost 33,000 annotated tools through the combined contributions of thousands of community members and semi-automated literature mining that keep the registry up to date. Recent improvements to the registry include machine-assisted scoring to prioritise curator review, and consolidation of both its standards stack and software architecture. bio.tools has also become a foundational upstream metadata source that is reused by other services in the ELIXIR Research Software Ecosystem and beyond, to support synchronisation, cross-linking, and additional downstream services. bio.tools is freely available at https://bio.tools.

PMID:42363751 | DOI:10.1093/nar/gkag420

J Psychosoc Oncol. 2026 Jun 27:1-16. doi: 10.1080/07347332.2026.2692942. Online ahead of print.

ABSTRACT

OBJECTIVE: This study sought to understand the differences in how young adults with various cancer predisposition syndromes (CPS) feel toward disclosing their diagnosis to romantic partners.

METHODS: Young adults with a CPS completed a cross-sectional survey. Data analysis of 158 responses was performed via SPSS v 27.0 descriptive statistics. One-way ANOVA analyses, and post-hoc pairwise comparisons examining CPS, gender, and sexual orientation were performed.

RESULTS: Individuals with Lynch syndrome favored disclosing later in a relationship compared to those with Li-Fraumeni syndrome (LFS) (p = 0.050). Individuals who identified as bisexual preferred disclosing more information about their CPS than those who identified as heterosexual (p = 0.035).

CONCLUSIONS: Individuals with various CPS experience a myriad of feelings and attitudes surrounding dating and disclosure. This information can lead to better sensitivity and awareness of this topic by healthcare providers, ultimately improving the level of care given to these individuals.

PMID:42363725 | DOI:10.1080/07347332.2026.2692942

Biopreserv Biobank. 2026 Jun 27:19475535261448800. doi: 10.1177/19475535261448800. Online ahead of print.

ABSTRACT

BACKGROUND: The Kids Eye Biobank collects biospecimens, images, and clinical data from pediatric ophthalmology patients for future research use. A broad informed consent model is used; participants have opt-in choices, which include the creation of cell lines/organoids, use of whole genome sequencing (WGS) data, sharing resources with industry, and receiving future communications. This study aimed to characterize participant consent preferences and investigate associations between participant characteristics and their consent preferences.

METHODS: Participant demographics, diagnosis, and consent preferences were abstracted from the Kids Eye Biobank’s records. Variables were analyzed using descriptive statistics and chi-square test. Patient engagement methods were used throughout the study.

RESULTS: Between January 2020 and April 2025, 391 patients were approached and 342 (87%) enrolled. Of the enrolled participants, 265 (78%) had a substitute decision-maker, and 205 (60%) were diagnosed with a malignant neoplasm affecting the eye. Demographic data were available for 273 (80%) participants; 50% were boys/men, 48% identified as belonging to a visible racial minority, and 67% reported a religious affiliation. Participants with malignant neoplasms opted in more to the use of WGS data and to the sharing of WGS data and cell lines/organoids with industry (p < 0.05). Participants belonging to a visible racial minority opted in less to the generation of cell lines/organoids (p < 0.05) and to receiving communications about future research (p = 0.002) compared with White participants.

CONCLUSION: Informed consent preferences may be influenced by participant diagnosis and/or race. These findings may help the Kids Eye Biobank tailor its communication strategies and diversify its participant population.

PMID:42363713 | DOI:10.1177/19475535261448800

J Adolesc Young Adult Oncol. 2026 Jun 27:21565333261464968. doi: 10.1177/21565333261464968. Online ahead of print.

ABSTRACT

PURPOSE: Adolescents and young adults (AYAs) with cancer are at risk for treatment-related infertility, yet gaps in fertility preservation (FP) counseling persist. While patient-level barriers are well described, provider-level factors remain understudied. We evaluated oncology providers’ perceived versus demonstrated knowledge of FP guidelines and identified barriers to oncofertility care.

METHODS: We conducted a cross-sectional survey of oncology providers at a single academic medical center caring for postpubertal AYA patients receiving gonadotoxic therapy. The survey assessed demographics, prior FP training, counseling and referral practices, and perceived barriers. Participants self-rated their FP knowledge and completed guideline-based clinical vignettes to assess demonstrated knowledge, enabling direct comparison of perceived versus demonstrated knowledge.

RESULTS: Providers reported limited formal oncofertility training, with most rating prior education as fair or poor. Knowledge varied across FP strategies, with high familiarity for ovarian suppression and sperm cryopreservation and lower familiarity for ovarian transposition and male-directed surgical techniques. A trend toward discordance between perceived and demonstrated knowledge was observed but was not statistically significant. Awareness of institutional FP resources and referral pathways was limited. Providers most frequently cited patient-level barriers, including treatment urgency and cost, although provider- and system-level barriers were also reported.

DISCUSSION: Oncology providers may overestimate oncofertility knowledge, contributing to inconsistent counseling and missed opportunities for FP. This pattern, combined with gaps in training and awareness of institutional protocols, highlights the need for competency-based education, clearer institutional communication, and improved referral systems. Objective assessments may better identify knowledge gaps and guide targeted interventions to support guideline-concordant FP care.

PMID:42363674 | DOI:10.1177/21565333261464968

Pain Res Manag. 2026;2026(1):e1671698. doi: 10.1155/prm/1671698.

ABSTRACT

BACKGROUND: Intravenous lidocaine infusion is increasingly used in chronic pain services; however, real-world data regarding durability of analgesic benefit and safety in routine practice remain limited.

OBJECTIVE: To evaluate patient-reported analgesic outcomes, duration of benefit and safety profile of intravenous lidocaine infusion in a tertiary chronic pain service.

METHODS: A retrospective service evaluation was conducted at Leicester General Hospital, pain management department, including all adult patients who received intravenous lidocaine infusion between October 2024 and March 2025. Lidocaine was administered at 3 mg/kg over 1 h under monitored day-case conditions. Patients were contacted by structured telephone follow-up to assess Numerical Rating Scale (NRS) pain scores, duration of benefit, adverse effects and satisfaction. Descriptive statistics were used to summarise outcomes.

RESULTS: Of 136 treated patients, 112 completed follow-up (82.4%). Mean baseline NRS decreased from 8.0 to 4.5 during the early posttreatment period, representing an absolute reduction of 3.5 points. More than 60% of patients reported clinically meaningful improvement, while sustained pain relief beyond 3 months was reported by 29% of patients. Adverse effects occurred in 17% of cases and were mild and self-limiting, with no serious adverse events observed. Overall satisfaction with treatment was high, with 85% of patients indicating that they would recommend intravenous lidocaine infusion for chronic pain management. Among these, 47% were receiving the infusion for the first time.

CONCLUSION: In this real-world cohort, intravenous lidocaine infusion was associated with short- to medium-term patient-reported pain improvement and a favourable safety profile. While a subset experienced sustained benefit beyond 3 months, most patients reported shorter duration relief. Prospective controlled studies using validated outcome measures are required to define long-term efficacy and optimal patient selection.

PMID:42363661 | DOI:10.1155/prm/1671698

Vet Dermatol. 2026 Jun 26. doi: 10.1111/vde.70098. Online ahead of print.

ABSTRACT

BACKGROUND: Fluorescent light energy (FLE; Phovia, Vetoquinol) is a photobiomodulation therapy that promotes healing and reduces inflammation. Cutaneous epitheliotropic lymphoma (CTCL) is a neoplastic skin disease with limited treatment options. Although FLE is not considered genotoxic, its use in neoplastic conditions is off-label.

HYPOTHESIS: To assess the safety and clinical effect of FLE as an adjunctive treatment for canine CTCL.

ANIMALS: Eight client-owned dogs were diagnosed with CTCL via biopsy analysis and immunohistochemical analysis.

MATERIALS AND METHODS: Each dog had one CTCL lesion treated with FLE with a lesion serving as a vehicle-control. Treatments were administered weekly for 6 weeks, followed by 3 months follow-up. Focal nodular lesions were assessed weekly using Response Evaluation Criteria of Solid Tumours (RECIST), while diffuse lesions were evaluated using the Canine Epitheliotropic Lymphoma Extent and Severity Index (CELESI). Owner-perceived efficacy and quality of life were assessed using the Owner Global Assessment of Treatment Efficacy (OGATE) and a quality-of-life (QoL) survey.

RESULTS: No statistically significant differences in estimated marginal means were observed between sites at any time point (p > 0.05). Within-subject analyses suggested more favourable lesion progression at FLE-treated sites, and 75% of RECIST-evaluated FLE lesions maintained stable disease. Diffuse FLE-treated lesions demonstrated clinical severity reductions of ≤ 35.3%. Over 66% of owners rated treatment response as ‘fair’ to ‘excellent’ on the OGATE. One dog was withdrawn at Week 3 as a consequence of unrelated worsening.

CONCLUSIONS AND CLINICAL RELEVANCE: FLE appears to be a safe adjunctive therapy for canine CTCL, although statistically significant treatment effects were not demonstrated.

PMID:42363651 | DOI:10.1111/vde.70098

J Intern Med. 2026 Jun 26. doi: 10.1111/joim.70130. Online ahead of print.

ABSTRACT

BACKGROUND: Existing models for predicting postoperative acute kidney injury (AKI) after non-cardiac surgery are often complex and insufficiently validated for broad clinical use. We developed and externally validated a simple yet accurate model for predicting both overall and critical AKI that can be readily applied in routine practice.

METHODS: The severity index model for AKI (SIM-AKI) was developed using data from 191,938 patients undergoing non-cardiac surgery at a tertiary hospital and externally validated using three independent datasets from other tertiary hospitals (n = 118,047; 86,092; 3727). Variables were selected using least absolute shrinkage and selection operator regression with 10-fold cross-validation, and predictor stability was assessed using backward elimination across 100 bootstrap resamples before multinomial logistic regression modeling. Model performance was evaluated using the C-statistic for discrimination, calibration plots, Brier scores, and decision curve analysis (DCA) for clinical utility.

RESULTS: The SIM-AKI model incorporated age, sex, diabetes mellitus, American Society of Anesthesiologists classification, cancer surgery, emergency status, major abdominal surgery, anemia, hypoalbuminemia, estimated glomerular filtration rate, intraoperative transfusion, and operation time. For overall AKI, C-statistics were 0.801 (95% CI 0.796-0.806) in development and 0.754, 0.742, and 0.759 in validation cohorts. For critical AKI, C-statistics were 0.838 (95% CI 0.826-0.850) in development and 0.796, 0.805, and 0.767 in validation cohorts, demonstrating good calibration and clinical benefit in DCA. The SIM-AKI compared favorably with existing AKI prediction models in discrimination.

CONCLUSION: SIM-AKI may serve as a reliable perioperative tool for predicting the risk of both overall and critical postoperative AKI in patients undergoing non-cardiac surgery.

PMID:42363648 | DOI:10.1111/joim.70130

Histopathology. 2026 Jun 26. doi: 10.1111/his.70202. Online ahead of print.

ABSTRACT

This systematic review with meta-analysis aims to analyse the existing literature on clinicopathological features of sporadic gastric hyperplastic polyps (GHP), with special emphasis on risk factors associated with neoplastic transformation, as well as available immunohistochemical and molecular data relevant to GHP carcinogenesis. We searched two electronic databases and included studies reporting the presence of dysplasia and adenocarcinoma arising in GHP. Meta-analysis of odds ratios (ORs) was performed using random-effects models. We included 58 studies, 11 of which were included in quantitative synthesis. The overall rate of neoplastic transformation in GHP was 6.0% and progression to adenocarcinoma was observed in 1.5%. Statistically significant risk factors for neoplastic transformation were age ≥65 years (OR 2.60; 95% confidence interval [CI] [1.88-3.59]), size ≥20 mm (OR 4.63; 95% CI [1.82; 11.77]) with increasing size thresholds, as well as intestinal metaplasia (OR 3.65; 95% CI [1.68; 7.97]). Although the evidence is limited, the available data suggest that GHP located in the cardia or arising in a dysplastic background gastric mucosa may represent higher-risk subsets. Immunohistochemical subtyping of dysplasia showed a progressive shift from a predominantly gastric phenotype in non-neoplastic GHP to a hybrid (gastric-intestinal) phenotype in dysplasia and adenocarcinoma. TP53 alterations and chromosomal instability were the most frequently reported molecular events. GHP present a significant neoplastic potential, particularly in the presence of additional clinicopathological risk factors. Lesion size, patient age and – above all – the status of the surrounding gastric mucosa should guide endoscopic management, pathological interpretation and surveillance strategies.

PMID:42363644 | DOI:10.1111/his.70202