Category: Nevin Manimala

Subst Use Addctn J. 2026 Mar 17:29767342261422061. doi: 10.1177/29767342261422061. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with opioid use disorder need prompt buprenorphine/naloxone (BUP/NX) and naloxone nasal spray (NNS) access from pharmacies, but audit studies report substantial availability deficits. No specific intervention has increased BUP/NX stocking, and little is known about the impact of transitioning specific NNS formulations to over-the-counter. The purpose of this study was to assess the impact of mailed academic detailing on BUP/NX availability and the ability to obtain NNS without a prescription.

METHODS: A prospective interventional study was conducted in a sample of 1000 Texas community pharmacies assigned 1:1 to intervention and control groups. The intervention group received academic detailing handouts with links to continuing education addressing BUP/NX and NNS. Pre- and post-intervention audits were conducted using a telephonic secret-shopper approach. Outcomes for BUP/NX included stocking, willingness to order if not stocked, and a composite outcome of stocking and willingness to order. NNS outcomes included availability without a prescription. McNemar and Wilcoxon signed-rank tests, and generalized estimating equations (GEE) were used for analyses.

RESULTS: Data from 757 pharmacies were included in analyses (374 intervention, 383 control). Baseline BUP/NX stocking was low (36.7%) with no statistically significant pre-to-post changes for either group. Most pharmacies were willing to order (60.5%) with no significant pre-to-post changes for either group. GEE analysis found no significant difference in odds of stocking between groups (aOR = 1.08, P = .73), but the intervention group had a significantly higher likelihood to order (aOR = 2.25, P = .02) and of achieving the composite outcome (aOR = 2.17, P = .01). NNS availability increased in both groups but did not differ significantly between groups (aOR = 1.00, P = .99).

CONCLUSIONS: A mailed academic detailing intervention did not change NNS availability or BUP/NX stocking but did modestly increase willingness to order BUP/NX. This intervention is easily replicable and scalable, but modifications to increase the magnitude of its effect are needed.

PMID:41841216 | DOI:10.1177/29767342261422061

Orthop Surg. 2026 Mar 17. doi: 10.1111/os.70278. Online ahead of print.

ABSTRACT

BACKGROUND: Massive rotator cuff tears (RCTs) often lead to superior migration and poor function. While superior capsular reconstruction (SCR) using the long head of the biceps tendon (LHBT) autograft is a promising technique, the optimal management of its distal portion (tenotomy vs. retention) remains unclear.

OBJECTIVE: To compare the clinical outcomes of SCR by a long head of the biceps tendon (LHBT) autograft with biceps tenotomy or not in massive RCTs.

METHODS: In this retrospective cohort study, we enrolled and followed 59 patients following SCR using the LHBT between 2016 and 2021. Patients were divided into two groups based on intraoperative management of the distal LHBT: the LHBT-retained group and the LHBT-tenotomy group. Statistical comparisons included repeated-measures ANOVA, two-way mixed-design ANOVA, chi-square/Fisher’s exact tests, and Mann-Whitney U tests as appropriate. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, constant score and range of motion (ROM), and the acromiohumeral distance (AHD) were assessed as outcome measures.

RESULTS: No major surgical complications were observed in any patient after surgery. The VAS score (7.0 vs. 0.6), AHD (3.2 ± 1.1 vs. 7.8 ± 0.8 mm), ASES (38 vs. 92), constant score (41 vs. 80), and ROM were statistically improved compared to their preoperative values. All patients were further subdivided into two groups according to the management of the distal end of the LHBT after transposition and fixation (retained group: the distal part of the LHBT was retained; tenotomy group: the distal part of the LHBT was resected). The two groups had comparable baseline demographic and clinical characteristics. We found that tenotomy group showed more significant function improvement within 12 months postoperatively (p < 0.05) compared with retained group. Nevertheless, compared with tenotomy group, the AHD of retsained group increased by 1.9 mm (5.0 ± 1.2 mm vs. 3.1 ± 0.8mm). Postoperative imaging assessment at 2 years revealed low and comparable retear rates (grades IV-V) between groups (retained group: 9.7% vs. tenotomy group: 7.1%).

CONCLUSION: SCR using the LHBT autograft significantly improves outcomes in massive RCTs. While both techniques are effective, patients with distal biceps tenotomy (tenotomy group) exhibited superior early functional recovery (within 12 months), whereas those with an intact distal LHBT (retained group) demonstrated significantly greater improvement in AHD. Both groups achieved comparably low retear rates.

LEVEL OF EVIDENCE: Level 4.

PMID:41841210 | DOI:10.1111/os.70278

Future Cardiol. 2026 Mar 17:1-10. doi: 10.1080/14796678.2026.2645012. Online ahead of print.

ABSTRACT

Cardiovascular diseases (CVDs) remain a leading cause of global morbidity and mortality, requiring precise risk prediction models for effective prevention and management. This review maps and evaluates globally utilized and country-specific CVD risk prediction models, including the Framingham Risk Score, Pooled Cohort Equations, PREVENT, WHO/ISH Risk Charts, INTERHEART, and SCORE2. A structured literature search was conducted using PubMed and Google Scholar, from which 30 relevant studies were selected. Most of the models integrate traditional risk factors such as age, sex, blood pressure, cholesterol, and smoking status to estimate CVD risk. While these models demonstrate moderate to good discrimination (C-statistics ranging from 0.66 to 0.80) and validation, their applicability varies across populations, with concerns about overestimation or underestimation in non-original cohorts. Notably, the WHO/ISH and Globorisk models address global diversity by incorporating regional calibrations, making them suitable for low- and middle-income countries. Similarly, the country-specific risk scores outperform global models due to their incorporation of local socio-demographics. Limitations persist across existing models, including the underrepresentation of younger individuals, ethnic minorities, and the exclusion of emerging risk factors. Future efforts must prioritize the development of locally validated, population-specific models to support equitable and effective CVD risk assessment and prevention.

PMID:41841199 | DOI:10.1080/14796678.2026.2645012

Int J Nurs Pract. 2026 Apr;32(2):e70134. doi: 10.1111/ijn.70134.

ABSTRACT

AIM: The aim of this study was to identify the effects of a hybrid maternal role enhancement program based on Meleis’ Transition Theory for working mothers.

METHODS: Using a non-equivalent control group pretest-post-test repeated-measures design, 46 participants were conveniently recruited and assigned to experimental (n = 24) and control (n = 22) groups. Data were collected before intervention (baseline), immediately after intervention (Post-test 1) and 2 weeks after intervention (Post-test 2) using structured questionnaires. The experimental group participated in the hybrid maternal role enhancement program, which included a 1-day offline workshop for both parents and 2 weeks of online support and counselling for mothers. Data were analysed using IBM SPSS Statistics 25.0.

RESULTS: The hybrid maternal role enhancement program had significant interaction effects (group × time effect) on parenting efficacy, maternal identity and spousal childcare support. Scores in the experimental group increased from baseline to Post-test 1 and Post-test 2, whereas the scores of those in the control group remained similar or decreased.

CONCLUSION: The nursing-led maternal role enhancement program developed based on the transition theory can be provided for working mothers with severe time and space restrictions as a hybrid program that combines online and offline programs.

PMID:41841183 | DOI:10.1111/ijn.70134

Neurooncol Adv. 2026 Feb 12;8(1):vdag034. doi: 10.1093/noajnl/vdag034. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: Precise glioma segmentation in magnetic resonance imaging (MRI) is essential for accurate diagnosis, optimal treatment planning, and advancing clinical research. However, most deep learning approaches require complete, standardized MRI protocols that are frequently unavailable in routine clinical practice. This study presents and evaluates GlioMODA, a robust deep learning framework designed for automated glioma segmentation that delivers consistent high performance across varied and incomplete MRI protocols.

METHODS: GlioMODA was trained and validated on the BraTS 2021 dataset (1251 training, 219 testing cases), systematically assessing performance across 11 clinically relevant MRI protocol combinations. Segmentation accuracy was evaluated using Dice similarity coefficients (DSC) and panoptic quality metrics. Volumetric accuracy was benchmarked against manual ground truth, and statistical significance was established via Wilcoxon signed‑rank tests with Benjamini-Yekutieli correction.

RESULTS: GlioMODA demonstrated state-of-the-art segmentation accuracy across tumor subregions, maintaining robust performance with incomplete or heterogeneous MRI protocols. Protocols including both T1-weighted contrast-enhanced and T2-FLAIR sequences yielded volumetric differences vs manual ground truth that were not statistically significant for enhancing tumor (median difference 55 mm³, P = .157) and whole tumor (median difference -7 mm³, P = 1.0), and exhibited median DSC differences close to zero relative to the 4‑sequence reference protocol. Omitting either sequence led to substantial and significant volumetric errors.

CONCLUSIONS: GlioMODA facilitates reliable, automated glioma segmentation using a streamlined 2‑sequence protocol (T1‑contrast + T2‑FLAIR), supporting clinical workflow optimization and broader implementation of quantitative volumetry compatible with RANO 2.0 criteria. GlioMODA is published as an open-source, easy-to-use Python package at https://github.com/BrainLesion/GlioMODA/.

PMID:41841144 | PMC:PMC12989096 | DOI:10.1093/noajnl/vdag034

J Cancer Allied Spec. 2026 Mar 12;11(1):51-61. doi: 10.2478/jcas-2025-0009. eCollection 2025 Jan.

ABSTRACT

INTRODUCTION: Chromophobe renal cell carcinoma (CHRCC) is the third most common RCC subtype, typically with a favorable prognosis, though some cases show aggressive behavior. The prognostic utility of tumor grading in CHRCC remains controversial, particularly regarding the Fuhrman grading system due to inherent nuclear atypia. The Paner et al. three-tiered chromophobe tumor grading (CTG) system addresses these limitations by incorporating nuclear crowding and anaplasia. This study evaluates CTG’s prognostic value versus Fuhrman grading and other factors like pT stage, sarcomatoid differentiation, and tumor necrosis.

MATERIALS AND METHODS: This retrospective study analyzed 51 patients who underwent radical nephrectomy for chromophobe renal cell carcinoma (CHRCC) at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, between 2014 and 2019. Tumors were graded using the Fuhrman and Paner CTG systems. Prognostic factors assessed included pT stage, sarcomatoid differentiation, and tumor necrosis. Statistical analysis used Chi-square and independent sample T-tests. Survival analysis was performed using Kaplan-Meier curves to determine overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS).

RESULTS: Most cases (68.6%) were CTG grade 1-2, and 31.4% were grade 3. All adverse events occurred in grade 3 tumors (DMFS 75%, RFS 93.8%, CSS 87.5%). Grades 1-2 had 100% survival. Fuhrman grading showed less prognostic relevance due to inconsistent results. Tumor necrosis and advanced pT stage correlated with poor outcomes. Sarcomatoid differentiation appeared in one of four progressing cases.

CONCLUSION: The Paner CTG system effectively stratifies CHRCC patients by prognostic risk. It outperforms Fuhrman grading in predicting adverse outcomes. Higher tumor grade, necrosis, and advanced pT stage all significantly correlated with poor prognosis. These findings support adopting the Paner grading system for CHRCC to improve risk stratification and clinical decisions. Larger studies are warranted to validate these results.

PMID:41841143 | PMC:PMC12989086 | DOI:10.2478/jcas-2025-0009

F1000Res. 2026 Mar 5;11:206. doi: 10.12688/f1000research.79534.2. eCollection 2022.

ABSTRACT

INTRODUCTION: Social distancing and wearing a face mask are highly recommended to mitigate the transmission of coronavirus disease 2019 (COVID-19). However, the success of these strategies relies on individuals’ adherence and public compliance. This study was conducted to assess the level of belief in social distancing and face mask practices in communities in low- and middle-income countries (LMICs) and to identify their possible determinants.

METHODS: A cross-sectional study was conducted in ten LMICs countries in Asia, Africa, and South America from February to May 2021. A questionnaire was used to assess the belief, practice, and their plausible determinants. Identification of the associated determinants was performed using a logistic regression model.

RESULTS: Our data revealed that only 62.6% and 66.9% of the participants had good beliefs in social distancing and good face mask practices, respectively. Residing in the Americas, having a healthcare-related job, knowing people in immediate social environment who are or have been infected and exposure to information of COVID-19 cases on social media or TV were factors significantly associated with good belief in social distancing. Residing country, gender, monthly household income, type of job and exposure to information of COVID-19 cases were significantly associated with face mask wearing practice.

CONCLUSION: The proportion of participants having good beliefs in social distancing and good face mask practices is relatively low (<75%). Hence, sustained health campaigns regarding social distancing benefits and face mask-wearing practices during COVID-19 are critical in LMICs.

PMID:41841141 | PMC:PMC12989056 | DOI:10.12688/f1000research.79534.2

Bioinform Adv. 2026 Feb 18;6(1):vbag061. doi: 10.1093/bioadv/vbag061. eCollection 2026.

ABSTRACT

MOTIVATION: Systemic lupus erythematosus patients exhibit a broad clinical spectrum of manifestations and suffer from high rates of treatment failure. These can be attributed to disease heterogeneity due to differentially dysregulated pathways. Precision medicine considering the individualized molecular disease driving mechanisms is a promising strategy to address challenges imposed by disease heterogeneity. Available patient blood transcriptome data coupled with pathway-based single-sample scoring approaches have been extensively employed to reveal molecular footprints of disease states and progression as well as delineate population heterogeneity. However, systemic understanding of pathways involved in disease pathogenesis remains lacking.

RESULTS: We created a SLE-diseaseome, an integrative multi-cohort collection of disease-relevant functional gene sets. This resource contains a comprehensive collection of disease-specific gene signatures combining knowledge from several pathway databases and signature sources robustly defined by integrating multiple studies. It offers reliable and extensive reference signatures in a disease-specific manner for functional interpretation of molecular data from clinical studies.

AVAILABILITY AND IMPLEMENTATION: The code used to run the pipeline and the R object containing the SLE-diseaseome collection are available at https://github.com/dtordom/SLEDiseaseome.

PMID:41841101 | PMC:PMC12989159 | DOI:10.1093/bioadv/vbag061

Cureus. 2026 Feb 13;18(2):e103529. doi: 10.7759/cureus.103529. eCollection 2026 Feb.

ABSTRACT

Background Erectile dysfunction (ED) is considered a condition commonly affecting men, particularly those over 40 years old, with a significant impact on quality of life. Phosphodiesterase-5 (PDE-5) inhibitors, including Avanafil and Tadalafil, are widely used for the treatment of ED. However, there is limited comparative data on their safety and efficacy. Objective This study aims to evaluate the safety and efficacy of Avanafil compared to Tadalafil when administered on-demand in patients with ED. Methods This prospective observational study was conducted over one year in a tertiary care hospital in India. A total of 106 patients with ED were enrolled and divided into two groups based on the medication prescribed by the treating physician: Group A received Avanafil (100 mg), and Group B received Tadalafil (10 mg). The key primary objective was to measure the change in the International Index of Erectile Function – Erectile Function (IIEF-EF) domain scores at 4, 8, and 12 weeks. Secondary outcomes included changes in other IIEF domains, Sexual Encounter Profile (SEP) scores, and partner satisfaction. Adverse events were recorded to assess safety. Results Both Avanafil and Tadalafil significantly improved IIEF-EF scores from baseline. Tadalafil showed superior efficacy, with statistically significant improvements in IIEF-EF scores at 4 weeks (p = 0.008), 8 weeks (p < 0.01), and 12 weeks (p < 0.01) compared to Avanafil. There were no significant differences between the two groups in terms of orgasmic function, sexual desire, intercourse satisfaction, or overall satisfaction. SEP profiles were similar between the groups throughout the study. Adverse effects were mild and comparable between the groups, with no significant differences in the overall incidence of side effects. Conclusion Tadalafil demonstrated slightly better efficacy in improving erectile function compared to Avanafil, although both drugs were effective and well-tolerated. The choice of treatment should consider patient preferences and specific clinical contexts, as both medications offer significant benefits with minimal risk of severe adverse effects. Both PDE-5 inhibitors were effective based on patient-reported outcomes, although objective rigidity was not measured.

PMID:41841099 | PMC:PMC12989142 | DOI:10.7759/cureus.103529

Cureus. 2026 Feb 12;18(2):e103514. doi: 10.7759/cureus.103514. eCollection 2026 Feb.

ABSTRACT

Introduction Breast cancer remains one of the leading causes of cancer-related mortality among women in India. Early detection and prevention are crucial, and medical students play a vital role in promoting awareness. Objective This study assessed how well undergraduate medical students in North India understand breast cancer symptoms, risk factors, screening, and treatment. Methods A cross-sectional study using a 30-item, semi-structured, self-developed questionnaire was distributed through Google Forms. The questions covered general awareness; biological, reproductive, and lifestyle risk factors; as well as screening practices. Students from different MBBS academic years participated. Responses were analyzed using GraphPad Prism 8.0.2, applying descriptive statistics and chi-square tests to identify associations, with significance set at p < 0.05. Results A total of 307 students responded, nearly two-thirds of whom were female. The most recognized key risk factors were family history (94.1%), smoking and alcohol consumption (86.3%), and childhood radiation exposure (87.3%). Awareness of biological risks such as early menstruation (71.7%) and late menopause (67.4%) was moderate. However, knowledge about reproductive risks was weaker: only 58% recognized nulliparity, 59% were aware of hormone replacement therapy as a risk factor, and 55% identified late first childbirth. Screening knowledge showed similar gaps. While 87% had heard of breast self-examination (BSE), only one-third knew the correct timing. Less than half were aware that mammography is advised in the 40s and 50s, and only 66% realized that breast cancer can occur without pain or a lump. Conclusion Undergraduate medical students in North India demonstrated moderate awareness of breast cancer, with notable gaps in understanding lifestyle-related risk factors and screening methods. Strengthening medical curricula and integrating breast cancer awareness programs are essential to enhance students’ knowledge and their future role in community health promotion.

PMID:41841097 | PMC:PMC12989060 | DOI:10.7759/cureus.103514