Category: Nevin Manimala

Climacteric. 2026 Jul 9:1-13. doi: 10.1080/13697137.2026.2685623. Online ahead of print.

ABSTRACT

OBJECTIVE: Menopause is a multidimensional health transition associated with physical, psychological and social consequences. Evidence from Asian settings remains limited, and symptom burden is often examined using single instruments rather than integrated severity measures. This study quantified menopausal symptom burden in Singapore and developed composite indices capturing overall symptom severity and cumulative burden.

METHOD: Baseline and follow-up data from the Singapore arm of a multi-site menopause study were analyzed. Participants self-reported menopausal stage and type. Symptoms were assessed using validated psychometric instruments. The Singapore Menopause Symptom Severity Score (SMSS-SG) integrated standardized symptom totals into a single severity metric. A Cumulative Burden Index for Singapore (CBI-SG) combined biological symptom severity (SMSS-SG), psychological burden, socioeconomic disadvantage and health-system barriers on a common scale. Descriptive analyses, non-parametric comparisons and validation assessments were performed.

RESULTS: Menopausal symptom burden was common and heterogeneous. Musculoskeletal and urogenital symptoms were the most severe, alongside high prevalence of sleep and mood-related symptoms. Overall severity peaked during perimenopause and remained clinically relevant in menopause and postmenopause. Surgical menopause was associated with higher symptom severity and cumulative burden than natural menopause, whereas medically induced menopause showed lower median severity. The SMSS-SG demonstrated good internal consistency and known-group validity, and both indices were inversely associated with health-related quality of life.

CONCLUSION: Menopausal symptom burden in Singapore is substantial and multidimensional. Composite severity and cumulative burden indices support epidemiological assessment and may support future symptom-led approaches to epidemiological surveillance, service planning and hypothesis generation within menopause research.

PMID:42423030 | DOI:10.1080/13697137.2026.2685623

Alcohol Clin Exp Res (Hoboken). 2026 Jul;50(7):e70357. doi: 10.1111/acer.70357.

ABSTRACT

BACKGROUND: Growing evidence suggests glucagon-like peptide-1 receptor agonists (GLP-1RAs) may represent a novel potential pharmacotherapeutic tool for alcohol use disorder (AUD). The objective of this study is to examine the association between GLP-1RA prescriptions and alcohol use.

METHODS: This cohort study used a cross-sectional measure of alcohol consumption and longitudinal electronic health record (EHR) data collected between 1981 and October 2023 from NIH’s All of Us Research Program, a large program to recruit and collect surveys, EHR, genomic, and wearable data from a wide array of Americans. Among 15,447 participants with at least two recorded GLP-1RA prescriptions on separate days, we created three groups based on the timing of Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) responses relative to first GLP-1RA prescription. This resulted in 3650 with current GLP-1RA prescriptions, 5642 with future GLP-1RAs (primary comparison group), and 544 with previous GLP-1RAs. AUDIT-C scores were compared across these groups and to propensity-score matched comparison groups.

RESULTS: Those with current GLP-1RA prescriptions had statistically significant but modestly lower AUDIT-C scores compared with those with future prescriptions (incidence rate ratio [IRR] = 0.95; 95% CI: 0.91-0.99; p = 0.01). Participants with a previous GLP-1RA prescription had lower AUDIT-C scores compared with those with future prescriptions, but this difference was not statistically significant. Results were similar using a matched comparison group with the current GLP-1RA group (IRR = 0.89; 95% CI: 0.85-0.93; p ≤ 0.001) and no significant difference for the previous prescription group. Analysis of individual AUDIT-C questions shows a significant association with GLP-1RA prescriptions and frequency of drinking but not drinks per occasion or binge drinking.

CONCLUSIONS: This study’s findings indicate that GLP-1RAs may reduce alcohol consumption by decreasing use frequency. Experimental studies and randomized controlled trials are needed to test the mechanisms and potential efficacy of GLP-1RAs in people with AUD.

PMID:42423024 | DOI:10.1111/acer.70357

Alcohol Clin Exp Res (Hoboken). 2026 Jul;50(7):e70372. doi: 10.1111/acer.70372.

ABSTRACT

BACKGROUND: Examining how the relationship between alcohol outlet density and alcohol-related harms may vary by neighborhood-level factors is important for informing the evaluation and implementation of environmental alcohol interventions and identifying other community conditions that can be modified to reduce alcohol-related harms and inequities. This study aims to extend prior research by testing whether housing eviction-a cause of housing insecurity and neighborhood destabilization-modifies the impact of alcohol outlet density on hospitalizations for assault and alcohol use disorder (AUD) in Pennsylvania ZIP codes.

METHODS: We used Bayesian hierarchical space-time misalignment models to examine the associations between inpatient assault and AUD hospitalizations and housing eviction filing rates, alcohol outlet density, and the proportion of outlets selling alcohol for off-premise consumption at the ZIP code level in Pennsylvania 2018-2022 (n = 7257 space-time units), reporting relative rates (RR) and 95% credible intervals (CIs). We tested whether eviction filing rates modified the associations between outlet density/the proportion of off-premise outlets and hospitalizations for AUD and assault.

RESULTS: In main effects models, a one percent increase in the eviction filing rate was associated with a 1.2% increase in AUD hospitalizations (95% CI: 1.01, 1.015) and a 1.9% increase in assault hospitalizations (95% CI: 1.002, 1.038). The addition of one outlet per square mile was associated with a 0.3% increase in AUD hospitalizations (95% CI: 1.002, 1.004) and a 0.6% increase in assault hospitalizations (95% CI: 1.003, 1.008). In interaction models, eviction filing rates strengthened the positive associations between outlet density and hospitalizations for both assault and AUD.

CONCLUSIONS: Reducing housing evictions may mitigate the impact of alcohol outlet density on AUD and assault. Future research, policy, and practice should explore opportunities for jointly addressing the alcohol environment and neighborhood housing conditions.

PMID:42423004 | DOI:10.1111/acer.70372

Disaster Med Public Health Prep. 2026 Jul 9;20:e128. doi: 10.1017/dmp.2026.10397.

ABSTRACT

Rapid mass displacement can transform active conflict into a broader public health emergency by compressing shelter demand and continuity-of-care needs into a narrow time frame. The March 2026 escalation in Lebanon provides a timely case to examine these dynamics within a health system already operating under severe constraints. This paper analyzes the early response phase, focusing on how displacement reshaped shelter operations, access to primary care, continuity of medications, and referral pathways. Much of the resulting health risk emerges from treatment interruption and weakened linkage to essential services. Beyond being a humanitarian outcome, displacement should be understood as a health systems event that can amplify secondary morbidity. In fragile settings, preparedness must prioritize health-protective sheltering, continuity of care, and coordinated referral mechanisms under conditions of disruption.

PMID:42423003 | DOI:10.1017/dmp.2026.10397

Alcohol Clin Exp Res (Hoboken). 2026 Jul;50(7):e70369. doi: 10.1111/acer.70369.

ABSTRACT

BACKGROUND: Alcohol elimination rate is associated with acute alcohol consequences, yet it remains difficult to measure reliably in real-world settings. Wearable transdermal alcohol concentration (TAC) sensors provide a feasible option through passive, continuous monitoring of biological alcohol exposure. This facilitates precise testing of whether alcohol elimination rate predicts alcohol-related consequences in naturalistic environments. Additionally, a faster alcohol elimination rate may buffer or reduce the risk of alcohol-related consequences following high and/or rapid consumption.

METHOD: Two observational studies (Alcohol Habits Study [n = 222] and Project ACE [n = 79]), each using a different alcohol sensor, were used in this study. Participants of both studies were young adults from universities who frequently engaged in heavy episodic drinking. Alcohol-related consequences were collected through daily self-reports the morning after drinking days and included metrics across multiple domains such as physical symptoms, interpersonal conflict, safety risk, sexual risk, and miscellaneous. Alcohol elimination rate and other dynamics were extracted from TAC-positive trajectories for each day. Associations were tested using multilevel modeling.

RESULTS: Both studies showed that days with faster elimination rates were associated with more alcohol-related consequences, although statistical significance was observed only in Project ACE. In the Alcohol Habits Study, a significant day-level interaction indicated that the association between peak TAC and alcohol-related consequences was reduced on days with faster alcohol elimination rates. Similar findings emerged in Project ACE but did not reach significance. Both studies demonstrated the same pattern of conditional association: as the daily fall rate increased, the simple association between peak TAC and alcohol-related consequences diminished to the point of non-significance.

CONCLUSION: Our results provide novel evidence that alcohol elimination may have (a) an independent association with alcohol-related consequences in natural settings and (b) a buffering impact on the association between peak TAC and alcohol-related consequences. The results span two studies using two separate wearable sensors, supporting the validity of findings. Future research testing these associations in larger and more diverse samples is warranted.

PMID:42422987 | DOI:10.1111/acer.70369

Ecol Lett. 2026 Jul;29(7):e70403. doi: 10.1111/ele.70403.

ABSTRACT

Habitat selection analyses, which discern the environmental conditions individuals select, often inform conservation planning. Through a literature review, we demonstrate that recent habitat selection studies rarely include fitness and health information. With a simulation study, we show that ignoring such information could support the protection of sink habitats. Our case studies demonstrate how health and fitness proxies can modify our understanding of habitat selection: (1) incorporating mass gain of thick-billed murres shows the energetic benefit of areas deemed secondary by a naive resource selection function; (2) including number of chicks in a step selection function (SSF) exposes the complex relationships glaucous-winged gulls have with landscapes impacted by humans; and (3) including external signs of trauma in the movement kernel of SSFs demonstrates other ways in which narwhal distribution can be altered. We urge movement ecologists to collect and use health and fitness data to improve ecological inference and conservation action.

PMID:42422971 | DOI:10.1111/ele.70403

Eur J Dent Educ. 2026 Jul 9. doi: 10.1111/eje.70204. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study is to evaluate the affordances of the Mobile Performance Support System (MPSS) in paediatric dentistry clinical practice through fourth-year dental students’ clinical performance and technology acceptance.

METHODS: The study involved 95 fourth-year students engaged in paediatric dentistry clinical training. The control group continued with their regular clinical practice training without any changes, whereas the experimental group received performance support through the MPSS. A time-series quasi-experimental design was employed to examine the impact of MPSS on students’ clinical performance. The researchers developed authentic analytical rubrics for all applications, which were designed to assess clinical performance. A post-test control group quasi-experimental design was employed to investigate the participants’ technology acceptance regarding the MPSS. Upon completion of the clinical training term, the researchers administered the Technology Acceptance Scale to all participants. The MPSS recorded the participants’ interaction logs in order to ascertain their use patterns. The collected data were subjected to statistical analysis using SPSS 25.0.

RESULTS: The experimental group demonstrated superior performance to the control group across all performance measures. The interaction logs showed that students used the MPSS not only during clinical hours, but also for clinical preparation. In addition, multi-stage implementations, such as the application of glass ionomer fissure sealant, were observed to receive higher visit rates.

CONCLUSION: The MPSS significantly improved fourth-year dental students’ clinical performance and received high technology acceptance, making it a scalable and effective tool for pediatric dentistry education.

PMID:42422970 | DOI:10.1111/eje.70204

Cancer Control. 2026 Jan-Dec;33:10732748261466117. doi: 10.1177/10732748261466117. Epub 2026 Jul 9.

ABSTRACT

IntroductionMantle cell lymphoma (MCL) constitutes an aggressive subtype of B-cell lymphoma and demonstrates significant clinical and biological heterogeneity. B symptoms are important clinical indicators in tumors. In the present study, we investigated the frequency and prognostic significance of B symptoms among different primary sites of MCL.MethodWe conducted an observational study of 2,025 MCL patients from the SEER database. We analyzed the frequency of B symptoms at different primary sites and evaluated their impact on prognosis.ResultsThe highest incidence of B symptoms was observed in the small intestine (35.29%), and the lowest in the nasopharynx (6.67%). Among patients with primary lymph node involvement, the intrathoracic and abdominal lymph nodes showed the highest proportion of B symptoms (both 40%), while the head, face, and neck lymph nodes showed the lowest (9.3%). In patients with primary site involvement of lymph nodes or nasopharynx, those with B symptoms had a worse prognosis than those without B symptoms (P < 0.05). Similarly, patients with primary lesions involving multiple regional lymph nodes, lymph node not otherwise specified (NOS), or inguinal/leg lymph nodes exhibited worse prognosis when B symptoms were present (P < 0.05).ConclusionIn summary, our study highlights the heterogeneity in both the frequency and prognostic significance of B symptoms across different primary sites in MCL patients.

PMID:42422964 | DOI:10.1177/10732748261466117

Circ Genom Precis Med. 2026 Jul 9:e005666. doi: 10.1161/CIRCGEN.125.005666. Online ahead of print.

ABSTRACT

BACKGROUND: Genetic differences may contribute to interindividual variability in LDL-C (low-density lipoprotein cholesterol) lowering with statin therapy. Polygenic risk scores may help identify individuals unlikely to achieve guideline-concordant LDL-C targets on statins, enabling earlier therapy intensification.

METHODS: We developed a multiancestry polygenic risk score for statin nongoal response (PRS-NGR) and evaluated its association with failure to achieve an on-statin LDL-C level of ≤70 mg/dL and with percent LDL-C reduction. This longitudinal cohort study used genotyping and electronic health record-linked data from the All of Us Research Program (2018-2025), the UK Biobank (2014-2023), and the Biobank Japan (2003-2008). Participants were statin users with at least 1 prestatin and 1 on-statin LDL-C measurement. Associations were assessed overall and by genetic ancestry, with replication in the UK Biobank and Biobank Japan.

RESULTS: The study included 46 564 participants from All of Us, 37 009 from the UK Biobank, and 3613 from Biobank Japan. In All of Us, higher PRS-NGR was associated with increased odds of nongoal response (odds ratio per SD, 1.43 [95% CI, 1.37-1.49]). Compared with the middle quintile, individuals in the top 1% had a higher risk, whereas those in the bottom 1% had a lower risk of nongoal response. Associations of PRS-NGR were consistent across African, European, and Latin American ancestry groups. Each SD increase in PRS-NGR corresponded to a 1.2-percentage-point smaller LDL-C reduction. Findings were replicated in the UK Biobank (odds ratio per SD, 2.39 [95% CI, 2.23-2.57]) and in Biobank Japan (odds ratio per SD, 1.31 [95% CI, 1.17-1.46]). Integration of PRS-NGR with guideline-based criteria identified individuals who derived a higher LDL-C% change and increased identification of statin-eligible individuals.

CONCLUSIONS: We developed and validated a multiancestry polygenic risk score that estimates the risk of nongoal LDL-C response to statin therapy. Incorporation of polygenic risk into lipid-lowering treatment paradigms may improve risk stratification and support more tailored therapy intensification strategies.

PMID:42422963 | DOI:10.1161/CIRCGEN.125.005666

J Med Eng Technol. 2026 Jul 9:1-16. doi: 10.1080/03091902.2026.2698512. Online ahead of print.

ABSTRACT

Reliable differentiation between cancer and non-cancer states using minimally invasive approaches remains a significant challenge. Most currently available biomarkers are cancer-type specific and may not capture systemic alterations associated with malignancy. This study evaluates the feasibility of microwave-assisted thermal profiling of blood as a method to distinguish cancer from non-cancer conditions. A cross-sectional analytical study was conducted involving 232 participants (87 cancer patients and 145 non-cancer individuals). A custom-built device was used to perform microwave heating of 0.5 mL venous blood samples. Temperature rise patterns were recorded using an infra-red thermal imager. Key parameters, including the time taken to reach the maximum temperature and maximum gradient time, temperature increase and rate of temperature increase, were extracted and statistically analysed. Significant differences in thermal profiles between cancer and non-cancer groups were observed. Cancer patients exhibited a higher Gradient time ratio (GTR) and lower Z_blood value, which indicates an alteration in thermal profile of blood due to cancer. The non-probabilistic prediction rule achieved 96.10 accuracy, with a sensitivity of 96.54 and specificity of 95.86. The microwave-based thermal profiling method demonstrated high diagnostic accuracy and has the potential to serve as a reliable cancer biomarker. Further validation in larger cohorts is required.

PMID:42422931 | DOI:10.1080/03091902.2026.2698512