Category: Nevin Manimala

J Forensic Sci. 2026 Aug 16. doi: 10.1111/1556-4029.70436. Online ahead of print.

ABSTRACT

The availability of highly sensitive multiplex kits has resulted in the more common observation of low-level and more complex (multiple contributors) DNA profiles within forensic casework. With the emergence of probabilistic genotyping software these complex DNA mixture profiles can now be interpreted. This has led to a shift in questioning within courtroom settings, where the number of contributors (NoC) assigned by the forensic DNA analyst is now often scrutinized. This study aims to assess the likelihood ratio (LR) behavior for the under- and over-assignment of a range of complex mixtures, including six-person mixtures, using the probabilistic genotyping software STRmix™. The mixtures were analyzed using FaSTR™ DNA and a NoC was “blindly” assigned by an analyst (i.e., without prior knowledge of the experimental design). LRs obtained for true contributors and non-contributors, under different NoC assignments, were compared and showed that overestimating NoC may lead to weak adventitious matches, while underestimating can lead to the false exclusions of true contributors. Little effect was observed on the LR assigned to the major contributors to these complex mixtures. Moreover, as the profile complexity increased (higher order mixtures), the impact on the LR for true contributors, when underestimating NoC by one, diminished, with only 35 of the 72 comparisons (~49%) resulting in a smaller LR for the under-assignment. It is paramount for DNA analysts to understand the LR behavior especially when questioned on the witness stand regarding their NoC assignment, as there is no ability to reassess or reinterpret the evidence in real-time.

PMID:42604865 | DOI:10.1111/1556-4029.70436

J Forensic Sci. 2026 Aug 16. doi: 10.1111/1556-4029.70451. Online ahead of print.

ABSTRACT

A substantial proportion of forensic evidence consists of skin or contact traces, commonly referred to as touch DNA. The collection of such biological material remains challenging due to its invisibility and low abundance. Further, depending on substrate type and surface properties, different recovery methods are employed, with adhesive tapes and stamps commonly applied to textile evidence. Although tape lifting is routine in many jurisdictions, limited data exist on the relative efficiency of adhesive materials, the optimal number of lifts, and their comparative performance in touch DNA recovery from textiles. To address the gap, this study evaluated four commercially available adhesive tapes/stamps for touch DNA collection from fabrics. A high DNA-shedding volunteer deposited touch DNA on cotton, denim, and, unexamined fleece in replicates (n = 360) using DNA Tape, Scene Safe Fast™ Minitapes, Force-Forex Adhesive Stamp, and DNA Stub Recording Stamp, as well as standard and increased lysis buffer volumes. No statistically significant differences were observed in DNA yield or STR profile quality among tapes, though substrate type notably influenced DNA recovery, and handling differences among products were noticed. Touch DNA deposition on denim showed high intraindividual variability. Increased lysis buffer volume did not alter extraction efficiency. Considering both performance and usability, the DNA Tape remained the preferred option in this DNA laboratory, while the DNA Stub Recording Stamp represented a practical alternative for on-site police collection.

PMID:42604862 | DOI:10.1111/1556-4029.70451

N Z Vet J. 2026 Aug 16:1-12. doi: 10.1080/00480169.2026.2708016. Online ahead of print.

ABSTRACT

AIM: To evaluate the efficacy of an inactivated, whole-cell Leptospira borgpetersenii serovar Tarassovi vaccine for prevention of urinary shedding of L. borgpetersenii strain Pacifica, in naturally challenged cattle.

METHODS: Three dairy farms in Northland, NZ, endemically infected with Pacifica, participated in a randomised controlled trial. Female calves (n = 291), aged 3-7 weeks, were randomly allocated in equal proportion to vaccinated and control groups. Two doses of test vaccine or saline were administered 4 weeks apart, then booster doses at 6 and 18 months. Blood and urine samples were collected once or twice between weeks 71 and 93, for determination of Tarassovi serology and shedding of pathogenic Leptospira by urine PCR, with subsequent amplicon sequencing of PCR-positive samples. For each farm separately, and pooled results from Farms 1 and 2, the proportion of animals shedding Leptospira in each group was compared statistically, and vaccine efficacy (VE) calculated.

RESULTS: A strong serological response to Tarassovi was demonstrated following two vaccine doses. Between weeks 81 and 93, when study heifers were 17-20 months old, a high proportion of unvaccinated controls were seropositive to Tarassovi (100%, 89% and 83% on Farms 1-3, respectively), consistent with exposure to Pacifica on each farm. On Farm 1, 13/30 (43%) controls and 0/29 vaccinates were shedding pathogenic Leptospira in urine, representing VE of 100% (95% CI = 73-100%; p < 0.001); Pacifica was confirmed in eight control animals, also representing efficacy of 100% (95% CI = 49-100%; p = 0.005). On Farm 2, 6/73 (8%) controls and 1/72 (1%) vaccinates were shedding pathogenic Leptospira; however, the difference was not significant (p = 0.116). On Farms 1 and 2 combined, 19/103 (18%) controls and 1/101 (1%) vaccinates were shedding pathogenic Leptospira, representing VE of 95% (95% CI = 70-100%; p < 0.001). On Farm 3, one unvaccinated control was found to be shedding, and no vaccinates. No other serovars of Leptospira were identified on any farm by urine PCR.

CONCLUSIONS: The Tarassovi vaccine conferred a very high level of protection (95-100% efficacy) against urinary shedding of L. borgpetersenii strain Pacifica in cattle, following two doses in calves and booster vaccinations at 6 and 18 months.

CLINICAL RELEVANCE: Given the serious zoonotic risk of leptospirosis, and the emergence of Pacifica as an important strain in NZ cattle, incorporation of an effective Tarassovi vaccine in standard leptospiral vaccination programmes is highly recommended.

PMID:42604856 | DOI:10.1080/00480169.2026.2708016

Aust Health Rev. 2026 Sep 3;50(3):AH25307. doi: 10.1071/AH25307.

ABSTRACT

OBJECTIVES: This study characterises the use of type 1 diabetes (T1D) guidelines and protocols in Australian T1D clinics working with paediatric patients, and determines if management practices align with T1D-specific guidelines.

METHODS: T1D clinic service leaders responded to an online survey on guidelines (e.g. glycated haemoglobin target levels, time in range targets, and technology uptake and management) and protocols (e.g. surgery) used. Responses were compared with T1D guidelines or protocols.

RESULTS: A representative healthcare professional from 32 T1D services (16 metropolitan; 16 regional) from all Australian states and territories completed the survey. Most services (90%) reported glycated haemoglobin targets of <7% and a time in range of ≥70% (95%). Twenty-one services (72%) developed shared care plans, giving access to schools (91%), patients/families (81%) and general practitioners (71%), and with referrals to other health professionals (52%). Most (79%) clinics provided patients with International Society for Pediatric and Adolescent Diabetes/National Institute of Clinical Excellence guideline-aligned responses on managing out-of-range blood glucose level readings from T1D-related technologies. Regional clinics (68%) provided guideline-aligned responses less frequently than metropolitan clinics (91%). Services used combinations of state-based, national and locally developed protocols for patient management.

CONCLUSIONS: This is the first Australia-wide study examining the protocols and guidelines followed for paediatric T1D management by T1D clinics. Most services reported management practices aligned with T1D guidelines. Greater sharing of care plans when referring patients to other services could improve care continuity. Increasing regional clinics’ delivery of guideline-aligned information to patients on using T1D technology could support patient self-management. This survey provides a benchmark of diabetes guideline awareness and protocol usage in Australia.

PMID:42604850 | DOI:10.1071/AH25307

Aust Health Rev. 2026 Sep 3;50(3):AH26057. doi: 10.1071/AH26057.

ABSTRACT

OBJECTIVE: This desktop/scoping document review aimed to determine differences in availability, content, definitions, and terminology used in NSW Health policy documents that pertained to end-of-life planning.

METHODS: A desktop/scoping comparative analysis of identified documents from the 15 NSW Local Health District (LHD) intranet sites was conducted to identify policy documents that describe elements of or were relevant to end-of-life planning. Of those that pertained to end-of-life planning, data were extracted and analysed using the READ approach.

RESULTS: A total of 105 documents were obtained, with 49 (46%) being identified as discussing or mentioning resuscitation plans, advance care plans, or advance care directives (36 LHD, 9 facility-level, and 5 state-level). The frequency of definitions identified in the 49 documents included 26 (53%) using advance care plan, 24 (48%) using advance care directive, and 16 (32%) using resuscitation plan. The greater proportion of these did not align with the state policy PD_2014_030. Significant variation was observed in terminology and abbreviations among all documents. Using the Australian Statistical Geography Standard Remoteness Structure of geographical remoteness, there are differences in the availability and accessibility between major cities (61% of documents) versus inner-regional/outer-regional/remote/very-remote-areas (11.4 /15.9/2.3/9.1%).

CONCLUSION: This review highlights variations in the number and type of documents available to clinicians across LHDs. There were evident disparities in the number of documents available on LHD intranets as well as between regional-remote NSW when compared to major cities. When viewed in conjunction with document-to-document inconsistencies in terminology and definitions, these findings highlight the possibility that current state policies are not meeting the needs of LHDs and hospitals at the local level. This underscores the importance of accepted, uniform definitions within the context of statewide policymaking.

PMID:42604849 | DOI:10.1071/AH26057

Stat Med. 2026 Aug;45(18-19):e70709. doi: 10.1002/sim.70709.

ABSTRACT

Epidemic models are invaluable tools to understand and implement strategies to control the spread of infectious diseases, as well as to inform public health policies and resource allocation. However, current modeling approaches have limitations that reduce their practical utility, such as the exclusion of human behavioral change in response to the epidemic or ignoring the presence of undetected infectious individuals in the population. These limitations became particularly evident during the COVID-19 pandemic, underscoring the need for more accurate and informative models. To address these challenges, we develop a novel Bayesian epidemic modeling framework to better capture the complexities of disease spread by incorporating behavioral responses and undetected infections. In particular, our framework makes three contributions: (1) leveraging additional data on hospitalizations and deaths in modeling the disease dynamics, (2) accounting for data uncertainty arising from the large presence of asymptomatic and undetected infections, and (3) allowing the population behavioral change to be dynamically influenced by multiple data sources (cases and deaths). We thoroughly investigate the properties of the proposed model via simulation, and illustrate its utility on COVID-19 data from Montréal and Miami.

PMID:42604828 | DOI:10.1002/sim.70709

Psychogeriatrics. 2026 Sep;26(5):e70204. doi: 10.1111/psyg.70204.

ABSTRACT

PURPOSE: This study aimed to assess the efficacy and safety of electroconvulsive therapy (ECT) for treating psychiatric symptoms and parkinsonism in patients affected by dementia with Lewy bodies (DLB), its prodromal phase, and Parkinson’s disease dementia (PDD).

METHODS: We retrospectively reviewed eight patients (four males, four females; mean age 71.5 ± 8.9 years) diagnosed with probable DLB or its prodromal phase, based on diagnostic criteria, who underwent ECT between January 2020 and December 2025. The efficacy and safety of ECT for psychiatric symptoms was evaluated using the Brief Psychiatric Rating Scale (BPRS) before and after treatment, and parkinsonism was assessed based on pre- and post-Hoehn-Yahr (HY) stage. Changes in scores were statistically analysed using the Wilcoxon signed-rank test. Adverse effects occurring during and after ECT were also recorded.

RESULTS: Three patients underwent ECT using the dose-titration method, while the others were treated using the half-age method. One patient experienced recurrent delirium following ECT, while no complications were noted in the other patients. There was a significant improvement in BPRS score observed (Wilcoxon signed-rank test, p = 0.012), though no significant change was noted in HY stage (p = 0.197).

CONCLUSION: These results suggest that ECT is a safe, well-tolerated, and effective treatment for patients with psychiatric-onset prodromal DLB, or mild DLB who present pharmacotherapy-resistant psychiatric symptoms. ECT may be a viable therapeutic option for DLB, particularly in an early stage of dementia.

PMID:42604817 | DOI:10.1111/psyg.70204

Asian J Endosc Surg. 2026 Jan-Dec;19(1):e70366. doi: 10.1111/ases.70366.

ABSTRACT

BACKGROUND: This study evaluates short-term outcomes of robot-assisted (Rt) and laparoscopic (Lap) intracorporeal anastomosis (IA) in colon resection using an exploratory single-center retrospective cohort and a systematic review and meta-analysis conducted in accordance with PRISMA guidelines.

METHODS: Patients with colon cancer who underwent laparoscopic or robotic surgery at our institution from 2015 to 2024 were retrospectively enrolled. Additionally, a meta-analysis was conducted using PubMed, Web of Science, Scopus, and the Cochrane Library to identify studies comparing Rt-IA and Lap-IA. Short-term outcomes were statistically compared between the two groups.

RESULTS: A total of 77 patients were included (Rt-IA 26, Lap-IA 51). Intraoperative blood loss was significantly lower in the Rt-IA group (median, 5 mL vs. 10 mL; p = 0.001). No statistically significant differences were detected in major postoperative complications or most recovery-related outcomes. For the meta-analysis, 11 studies (1 prospective and 10 retrospective) met the inclusion criteria. After adding our institutional data, the pooled analysis showed that operative time was significantly longer in the Rt-IA group (MD, 54.02 min; 95% CI, 34.18-73.86; I² = 95.4%), whereas the Rt-IA group demonstrated significantly less blood loss (MD, -14.33 mL; 95% CI: -27.04 to -1.63; I² = 19.3%).

CONCLUSIONS: The results of our institutional analysis together with meta-analysis suggest that Rt-IA may be associated with longer operative time but slightly lower blood loss than Lap-IA. These findings suggest that Rt-IA may be a feasible alternative to Lap-IA; however, the results should be interpreted with caution given the limitations of the available evidence.

PMID:42604816 | DOI:10.1111/ases.70366

Stat Med. 2026 Aug;45(18-19):e70704. doi: 10.1002/sim.70704.

ABSTRACT

In several biomedical contexts, the need for diagnostic analyses of data that is a set of directions in 2, 3, or higher dimensions arises, as for instance, when considering the relative movement of body parts like the limbs, or looking at anatomical orientations. Commonly used statistical tools, including graphical tools developed for data on the real line, or for dealing with multidimensional data taking values on Euclidean spaces, are quite inappropriate for analyzing such data, due to major differences in their underlying geometry. Taking clues from the Box-plot, which was introduced by Tukey [1977] for linear data, here we propose what we label a “Cloud-plot”, which is a visualization tool and diagnostic framework for plotting data on 3-dimensional directions, which take values on the surface of a unit sphere, the 𝕊 2 . The analysis is based on “geodesic distances” between any 2 observations, which are the shortest paths between these two points on the surface of the sphere. Using these distances, we construct robust analogues of the spherical median and the quartiles. This is followed by a definition of the “Spherical Median Absolute Deviation” ( S M A D ). We use these quantities to define outliers, and the performance of the proposed method is evaluated through a comprehensive simulation study that compares true and false positive rates given by several existing discordancy tests. Our extensive results indicate that the approach based on our Cloud-plot provides a very successful and competitive performance for detecting outliers, and remains stable across a range of sample sizes and contamination settings. The cloud-plot is illustrated using two interesting medical applications viz. (i) the identification of structural biomarkers of glaucoma, and (ii) the analysis of functional joint instability in gait cyclograms. These examples demonstrate the potential of the Cloud-plots to detect directional anomalies that may not be captured otherwise by tools commonly used on Euclidean spaces.

PMID:42604814 | DOI:10.1002/sim.70704

Bull Tokyo Dent Coll. 2026 Aug 15. doi: 10.2209/tdcpublication.2025-0038. Online ahead of print.

ABSTRACT

Understanding occlusal balance in complete dentures requires conceptualizing mandibular movement and denture dynamics, which many dental students find difficult. This study introduced and evaluated an instructional digital model designed to facilitate accurate 3-dimensional and dynamic representation of these phenomena. This model allowed 360° visualization of mandibular movement and denture dynamics. Its effectiveness was evaluated when used in conjunction with small-group discussions (SGDs) for teaching occlusal balance to undergraduate dental students. Fifth-year students (n=128) at Tokyo Dental College completed both an SGD session and a digital-model learning session, with the order randomized at the small-group level (SGD-first group, n=67; digital model-first group, n=61). Comprehension was assessed using a pre-test and two posttests administered after each session (post-test 1 and post-test 2), each scored on a 10-point scale. Inter- and intra-group comparisons were performed using the Mann-Whitney U and Wilcoxon signed-rank tests, respectively. There were no significant differences between the SGD-first and digital model-first groups in pre-test (4.01±1.90 vs. 4.20±2.00) or post-test 1 scores (5.12±1.91 vs. 4.54±2.20). After completing both sessions, post-test 2 scores were higher in students who completed SGD followed by digital model learning (6.12±2.09) than in those who completed digital model learning followed by SGD (5.59±2.10), with a statistically significant difference between instructional sequences (p=0.046). Intra-group analyses also showed a statistically significant difference between post-test 1 and post-test 2 in both groups, with higher scores at post-test 2 (p<0.05). These results suggest that combining SGDs with the digital model enhances student comprehension of occlusal schemes and balance as it allows these phenomena to be confirmed visually.

PMID:42604801 | DOI:10.2209/tdcpublication.2025-0038