Category: Nevin Manimala

Am J Epidemiol. 2026 Apr 22:kwag087. doi: 10.1093/aje/kwag087. Online ahead of print.

ABSTRACT

Understanding regional and racial variation in the risk of hospitalization with Alzheimer’s disease and related dementias (ADRD)-and how it differs from other conditions-is required to inform effective practice and policy. However, no prior studies have simultaneously estimated county-level regional and race-specific variation in hospitalization risk. We assessed hospitalizations with and without ADRD diagnoses among Black and White Medicare Fee-for-Service beneficiaries from 2000-2018 and used Bayesian shared component models to estimate geographic variation in hospitalizations jointly for both racial groups. We decomposed hospitalization risk across 3037 counties into (1) risk shared by all beneficiaries and (2) risk specific to either Black or White beneficiaries. We analyzed 143 891 769 hospitalizations (13.2% with ADRD). For hospitalization with ADRD, shared risk was elevated in southern and eastern states; Black-specific risk was elevated in the Midwest, Florida, and California; and White-specific risk was elevated in Appalachia. Black relative risk was significantly higher than White relative risk in 90.2% (2740/3037) of counties for hospitalization with ADRD and 44.7% (1359/3037) of counties for hospitalization without ADRD. These findings underscore the importance of considering regional differences in race-specific risk when assessing hospitalization disparities.

PMID:42017264 | DOI:10.1093/aje/kwag087

Clin Child Psychol Psychiatry. 2026 Apr 22:13591045261446034. doi: 10.1177/13591045261446034. Online ahead of print.

ABSTRACT

BackgroundRecent data highlight problematic rates of mental health symptoms (MHS) among adolescents and young adults following the COVID-19 pandemic, with implications for early identification and clinical service provision. This study estimated the prevalence of MHS and its sociodemographic correlates among Canadian youths.MethodsWe conducted a cross-sectional analysis of 896 iundividuals aged 18-24 years using data from Statistics Canada’s Survey on COVID-19 and Mental Health. Symptoms of anxiety, psychological distress, depression, and post-traumatic stress disorder (PTSD) were assessed using validated self-report instruments. Analyses included descriptive statistics, Pearson’s chi-square tests, two-way analysis of covariance (ANCOVA), and multivariate linear regression.ResultsParticipants’ mean (SD) age was 21.2 (2.0) years; 53% identified as women, and 81% lived in urban areas. Prevalence was highest for psychological distress (57.0%), followed by depression (31.6%), anxiety (23.7%), and PTSD symptoms (12.6%). Women reported higher anxiety and distress than men (p < 0.05). In multivariable analyses, female gender, non-essential worker status, poorer self-rated mental health, weaker community belonging, lower household income, lower life satisfaction, and pre-existing mental health disorder were associated with greater symptom severity (p < 0.05).ConclusionThe rising prevalence of mental health symptoms reflects gendered, socioeconomic, and psychosocial vulnerabilities, requiring trauma-informed clinical screening and equity-focused public health interventions for Canadian youth.

PMID:42017241 | DOI:10.1177/13591045261446034

Stroke. 2026 Apr 22. doi: 10.1161/STROKEAHA.125.054127. Online ahead of print.

ABSTRACT

BACKGROUND: The benefit of endovascular thrombectomy (EVT) in patients with stroke with proximal large vessel occlusion in the anterior circulation has been confirmed by several randomized controlled trials. However, evidence regarding EVT for anterior cerebral artery occlusion (ACAo) remains limited. This study aimed to compare clinical outcomes between EVT and standard medical management (SMM) in patients with ACAo.

METHODS: This retrospective multicenter study examined data from patients with acute ischemic stroke caused by ACAo (A1/A2/A3 segments) within 24 hours of symptom onset across 25 Chinese centers between September 2019 and September 2024. Eligible patients had ACAo verified by computed tomography angiography, magnetic resonance angiography, and digital subtraction angiography, a prestroke modified Rankin Scale score of ≤2, and received either EVT or SMM exclusively. Patients were excluded due to clot migration from proximal major arteries to the anterior cerebral artery, multiterritory occlusion, or absence of 90-day modified Rankin Scale score data. The primary outcome was the 90-day modified Rankin Scale score distribution. Safety outcomes encompassed 24-hour symptomatic intracranial hemorrhage and 90-day mortality rates. Propensity score matching and inverse probability of treatment weighting analyses were conducted to equilibrate baseline confounders between the EVT and SMM groups.

RESULTS: A total of 343 patients with ACAo met the inclusion criteria and were enrolled across all participating centers. Following adjustment for confounders using inverse probability of treatment weighting, the EVT group had statistically significant improvement in 90-day modified Rankin Scale score (adjusted odds ratio, 2.14 [95% CI, 1.59-2.89]; P<0.001), excellent functional outcome (aRR, 1.77 [95% CI, 1.27-2.48]; P<0.001) and functional independence (aRR, 2.35 [95% CI, 1.63-3.39]; P<0.001) compared with the SMM group. Safety outcomes, including symptomatic intracranial hemorrhage and mortality, showed no significant differences between groups. Subgroup analysis revealed improved secondary outcomes in patients with baseline National Institutes of Health Stroke Scale score ≥6.

CONCLUSIONS: EVT for ACAo is associated with better clinical outcomes compared with SMM, particularly in patients with moderate to severe stroke, without increased risk of symptomatic intracranial hemorrhage or 90-day mortality.

REGISTRATION: URL: www.chictr.org.cn; Unique identifier: ChiCTR2500096954.

PMID:42017224 | DOI:10.1161/STROKEAHA.125.054127

J Antimicrob Chemother. 2026 Apr 3;81(5):dkag136. doi: 10.1093/jac/dkag136.

ABSTRACT

OBJECTIVES: Effective alternatives to standard of care treatment for E. faecalis infective endocarditis (EFIE) are needed. Some in vitro studies have suggested daptomycin and ceftaroline have synergistic activity against E. faecalis. We aimed to assess the in vitro and in vivo activity of daptomycin in combination with ceftaroline against E. faecalis clinical isolates with and without high-level of aminoglycoside resistance (HLAR).

MATERIALS AND METHODS: A panel of six endocarditis-associated E. faecalis isolates were used for time-kill assays at initial standard and high inocula. Daptomycin (10 mg/kg/day intravenously) and daptomycin (10 mg/kg/day iv) plus ceftaroline (600 mg q12 hours intravenous) were compared in vivo using a human-like pharmacokinetic model in two treatment groups using the experimental EFIE model in rabbits.

RESULTS: The combination of daptomycin plus ceftaroline achieved synergy against all three HLAR and all three non-HLAR strains in time-kill assays at initial standard inoculum. A bactericidal effect was observed in two of the three HLAR E. faecalis isolates. For HLAR EFAE-188, the use of daptomycin plus ceftaroline significantly decreased the bacterial density in vegetations compared with daptomycin alone (median density 5.2 versus 6.7 log10 cfu/g; P = 0.028). For non-HLAR EFAE-468, the bacterial density in vegetations was lower with the combination therapy than with daptomycin alone (median density 5.2 versus 6.8 log10 cfu/g; P = 0.072). Adding ceftaroline prevented the development of daptomycin-resistant E. faecalis isolates in all cases.

CONCLUSIONS: Daptomycin plus ceftaroline represents a promising alternative for treating EFIE. Further clinical studies are needed to confirm these findings.

PMID:42017201 | DOI:10.1093/jac/dkag136

J Ind Ecol. 2025;29(1):233-245. doi: 10.1111/jiec.13602. Epub 2024 Dec 29.

ABSTRACT

Statistical tests are used to examine the role of prices for petroleum, coal, and farm products in the Great Depression. A new empirical mapping of relationships between monthly energy and farm product prices and key macroeconomic variables shows how biophysical factors intersected with the price system in the 1930s US economy. Deflation was a critical feature of the Depression, with the US aggregate wholesale price index falling by 37 percentage points between October 1929 and February 1933. Petroleum product prices and farm product prices can explain 89% of changes to the aggregate wholesale price index over the 1930s. Granger causality tests show that petroleum product prices led changes to money supply in the 1930s, by 8 months, while farm product and all-commodities prices Granger caused changes to industrial production. Changes in prices from October 1929 to February 1933 varied substantially between commodities, with prices of coal, metals, and building materials-the essential ingredients for capital formation-all increasing in real terms. Real bituminous coal prices are found to Granger cause changes to money supply, personal income, and industrial production over the 1930s. Overall, the results add further support to the hypothesis that the Great Depression was caused by an energy transition, following discovery of large quantities of petroleum in the US Southwest.

SUPPLEMENTARY INFORMATION: The online version of this article (doi:10.1111/jiec.13602) contains supplementary material, which is available to authorized users.

PMID:42017193 | PMC:PMC13092543 | DOI:10.1111/jiec.13602

Int J Womens Health. 2026 Apr 16;18:538491. doi: 10.2147/IJWH.S538491. eCollection 2026.

ABSTRACT

BACKGROUND: This 1-year cohort study aimed to track long COVID prevalence, identify associated risk factors, and assess its association with hospitalization.

METHODS: The GINA-COVID cohort study included 2698 COVID-19 patients from Spain, who reported persistent symptoms spontaneously mentioned in an open questionnaire one year after infection. We recorded symptom onset, duration, and recovery rates at 12 months. Hospitalization data were collected from the Catalan Health System. We performed descriptive statistics and logistic regression models stratified by sex to identify factors associated with long COVID, using multiple imputation for missing values and model selection via stepwise regression based on the Akaike Information Criterion.

RESULTS: Significant sex differences appeared, with females showing a two-fold higher risk of developing long COVID compared to males (OR=1.95; 95% CI, 1.68-2.29). Females reported higher prevalence and a greater number of persistent symptoms, with fatigue being the most common in both sexes (36% in females, 26% in males at 3 months). The recovery rate at 12 months was lower in females (23% vs. 34%, p<0.001). Hypertension emerged as the most significant protective factor for long COVID in females (OR=0.64; 95% CI, 0.48-0.84), whereas COVID-19 severity was the most influential risk factor in males (OR=2.34; 95% CI, 1.79-3.08). Despite these differences, the trajectory of persistent symptoms over time was similar between the sexes. Importantly, long COVID did not increase hospital admissions.

CONCLUSION: Findings underscore the importance of sex-specific approaches in managing long COVID and suggest further investigation into hypertension’s protective role in females and disease severity’s impact in males.

PMID:42017188 | PMC:PMC13094581 | DOI:10.2147/IJWH.S538491

Clin Ophthalmol. 2026 Apr 16;20:589703. doi: 10.2147/OPTH.S589703. eCollection 2026.

ABSTRACT

PURPOSE: To evaluate functional and anatomical outcomes of faricimab in treatment-naïve patients with neovascular age-related macular degeneration (nAMD) presenting with subretinal hemorrhage (SRH).

SUBJECTS AND METHODS: A multicenter retrospective chart review was completed in retina practices in Canada and the United States from June 2022 to September 2025. Treatment-naïve nAMD patients with SRH receiving faricimab were evaluated. Standardized imaging protocols and treat-and-extend guidelines were employed. Primary outcome was visual acuity (VA) change; secondary outcomes included central subfield thickness (CST), pigment epithelial detachment (PED) height, and qualitative assessment of subretinal hyperreflective material (SHRM) and subretinal fibrosis. Outcomes were analyzed following three consecutive loading doses using Friedman statistics for repeated measures. Paired analysis was performed using Wilcoxon signed rank test. Detailed characterization of SRH included measurements of hemorrhage size in disc diameters (DD), location in terms of subfoveal versus extrafoveal, and duration from symptom onset to treatment initiation. Univariate regression analysis was performed to identify predictors of SRH resolution (effect ratio and 95% CI) and visual acuity improvement (odds ratio and 95% CI).

RESULTS: This study included 63 treatment-naïve patients with nAMD and SRH (mean age was 81.6 ± 8.2 years; 58.2% females; n = 28 from Canada and n = 35 from United States; mean total follow-up duration was 17.5 ± 6.0 months). Significant VA improvement was observed (Friedman statistic: 26.3, p < 0.00001), with 42.6% of patients gaining ≥3 lines of vision after loading doses. CST decreased substantially from 391.8 µm to 249.4 µm (p < 0.00001, z = -5.48) and mean PED height reduced from 309.6 µm to 110.7 µm (p < 0.00001, z = -3.51). SHRM and subretinal fibrosis were noted in 81.6% and 25.4% of cases, respectively, at baseline. Of this, 70% had resolution of SHRM and 50% had improvement in fibrosis, at last follow up visit. Univariate analysis of predictors of faricimab injection account to achieve SRH resolution in n = 33 patients identified three significant predictors: SHRM-presence at baseline (effect ratio = 0.531, 95% CI 0.399-0.707, p < 0.0001), combined intraretinal fluid (IRF) and subretinal fluid (SRF) (effect ratio = 1.43, 95% CI 1.09-1.87, p = 0.011), and non-Caucasian ethnicity (effect ratio = 1.45, 95% CI 1.03-2.04, p = 0.031). Analysis of predictors of VA improvement >3 lines did not reveal any clinically meaningful associations.

CONCLUSION: This study demonstrates faricimab’s efficacy in nAMD with SRH, a challenging phenotype traditionally associated with poor visual prognosis. The dual-pathway inhibition of VEGF-A and Ang-2 achieved rapid hemorrhage clearance and meaningful vision gains, offering clinical hope for this high-risk population.

PMID:42017182 | PMC:PMC13094561 | DOI:10.2147/OPTH.S589703

Eur J Obstet Gynecol Reprod Biol X. 2026 Apr 10;30:100459. doi: 10.1016/j.eurox.2026.100459. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: Insulin resistance (IR) is the pathogenic mechanism responsible for polycystic ovarian syndrome (PCOS) and excess of visceral adipose tissue (VAT).

OBJECTIVES: We examined VAT and IR using the homeostasis model assessment (HOMA) in patients with PCOS and controls.

STUDY DESIGN: In this cross-sectional, observational study, we included 74 patients newly diagnosed with PCOS and a similar number of age- and weight-matched healthy women as controls. Haematological, biochemical, and hormonal parameters were estimated from a fasting blood sample taken during the follicular phase, and VAT was assessed using dual-energy X-ray absorptiometry (DEXA). The results were analyzed using relevant statistical methods, and a p-value of less than 0.05 was considered significant.

RESULTS: The study participants (n = 148) had a mean age of 23.6 ± 3.7 years, body weight of 59.9 ± 11.6 kg, and a body mass index (BMI) of 25.2 ± 3.2 kg/m². Among the PCOS patients, 25 had a normal BMI and 49 were obese. The VAT (grams) was comparable between patients (484.3 ± 218.2) and controls (439.9 ± 212.8) (p = 0.1591). The percentage of fat in the trunk/legs was higher in PCOS patients (0.9 ± 0.1) than controls (0.87 ± 0.08) (p = 0.0329). Correlation analysis revealed a positive correlation of 17-hydroxy progesterone (17OHP) with many adiposity parameters in both groups (p < 0.001).

CONCLUSION: The VAT was similar in PCOS and controls, and HOMA showed significant correlation with VAT. 17 OHP correlated with many metabolic and hormonal parameters in both groups. Further studies with larger sample sizes are needed to confirm our findings.

PMID:42017171 | PMC:PMC13092751 | DOI:10.1016/j.eurox.2026.100459

Cardiol Res Pract. 2026 Apr 20;2026:6984101. doi: 10.1155/crp/6984101. eCollection 2026.

ABSTRACT

INTRODUCTION: Fasting blood glucose and myocardial infarction share some common pathophysiological risk factors, but the exact relationship between them remains unclear. This study aims to provide evidence for the association between fasting blood glucose and myocardial infarction by analyzing data from the National Health and Nutrition Examination Survey (NHANES) 2015-2018 and Mendelian randomization (MR) analysis.

METHODS: A two-sample MR study was conducted to explore the causal relationship between fasting blood glucose and myocardial infarction using summary statistics from genome-wide association studies (GWAS). The inverse variance weighted (IVW) method and other supplementary MR methods were mainly used to verify the causal association, and sensitivity analysis was performed to confirm the robustness of the results. In addition, weighted multivariable adjusted logistic regression analysis was used to evaluate the relationship between fasting blood glucose and the myocardial infarction-related multivariable association model constructed with HDL as the core indicator based on NHANES data from 2015 to 2018.

RESULTS: A total of 4807 participants were included in the observational study based on NHANES data. Weighted multivariable adjusted logistic regression analysis showed a positive correlation between fasting blood glucose and the myocardial infarction model, with an odds ratio (OR) of -0.027 and a 95% confidence interval (CI) of [-0.042, -0.011]. MR analysis also indicated a causal relationship between myocardial infarction and fasting blood glucose (IVW: OR = 1.0026, 95% CI = 1.0006-1.0046, p = 0.0098). Sensitivity analysis further confirmed the robustness and reliability of these study results (all p > 0.05).

CONCLUSION: There is a causal relationship between fasting blood glucose and myocardial infarction.

PMID:42017137 | PMC:PMC13093073 | DOI:10.1155/crp/6984101

Cureus. 2026 Mar 21;18(3):e105598. doi: 10.7759/cureus.105598. eCollection 2026 Mar.

ABSTRACT

Aim and objectives To compare the tissue displacement produced by the Hindels impression method, the selective pressure method, and the functional reline method in the anterior, middle, and posterior regions of bilateral distal extension ridges. Additionally, the study aims to identify the impression technique that provides optimal tissue recording for distal extension removable partial denture support. Materials and methods A patient with bilaterally missing mandibular posterior teeth was selected for the study. Five definitive casts were fabricated using each of the three impression techniques. Tissue displacement in the anterior, middle, and posterior regions was measured using a digital vernier caliper. The collected data were subjected to statistical analysis to evaluate intra-group and inter-group differences among the three techniques. Results Within each technique, tissue displacement values increased from the anterior to the posterior regions; however, these differences were not statistically significant (P > 0.05). Inter-group comparison demonstrated that both the Hindels and selective pressure methods produced significantly greater tissue displacement than the functional reline method across all regions (P < 0.001). No statistically significant difference was observed between the Hindels and selective pressure methods (P > 0.05). The overall mean tissue displacement was highest with the selective pressure method, followed closely by the Hindels method, and lowest with the functional reline method, indicating better functional tissue recording for distal extension removable partial denture support. Conclusion The Hindels and selective impression techniques demonstrated greater tissue displacement compared with the functional reline method, with the selective pressure technique showing the most favorable overall performance for distal extension removable partial dentures. These findings suggest that controlled functional recording of the edentulous ridge may promote favorable tissue recording, defined as capturing the supporting mucosa in a physiologically acceptable and controlled functional state. Such recording facilitates more balanced load distribution between the supporting mucosa and abutment teeth, thereby potentially enhancing denture stability.

PMID:42017112 | PMC:PMC13094667 | DOI:10.7759/cureus.105598