Category: Nevin Manimala

Int J Urol. 2026 Jul;33(7):e70582. doi: 10.1111/iju.70582.

ABSTRACT

OBJECTIVES: Talazoparib plus enzalutamide improved overall survival (OS) in the biomarker-unselected TALAPRO-2 population, but OS benefit was not statistically significant in the homologous recombination repair (HRR) non-deficient or unknown subgroup, whereas radiographic progression-free survival (rPFS) was prolonged. We explored time-dependent patterns in estimated treatment effects in this subgroup.

METHODS: Approximate individual-level data for 636 patients were reconstructed from published Kaplan-Meier curves; original trial-level patient data were unavailable. The proportional hazards assumption was assessed using Schoenfeld residuals and log-log plots. Interval-specific hazard ratios (HRs) were estimated using piecewise Cox models. A treatment-by-log(time + 1) interaction was evaluated formally. Sensitivity analyses included alternative interval schemes, landmark analyses, restricted mean survival time (RMST), and descriptive application of the same piecewise framework to the HRR-deficient subgroup.

RESULTS: The proportional hazards assumption was not rejected for OS (p = 0.63) or rPFS (p = 0.37). For OS, the 36-48-month interval showed a nominally lower hazard with talazoparib (HR 0.59; 95% confidence interval [CI] 0.36-0.97; nominal p = 0.039). For rPFS, the lowest HR occurred at 0-6 months (HR 0.56; 95% CI 0.37-0.86; p = 0.008). Treatment-by-log(time + 1) interactions were not statistically significant for OS (p = 0.44) or rPFS (p = 0.12).

CONCLUSIONS: This reconstructed-data post hoc analysis suggested exploratory time-dependent patterns in effect estimates without formal evidence of a time-varying treatment effect. Findings are descriptive, hypothesis-generating, and should not be extrapolated to molecularly confirmed HRR-proficient disease.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT03395197.

PMID:42502892 | DOI:10.1111/iju.70582

PeerJ. 2026 Jul 22;14:e21473. doi: 10.7717/peerj.21473. eCollection 2026.

ABSTRACT

BACKGROUND: Neonatal mortality remains one of the most pressing global health challenges, disproportionately affecting low- and middle-income countries. In Ethiopia, complex interrelated factors contribute to high neonatal mortality rates, creating a multifaceted public health concern that demands comprehensive investigation. Despite the magnitude of this challenge, there exists a notable lack of longitudinal studies that examine the temporal patterns of neonatal deaths, survival, and associated risk factors throughout the complete neonatal period. This study addresses this gap by evaluating survival outcomes and identifying determinants of mortality among neonates admitted to the neonatal intensive care unit at Zewditu Memorial Hospital, a referral facility serving a high-burden urban population in Addis Ababa, Ethiopia.

METHODS: A retrospective cohort study of 1,014 neonates admitted to the neonatal intensive care unit from September 11, 2020 to September 10, 2023 was conducted. Systematic random sampling was used to select patients. An electronic data collection method was used, and the data were exported to STATA version 17.0 for cleaning and analysis. Bi-variable and multivariable Cox proportional hazard regression models were employed to identify mortality risk predictors. Kaplan-Meier survival estimates and log-rank tests were used to compare survival probabilities. Model adequacy was assessed using the Cox-Snell residual test.

RESULTS: Over 7,945 neonate-days, the mortality incidence rate was 13.72 deaths per 1,000 neonate-days (95% confidence interval (CI) [11.37-16.55]), with most deaths occurring within the first week. Significant predictors of mortality risk were extremely low birth-weight (<1,000 g; Adjusted Hazard Ratio (AHR) = 18.94, 95% CI [7.89-45.23]), very low birth weight (1,000-1,499 g; AHR = 5.09, 95% CI [2.75-9.43]), perinatal asphyxia (AHR = 3.52, 95% CI [2.25-5.49]), neonatal sepsis (AHR = 2.47, 95% CI [1.28-4.77]), respiratory distress syndrome (AHR = 1.65, 95% CI [1.01-2.68]), and meconium aspiration syndrome (AHR = 2.35, 95% CI [1.20-4.57]).

CONCLUSION: This study found associations between elevated neonatal mortality rates and birth weight and specific perinatal complications as key factors linked to survival. The predominance of deaths within the first week, particularly among neonates with low birth weight, perinatal asphyxia, sepsis, respiratory distress syndrome, and meconium aspiration syndrome, necessitates the implementation of risk-stratified care and intensive early monitoring. These findings provide evidence for targeted interventions that could substantially reduce neonatal mortality in resource-constrained healthcare settings.

PMID:42502858 | PMC:PMC13401358 | DOI:10.7717/peerj.21473

Psychol Res Behav Manag. 2026 Jul 21;19:620815. doi: 10.2147/PRBM.S620815. eCollection 2026.

ABSTRACT

BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) requires patients to perform complex self-management tasks at home. Fear of progression and coping styles may influence self-management, but their dimension-level relationships remain poorly understood.

OBJECTIVE: To investigate the network structure linking fear of progression, coping styles, and self-management among CAPD patients and identify central and bridging dimensions that may be relevant for nursing assessment and intervention planning.

METHODS: A cross-sectional study was conducted among 328 CAPD patients in a tertiary hospital in Sichuan, China. Fear of progression, coping styles, and CAPD self-management were assessed using validated questionnaires. A psychometric network was estimated at the dimension level, and centrality, bridge centrality, and network stability were evaluated.

RESULTS: The strongest edge was observed between physical health-related and social/family-related fear of progression (edge weight = 0.663). Confrontation coping exhibited the highest strength and expected influence and showed the strongest cross-community connectivity, with bridge strength and bridge expected influence z-scores of 2.57 and 2.60, respectively. The strongest cross-community edge was identified between confrontation coping and diet management (edge weight = 0.264). Centrality and bridge centrality analyses demonstrated acceptable-to-good stability.

CONCLUSION: Confrontation coping emerged as a central and bridging dimension linking psychological responses and self-management behaviours in CAPD patients. These findings reflect statistical connectivity rather than causal relationships and may help identify priorities for nursing assessment and future intervention research.

PMID:42502848 | PMC:PMC13401381 | DOI:10.2147/PRBM.S620815

Mater Today Bio. 2026 Jul 15;39:103465. doi: 10.1016/j.mtbio.2026.103465. eCollection 2026 Aug.

ABSTRACT

The key for nanozymes to achieving sequential infection-inflammation-repair in wound infection therapy and healing lies in how to resolve the contradiction of reactive oxygen species (ROS) regulation between antibacterial therapy and anti-inflammation. Herein, a freestanding pristine CuGeO₃ (CGO) nanozyme film (NF) composed of nanowires is first designed and simply synthesized. Such a NF with flexibility, wet tissue adhesion properties, alongside water/blood absorbing capability could serve as a wound dressing and present superb antibacterial/antibiofilm efficacy for photothermal/chemodynamic synergistic therapy of wound infection owing to its extraordinarily outstanding photothermal performance, and glutathione depletion-enhanced peroxidase-like activity to generate ROS in acidic infection microenvironments (IMEs). Attractively, it is disclosed that after completing infection therapy, the enzyme activity of this CGO NF automatically and continuously switches into catalase-like activity to eliminate ROS as IMEs switches into neutral microenvironments. This promotes the M2 phenotype polarization of macrophages to relieve inflammation and accelerate wound repair. Furthermore, the longer and entangled nanowire structure of the CGO NF prone to retention in the wound site minimizes its toxicity to healthy tissues. Overall, it is the first paradigm to leverage a photothermal NF consisting of inorganic nanomaterials only as a wound dressing. Based on such a safe, effective, activity-switchable NF dressing, adaptive infection-inflammation-repair cascade in wound infection therapy and healing has been realized, achieving 98.7% wound closure within 10 days. We believe this work will foster the therapeutic application of activity-switchable nanozymes, and provide meaningful insights into nanozymes-based wound infection therapy and healing.

PMID:42502815 | PMC:PMC13400452 | DOI:10.1016/j.mtbio.2026.103465

Food Sci Nutr. 2026 Jul 24;14(7):e72171. doi: 10.1002/fsn3.72171. eCollection 2026 Jul.

ABSTRACT

Preventing sarcopenia is a major goal for older adults. High protein breakfast, while maintaining overall daily intake, has been proposed as a promising approach to support muscle health. However, the optimal timing of protein consumption remains uncertain. Therefore, the specific effects of breakfast protein intake are therefore important for refining nutritional recommendations. The methodology of this review is as follows: which included randomized controlled trials (RCTs) comparing morning protein intake with no intake in healthy and frail adults aged ≥ 60 years. A trained librarian developed comprehensive search strategies for MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias using Cochrane’s RoB tool 1.0. Standardized mean differences (SMD) were calculated using Review Manager. Seven RCTs involving 305 participants were included. Five studies (n = 181) reported lean mass with an SMD of -0.11 (95% CI, -0.41 to 0.18). Six studies (n = 274) measured grip strength (SMD -0.01; 95% CI, -0.25 to 0.23). Three studies (n = 157) evaluated lower limb strength (SMD -0.11; 95% CI, -0.41 to 0.18), showing similar results. Morning protein intake had a marginal reduction in total daily energy intake (SMD -0.35; 95% CI, -0.70 to 0.00), and had a significant reduction in trials without exercise (SMD, -0.47; 95% CI, -0.82 to -0.11). As a conclusion, morning protein intake may not improve muscle mass, strength, or physical performance among older adults and may reduce little food intake without exercise. But the evidence is very uncertain. Further high-quality RCTs are needed for the effects of morning protein intake on muscle health in older adults.

PMID:42502805 | PMC:PMC13400828 | DOI:10.1002/fsn3.72171

JID Innov. 2026 Jun 4;6(5):100498. doi: 10.1016/j.xjidi.2026.100498. eCollection 2026 Sep.

ABSTRACT

Skin cancer is a growing public health concern, yet patterns in younger adults remain inadequately described. We quantified the global incidence, mortality, disability-adjusted life years, and age-standardized rates of melanoma and nonmelanoma skin cancer in adults aged 20-44 years using Global Burden of Disease 2021 estimates and assessed United States melanoma mortality in those aged 25-44 years from 1999 to 2023 using national vital statistics. From 1990 to 2021, age-standardized melanoma incidence declined, whereas nonmelanoma skin cancer cases rose from 142,018 to 292,052, with an increasing age-standardized incidence of basal cell carcinoma. The burden was greatest in countries with higher sociodemographic development and peaked at ages 40-44 years; women experienced a higher incidence, but men had higher mortality. In the United States, melanoma mortality decreased from 0.99 to 0.47 deaths per 100,000 between 1999 and 2023, representing an average annual reduction of 3.56%. Projections suggest continued declines in melanoma but sustained increases in nonmelanoma skin cancer. These findings indicate a growing and uneven skin cancer burden in young adults, supporting targeted prevention and earlier detection.

PMID:42502795 | PMC:PMC13400237 | DOI:10.1016/j.xjidi.2026.100498

Prev Med Rep. 2026 Jul 13;69:103571. doi: 10.1016/j.pmedr.2026.103571. eCollection 2026 Sep.

ABSTRACT

OBJECTIVE: To identify the optimal 2-h glucose reduction and baseline level for preventing progression from impaired glucose tolerance to type 2 diabetes using meta-regression.

METHODS: We systematically reviewed randomized clinical trials of lifestyle modifications and/or anti-hyperglycemic medications reporting both 2-h glucose and diabetes prevention in impaired glucose tolerance. PubMed (1997), Cochrane Library (1995), and Ichushi-Web (Japanese medical literature database; 2000) were searched from inception through January 26, 2025. A meta-regression model examined log-transformed hazard ratios for diabetes progression, with 2-h glucose reduction and baseline level as predictors.

RESULTS: From 1372 candidates, 32 studies (n = 33,839 participants) were analyzed. The model indicated linear relationship and the early intervention at a baseline 2-h glucose of 140 mg/dL (7.8 mmol/L) could prevent 44% of diabetes with only a 10 mg/dL (0.56 mmol/L) reduction. Conversely, later interventions at a baseline 2-h glucose of 170-190 mg/dL (9.4-10.6 mmol/L) require larger 2-h glucose reductions of 20-30 mg/dL (1.1-1.7 mmol/L) for similar preventive effects (40-42%); which may necessitate pharmacotherapy.

CONCLUSIONS: This meta-regression analysis demonstrates that early and minimal interventions for impaired glucose tolerance are optimal, suggesting that its timely detection is vital for diabetes prevention.

PMID:42502745 | PMC:PMC13400255 | DOI:10.1016/j.pmedr.2026.103571

Int J Endocrinol Metab. 2026 Jun 22;24(4):e168325. doi: 10.5812/ijem-168325. eCollection 2026 Oct 31.

ABSTRACT

BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a serious complication after heart transplantation, with reported incidence rates ranging from 2% to 53% among solid organ transplant recipients. Comprehensive epidemiological data on prediabetes (Pre-DM) and diabetes mellitus (DM) in heart transplant populations remain limited, particularly in Middle Eastern populations.

OBJECTIVES: This decade-long study investigated the prevalence of DM and Pre-DM among heart transplant recipients and evaluated selected intraoperative risk factors.

METHODS: This retrospective cohort study included 250 heart transplant recipients who received post-transplant care at Dr. Masih Daneshvari Hospital, Tehran, Iran, between 2010 and 2020. Overall, 244 patients were included in the final analysis. Data included anthropometric measurements, cardiovascular parameters, and metabolic profiles. Pre-DM and DM were diagnosed according to the American Diabetes Association criteria. Statistical analyses were performed using SPSS version 26.

RESULTS: The study population comprised 192 males (78.7%) and 52 females (21.3%), with a mean age of 38.46 ± 12.69 years. At transplantation, 36.5% of recipients had established DM, 29.1% had Pre-DM, and 34.4% had normal glucose metabolism. Among patients with DM, 58.4% (52 of 89) were unaware of their diagnosis before transplantation. New-onset PTDM occurred in 6.8% of previously normoglycemic patients by 6 months. The prevalence of hypertension differed markedly by glucose status (P < 0.001): 100% of the normal group had normal blood pressure, 97.2% of patients with Pre-DM had stage 1 hypertension, and 87.6% of patients with DM had stage 2 hypertension. Dyslipidemia, particularly low high-density lipoprotein (HDL), was present in all groups. Pre-transplant hyperglycemia was associated with a numerically higher, but nonsignificant, mortality risk (hazard ratio [HR] = 1.371; 95% CI, 0.891 – 2.132; P = 0.162), which reversed after age adjustment (HR = 0.676; P = 0.083), consistent with negative confounding.

CONCLUSIONS: Pre-transplant metabolic dysfunction was highly prevalent, and 58.4% of diabetic recipients were unaware of their diagnosis. Although the association with mortality was nonsignificant and reversed after adjustment for age, these findings underscore the need for systematic pre-transplant metabolic screening, post-transplant glucose monitoring, and multidisciplinary care in heart transplant recipients.

PMID:42502735 | PMC:PMC13401106 | DOI:10.5812/ijem-168325

J Ophthalmol. 2026 Jul 25;2026:9418834. doi: 10.1155/joph/9418834. eCollection 2026.

ABSTRACT

OBJECTIVE: To investigate the impact of chalazion history on meibomian gland loss and dry eye disease (DED).

METHODS: This study was a retrospective case-control study. Sixty patients with a history of chalazion admitted to a certain hospital from June 2021 to June 2024, who were selected as the previous chalazion group, and another 90 patients with no previous history of chalazion who visited the outpatient clinic consecutively during the same period were selected as the nonchalazion group. Comprehensive ocular surface parameters were compared between groups to evaluate long-term meibomian gland loss and DED. The chalazion group was further divided into MG loss (n = 42) and non-MG loss (n = 18) subgroups based on glandular loss status. Logistic regression analyzed factors influencing meibomian gland loss. The MG loss subgroup was stratified by severity into mild-moderate (< 1/3 or 1/3-2/3 loss) and severe (> 2/3 loss) groups for comparison of parameters of DED (Schirmer’s test, tear break-up time [BUT], and fluorescein staining [FL]). Pearson’s correlation assessed the relationship between meibomian gland loss severity and DED manifestations.

RESULTS: Significant differences were observed between the chalazion and nonchalazion groups in tear meniscus height, BUT, conjunctival redness index, and lipid layer thickness (p < 0.05). The MG loss subgroup indicated statistically significant differences from the non-MG loss subgroup in chalazion recurrence frequency, surgical history, tear meniscus height, BUT, conjunctival redness index, and lipid layer thickness (p < 0.05). All differential indicators demonstrated no collinearity (VIF ≤ 10, tolerance ≥ 0.1). Logistic regression identified chalazion recurrence frequency and surgical history as independent risk factors for meibomian gland loss. Pearson’s analysis revealed negative correlations between meibomian gland loss severity and both Schirmer’s test results (r1 = -0.761) and BUT (r2 = -0.543), and a positive correlation with FL scores (r3 = 0.752) (all p < 0.05).

CONCLUSION: Retrospective analysis revealed that a proportion of patients with meibomian gland loss had prior chalazion history, demonstrating distinct ocular surface characteristics compared to nonchalazion patients. Recurrent chalazion episodes and surgical history were identified as significant contributors to meibomian gland loss, with glandular loss severity showing strong correlations with DED clinical parameters. These findings highlight the substantial impact of recurrent chalazion and surgical interventions on meibomian gland dysfunction and DED development, emphasizing the need for early clinical recognition and proactive management.

PMID:42502732 | PMC:PMC13401330 | DOI:10.1155/joph/9418834

Public Health Pract (Oxf). 2026 Jul 8;12:100824. doi: 10.1016/j.puhip.2026.100824. eCollection 2026 Dec.

ABSTRACT

OBJECTIVES: Despite substantial progress in the fight against HIV/AIDS, the epidemic continues to pose a major global public health challenge, with persistent residential disparities. However, the contributing factor for urban-rural disparities in Ethiopia is limited. Therefore, this study aims to identify inequalities in HIV testing across residences and identify contributing factors in Ethiopia.

STUDY DESIGN: A cross-sectional study design was used to analyse secondary data.

METHODS: We used Individual Recode (IR) dataset, which includes women of reproductive age, and the Male Recode (MR) dataset, which includes men aged 15-59 years, from the 2016 Ethiopian Demographic and Health Survey (EDHS). Descriptive statistics summarised participants’ socioeconomic and demographic characteristics. A multivariate decomposition analysis was employed to assess residential disparities in HIV testing.

RESULT: Overall, 44.9% of participants reported having been tested for HIV. Uptake was substantially higher among urban residents, with 69.3% reporting HIV testing compared with 38.3% of rural residents. The urban-rural gap was explained by both differences in participant characteristics and differences in the effects of those characteristics. Overall, 23.5% of the disparity was attributable to compositional factors, while 76.5% was attributable to coefficient effects. Being married (-12.7%), secondary (12.2%), and higher education (17.3%), and metropolises (3.7%) were the major compositional factors.

CONCLUSION: There was a substantial disparity in HIV testing between urban and rural residents in Ethiopia. The residential difference in HIV testing was largely driven by differences in characteristics such as marital status, education level, and metropolises, which influenced HIV testing. Policy makers should strengthen interventions aiming to increase HIV testing, particularly in rural areas, with a focus on enhancing education and engagement with health services.

PMID:42502692 | PMC:PMC13400955 | DOI:10.1016/j.puhip.2026.100824