Category: Nevin Manimala

Int J Gynaecol Obstet. 2026 Apr 25. doi: 10.1002/ijgo.71038. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess racial and ethnic disparities in preterm delivery in the US and evaluate whether insurance type modifies these associations.

METHODS: We analyzed National Center for Health Statistics natality data (2018-2024) comprising 24,918,700 singleton live births. Preterm delivery was defined as birth before 37 completed weeks of gestation. Multivariable logistic regression with robust variance was used to estimate adjusted odds ratios, predicted probabilities, and absolute risk differences across race/ethnicity and insurance categories, adjusting for maternal sociodemographic, clinical, and obstetric factors.

RESULTS: Overall, 2,134,329 of 24,918,700 singleton live births (8.6%) were preterm during the study period, with annual rates remaining stable between 8.23% and 8.75%. In multivariable-adjusted analyses, non-Hispanic Black women had the highest odds of preterm delivery (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI]: 1.39-1.40), compared with non-Hispanic White women. Racial and ethnic disparities persisted across all insurance strata; among uninsured women, non-Hispanic Black women had the largest absolute risk difference relative to non-Hispanic White women (5.74 percentage points; 95% CI: 5.52-5.96), which was attenuated but remained significant among Medicaid (2.38 percentage points; 95% CI: 2.33-2.43) and privately insured women (2.66 percentage points; 95% CI: 2.60-2.73). Insurance coverage attenuated but did not eliminate these disparities.

CONCLUSION: Racial and ethnic disparities in preterm delivery persist in the US despite insurance coverage, underscoring the need for policies that address both healthcare access and structural determinants of maternal health.

PMID:42033123 | DOI:10.1002/ijgo.71038

Muscle Nerve. 2026 Apr 25. doi: 10.1002/mus.70258. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Quantitative analysis should be useful to all electrodiagnostic medical consultants (EMC). We tested a beta version of the audio-visual electromyography (AVEMG) method that quantifies the audio and visual characteristics of the interference pattern (IP) signal assessed by the EMC.

METHODS: IP was recorded from multiple sites in 10 commonly tested upper and lower limb muscles. For each 200 ms epoch, AVEMG measured its Amplitude, Fullness and Pitch. Pitch reflects the sound characteristics, e.g., dull, sharp. The firing rate of motor units and discreteness of the pattern was also assessed. Reference (RVs) values were defined for Amplitude and Pitch based on Fullness of the pattern using recordings from 10 to 14 normal subjects. Normal and abnormal muscles were tested in 36 patients referred to the laboratory (139 muscles). The concordance between subjective assessment and AVEMG was assessed by a χ² test.

RESULTS: AVEMG successfully rejected most epochs with noise, interference, spontaneous activity, insertional activity and needle artifacts. RVs differed among muscles. As example, the first dorsal interosseous and triceps had the highest Amplitude in upper limb muscles. AVEMG was abnormal in 80% of studies considered abnormal by subjective assessment. The association between subjective assessment and AVEMG was statistically significant (χ² (1, N = 139) = 59, p < 0.0001).

DISCUSSION: AVEMG provides real time quantitation in the background and does not interfere with workflow or add examination time or complexity to the routine needle EMG examination. It will be of interest to further assess its value by refining RVs and performing multicenter studies with operators having different skill levels.

PMID:42033101 | DOI:10.1002/mus.70258

Alzheimers Dement. 2026 Apr;22(4):e71383. doi: 10.1002/alz.71383.

ABSTRACT

INTRODUCTION: The role of life-course socioeconomic position (SEP) in cognitive aging remains unclear. We assessed the association between life-course SEP with cognitive change and prevalent mild cognitive impairment (MCI).

METHODS: We used data from the Hispanic Community Health Study/Study of Latinos (2008 to 2011) and its Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) ancillary study (2015 to 2018, n = 6351; aged ≥45 years). Weighted linear and logistic regression analyses estimated the association between childhood and adult SEP (low and high) and socioeconomic mobility (enduring high or low SEP, upward or downward mobility) with change in cognitive function and prevalent MCI, respectively.

RESULTS: Childhood SEP was associated with greater adverse cognitive change but was not associated with prevalent MCI. Low adult SEP, downward mobility, and enduring low SEP were associated with greater adverse cognitive change. Enduring low SEP was additionally associated with higher odds of MCI.

DISCUSSION: Life-course SEP is associated with changes in cognitive aging in middle-aged and older Hispanic/Latino adults.

PMID:42033094 | DOI:10.1002/alz.71383

Alzheimers Dement. 2026 Apr;22(4):e71370. doi: 10.1002/alz.71370.

ABSTRACT

INTRODUCTION: National Veterans Affairs electronic health records were used to examine the association between traumatic brain injury (TBI) severity and four dementia phenotypes ranging from narrow (strict AD) to broad (all-cause dementia).

METHODS: Veterans with TBI (n = 91,753) and a propensity score-matched comparison group of veterans without TBI (n = 183,506) were included. Four validated dementia phenotypes defined using International Classification of Diseases (ICD) codes were evaluated. The association between TBI severity and each dementia phenotype was examined using adjusted logistic regression.

RESULTS: TBI severity was significantly associated with increased odds of developing dementia across the three broader dementia phenotypes in a dose-response manner (moderate/severe/penetrating TBI > mild TBI). Those with unclassified TBI had disease risk falling in between mild and more severe TBI. In contrast, TBI was associated with decreased risk of strict AD across all severity levels.

DISCUSSION: Findings support a dose-response relationship between TBI severity and broader dementia risk but raise questions regarding the TBI-AD link.

PMID:42033091 | DOI:10.1002/alz.71370

Clin Chem Lab Med. 2026 Apr 20. doi: 10.1515/cclm-2026-0435. Online ahead of print.

ABSTRACT

OBJECTIVES: Large language models (LLMs) show promise for interpreting laboratory reports, yet real-world validation remains limited. This study evaluated five advanced LLMs in interpreting urinalysis reports for kidney diseases using real-world clinical data, providing empirical evidence for the utility of LLM-assisted result interpretation.

METHODS: We retrospectively collected 120 urinalysis reports from patients with primary glomerular diseases and secondary nephropathies. The testing platforms included the Sysmex UF5000 and Mindray EU8600. Five LLMs (ChatGPT-5, Claude-4.5, Gemini-2.5, DeepSeek-V3.1, Qwen-3) were tasked with interpreting reports across five functional dimensions. Four certified laboratory technologists and four licensed physicians evaluated outputs using a 5-point Likert scale across six quality dimensions. Statistical analyses employed Friedman and Wilcoxon signed-rank tests.

RESULTS: All five LLMs demonstrated clinical utility in interpreting urinalysis reports. Proprietary LLMs achieved higher overall scores (Claude-4.5: 4.78 ± 0.47; ChatGPT-5: 4.73 ± 0.50; Gemini-2.5: 4.69 ± 0.54) compared to open-source LLMs (DeepSeek-V3.1: 4.58 ± 0.66; Qwen-3: 4.57 ± 0.69). Across functional dimensions, the models performed proficiently in identifying abnormal parameters and analyzing their correlations, but suboptimally in interpreting instrument flags. Instrument-dependent variability was observed (Sysmex vs. Mindray, p<0.001). In quality assessments, Claude-4.5 exhibited the best overall performance, ChatGPT-5 excelled in accuracy and clarity, and Gemini-2.5 demonstrated strong practicality. Regarding safety, Claude-4.5 exhibited the lowest hallucination rate (7.5 %). Common hallucinations included misinterpretation, definition errors, and over-interpretation.

CONCLUSIONS: LLMs demonstrate significant capability in urinalysis interpretation, though proprietary models currently excel in reasoning and hallucination resistance. Instrument-specific flag interpretation and hallucination mitigation remain critical challenges requiring Retrieval-Augmented Generation (RAG) integration and human oversight.

PMID:42033087 | DOI:10.1515/cclm-2026-0435

Cancer Med. 2026 May;15(5):e71837. doi: 10.1002/cam4.71837.

ABSTRACT

BACKGROUND: Allostatic load (AL) reflects the cumulative physiological burden of chronic stress across cardiovascular, metabolic, immune, and renal systems. While AL has been implicated in cancer development, evidence in Asian populations remains limited. We examined sociodemographic and lifestyle factors of AL and its association with colorectal cancer (CRC) risk in a multiethnic Asian cohort.

METHODS: Data were drawn from 30,443 Chinese, Malay, and Indian adults (≥ 18 years) between 2004 and 2016. Participants were followed from baseline assessment until CRC diagnosis, death, or end of follow-up, whichever occurred first (median follow-up: 7.2 years). AL was derived from nine biomarkers, with high-risk cutoffs set at the 75th percentile (≤ p25 for HDL). High AL was defined as a score ≥ 3. CRC incidence was ascertained through linkage with the Singapore Cancer Registry. Modified Poisson regression was used to identify factors associated with high AL, and Cox proportional hazards models assessed associations with incident CRC. CRC incidence was ascertained through linkage with the Singapore Cancer Registry.

RESULTS: During follow-up, 162 CRC cases were observed; 60.3% of participants had high AL. Older age, male sex, Malay and Indian ethnicity, lower education, unemployment, diabetes, low physical activity, and prolonged sitting were significantly associated with higher AL scores. High AL was associated with increased CRC risk after adjustment for age, sex, ethnicity, and cohort (aHR = 1.53; 95% CI = 1.10, 2.14). The association remained similar in models additionally adjusting for SES, smoking, history of diabetes, or physical activity and sitting time.

DISCUSSION: These findings are consistent with prior research in Western populations and highlight AL as a potential biomarker for identifying individuals at increased CRC risk. Incorporating AL into population health strategies may support earlier detection and targeted prevention in Asian settings.

PMID:42033061 | DOI:10.1002/cam4.71837

Physiol Rep. 2026 Apr;14(8):e70887. doi: 10.14814/phy2.70887.

ABSTRACT

Heart rate variability (HRV) is widely used to assess cardiac health, yet uncertainty persists regarding HRV variations across the menstrual cycle and their association with reproductive hormones. Few studies have evaluated the full spectrum of HRV parameters, and most estimated menstrual phases from the last menstrual period without considering individual cycle length. This study aimed to compare HRV parameters across three menstrual phase groups, using accurate cycle tracking based on the next menstrual period and actual cycle length, and to correlate HRV with estradiol, progesterone, and the estradiol/progesterone (E/P) ratio. In 112 healthy women with regular cycles, HRV parameters were measured using a heart rate sensor, and serum hormone levels were obtained. Menstrual phase groups were defined using back-extrapolation from the next cycle. Data from 99 participants were analyzed: menstruation (n = 38), periovulatory (n = 30), and premenstrual phase (n = 31). HF was significantly higher during the peri-ovulatory phase, while estradiol and progesterone peaked premenstrually. The E/P ratio was highest pre-ovulatory. Estradiol correlated with most HRV measures; however, only the mean RR-interval in the premenstrual phase was statistically significant, with estradiol emerging as a negative independent predictor. These findings conclude notable HRV variation across menstrual phases and suggest that estradiol fluctuations may influence autonomic regulation.

PMID:42033060 | DOI:10.14814/phy2.70887

Angew Chem Int Ed Engl. 2026 Apr 24:e2407356. doi: 10.1002/anie.2407356. Online ahead of print.

ABSTRACT

Infrared nonlinear optical (NLO) materials are essential for laser and photonic technologies, limited by fragmented material systems, lengthy development cycles, and trial-and-error synthesis. To overcome these barriers, we developed an integrated computational-experimental framework integrating first-principles high-throughput calculations, machine learning, and targeted synthesis. We establish a multidimensional properties dataset of 1807 non-centrosymmetric compounds and define a comprehensive figure of merit (CFOM) Q based on the statistical average of this dataset to quantify performance trade-offs. Multidimensional statistical analysis uncovers composition-structure-performance relationships, and reveals superior structure and chemical compositions governing enhanced NLO performance. A Q-based crystal graph neural network classifier is developed, achieving strong predictive accuracy (AUC = 0.95). We identify 12 unreported candidates (Q > 2) from 5105 compounds combining high-throughput calculation and machine learning. Experiments confirm that defect-chalcopyrite HgAl₂Q₄ (Q = S, Se, Te) shows wide band gaps (1. 55-2.82 eV), suitable birefringence (0.06-0.08), and strong NLO responses (2.2-5 × AGS). This work provides an effective pathway for accelerating the discovery of high-performance optoelectronic materials.

PMID:42033040 | DOI:10.1002/anie.2407356

Cancer Med. 2026 May;15(5):e71849. doi: 10.1002/cam4.71849.

ABSTRACT

INTRODUCTION: Colorectal cancer (CRC) screening rates remain below recommended clinical guidelines, especially among people of color. This study aimed to assess CRC screening rates, identify barriers, and develop improvement strategies in racially diverse communities using community-based participatory design, engaging Community Health Action Teams (CHATs).

METHODS: This mixed-methods study employed surveys and focus groups, with data collection instruments co-designed with community members to ensure relevance and accuracy. A random sample of households with screen-eligible residents received a survey, focusing on assessing screening rates and identifying facilitators and barriers to CRC screening. Focus groups used snowball sampling in the same communities to deepen understanding through qualitative insights.

RESULTS: Of 1,798 survey respondents, 81% reported participating in CRC screening, with 69% being up to date. Awareness of CRC’s preventable and treatable nature, when detected early, (b = 0.647, p < 0.001, OR = 1.91); understanding its asymptomatic potential (b = 0.345, p < 0.001, OR = 1.42); and recognition of its ranking as the second most deadly cancer (b = 0.354, p = 0.007, OR = 1.42) were significant predictors of screening adherence. Knowledge of at-home tests increased compliance with screening (b = 0.752, p < 0.001, OR = 2.12). Barriers reported by unscreened respondents included a lack of symptoms (19%), absence of motivation (19%), being asymptomatic (20%), and for insured individuals, a lack of physician orders for screening (19%). Insights from focus groups, including 65 participants, revealed multi-level barriers, echoing survey findings where relationships with medical providers emerged as the strongest predictor of screening participation.

CONCLUSIONS: The study informed the creation of six key outreach messages and two strategies co-led by CHATs, emphasizing CRC screening importance, test options, and cost considerations. Suggested strategies include organizing community events to raise awareness and enhancing direct provider-to-patient communication to encourage screening uptake.

PMID:42033015 | DOI:10.1002/cam4.71849

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2025 Dec 28;50(12):2407-2416. doi: 10.11817/j.issn.1672-7347.2025.250455.

ABSTRACT

OBJECTIVES: Ileal conduit diversion is currently the most commonly used urinary diversion method for patients undergoing radical cystectomy. Because intestinal reconstruction is involved, perioperative enteral nutrition intake is limited, placing patients at risk of malnutrition and affecting postoperative recovery and quality of life. Whole-process perioperative nutritional management is of great significance for promoting rapid postoperative recovery in such patients. This study aims to explore the effects of whole-process nutritional management intervention based on the information-knowledge-attitude-practice (IKAP) theory on nutritional status and quality of life in patients undergoing radical cystectomy for bladder cancer.

METHODS: A total of 69 patients who underwent radical cystectomy with ileal conduit diversion for bladder cancer in the Department of Urology, Third Xiangya Hospital of Central South University, between January 2022 and December 2024 were included. Patients were grouped according to admission time. Patients admitted between January 2022 and October 2023 were assigned to the control group (n=34) and received routine perioperative nutritional support for radical cystectomy with ileal conduit diversion. Patients admitted between November 2023 and December 2024 were assigned to the intervention group (n=35) and received whole-process nutritional management based on IKAP theory. Nutritional Risk Screening 2002 (NRS2002) score, Onodera’s prognostic nutritional index (OPNI), and the third edition Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTCQLQ-C30) were compared between the 2 groups at 3 time points: day 1 after admission, 1 day before discharge, and 1 month after discharge. The incidence of postoperative related complications between the two groups was also compared.

RESULTS: In both groups, the NRS2002 score at 1 month after discharge was lower than that at 1 day before discharge, and the intervention group had lower scores than the control group, with statistically significant differences (all P<0.05). The OPNI at 1 month after discharge was significantly higher than that at 1 day before discharge in both groups, and the intervention group had higher values than the control group, with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of postoperative related complications between the 2 groups (all P>0.05). The EORTCQLQ-C30 scores in the intervention group were higher than those in the control group at 1 day before discharge and 1 month after discharge, with statistical significant differences (both P<0.05).

CONCLUSIONS: Whole-process nutritional management based on IKAP theory can improve the nutritional status and prognosis of patients undergoing radical cystectomy with ileal conduit diversion and improve their quality of life.

PMID:42033000 | DOI:10.11817/j.issn.1672-7347.2025.250455