Category: Nevin Manimala

Death Stud. 2026 Aug 29:1-22. doi: 10.1080/07481187.2026.2723779. Online ahead of print.

ABSTRACT

The hypothesis based on terror management theory and fear of death was that higher state ageism is associated with lower state suicide rates among the 48 contiguous U.S. states. Ageism scores were based on responses of 331,056 adults to an implicit association test between 2002 and 2020. Age-adjusted suicide rates for 2018-2022 pertained to four different age categories: 20 years and over, 20-39 years, 40-64 years, and 65 years and older. Statistical controls were socioeconomic status, income inequality, urbanization, Black population percent, religiosity, political conservatism, distress, and depression. Pearson correlations between ageism and the four age-based suicide rates ranged from -.55 to -.62. Multiple regressions with the eight controls and ageism as predictors produced βs for ageism ranging from -.52 to -.59. Multicollinearity and spatial autocorrelation were not problematic. Explanatory speculation focuses on higher fear of death, which is integrally associated with higher ageism, serving as a deterrent to suicide.

PMID:42667693 | DOI:10.1080/07481187.2026.2723779

J Clin Psychol. 2026 Aug 29. doi: 10.1002/jclp.70216. Online ahead of print.

ABSTRACT

OBJECTIVES: Mindfulness is increasingly being implemented in child and adolescent therapy. However, little is known about its effectiveness in individual settings within a clinical outpatient context. We investigated the effects of session-introducing mindfulness interventions (IG-M) compared to session-introducing relaxation interventions (CG-R) and no standardized session-introduction (CG) on symptomatic outcome and therapeutic alliance in cognitive-behavioral therapy using a randomized controlled design.

METHOD: One thousand four hundred and seventy-eight of 90 outpatient adolescents (11-19 years) diagnosed with depression, an anxiety disorder, or a hyperkinetic disorder were assessed. Symptomatic outcome was assessed by the German version of the Youth Self-Report 11-18R at five measurement time points (pre, 3rd, 10th, 17th therapy session, post), therapeutic alliance was assessed by the German version of the Therapeutic Alliance Scales for Children after every therapy session (1st-24th therapy session). Statistical analyses were conducted using multilevel modeling. The RCT was registered at ClinicalTrials.gov (NCT04034576).

RESULTS: Multilevel modeling revealed a significant decrease of symptomatic outcome in IG-M compared to CG, but not compared to CG-R, over time. A significant increase in therapeutic alliance over time was observed from the therapists’ perspective with no group differences. Therapeutic alliance from patients’ perspective significantly increased in IG-M and significantly decreased in CG. There was no statistically meaningful change in therapeutic alliance from the patients’ perspective in CG-R.

CONCLUSION: IG-M had positive effects on symptomatic outcome and therapeutic alliance compared to CG, but did not outperform CG-R. Future studies that control confounding variables are highly relevant to understand the role of mindfulness in individual youth psychotherapy.

PMID:42667691 | DOI:10.1002/jclp.70216

Int J Epidemiol. 2026 Aug 18;55(5):dyag164. doi: 10.1093/ije/dyag164.

ABSTRACT

BACKGROUND: Synthetic data hold substantial potential to address practical challenges in epidemiology due to restricted data access and privacy concerns. However, many current methods suffer from limited quality, high computational demands, and complexity for non-experts. Furthermore, common evaluation strategies for synthetic data often fail to directly reflect statistical utility and measure privacy risks sufficiently. Against this background, a critical underexplored question is whether synthetic data can reliably reproduce key findings from epidemiological research while preserving privacy.

METHODS: We propose adversarial random forests (ARF) as an efficient and convenient method for synthesizing tabular epidemiological data. To evaluate its performance, we replicated statistical analyses from six epidemiological publications covering blood pressure, anthropometry, myocardial infarction, accelerometry, loneliness, and diabetes, from the German National Cohort (NAKO Gesundheitsstudie), the Bremen STEMI Registry U45 Study, and the Guelph Family Health Study. We further assessed how dataset dimensionality and variable complexity affect the quality of synthetic data, and contextualized ARF’s performance by comparison with commonly used tabular data synthesizers in terms of utility, privacy, generalization, and runtime.

RESULTS: Across all replicated studies, results on ARF-generated synthetic data consistently aligned with original findings. Even for datasets with relatively low sample size-to-dimensionality ratios, replication outcomes closely matched the original results across descriptive and inferential analyses. Reduced dimensionality and variable complexity further enhanced synthesis quality. ARF demonstrated favourable performance regarding utility, privacy preservation, and generalization relative to other synthesizers and superior computational efficiency.

CONCLUSIONS: In summary, ARF reliably generates high-quality synthetic data that replicate diverse epidemiological analyses while offering a competitive privacy-utility trade-off.

PMID:42667682 | DOI:10.1093/ije/dyag164

Vet Med Sci. 2026 Sep;12(5):e71204. doi: 10.1002/vms3.71204.

ABSTRACT

BACKGROUND: Mastitis in dairy animals is a major economic and public health concern in Nepal, exacerbated by the emergence of antimicrobial-resistant pathogens. This study aimed to determine the prevalence and antibiotic resistance patterns of Staphylococcus aureus isolated from bovine milk in Bardaghat Municipality, Nepal.

RESULTS: A cross-sectional survey screened 196 milk samples from lactating cows and buffaloes using the California Mastitis Test (CMT). The overall prevalence of S. aureus was 39.79%. Strikingly, 100.00% of isolates exhibited resistance to oxacillin, indicating the widespread presence of methicillin-resistant Staphylococcus aureus (MRSA). Moreover, 25.64% of isolates were multidrug-resistant (resistant to n 3 antibiotic classes), and 18% had a multiple antibiotic resistance (MAR) index > 0.2. No statistically significant associations were found between the prevalence of S. aureus and evaluated risk factors.

CONCLUSIONS: These findings underscore an urgent need for improved mastitis management, including routine bacterial screening, judicious antibiotic use and public health measures to mitigate transmission of resistant S. aureus to humans.

PMID:42667655 | DOI:10.1002/vms3.71204

J Man Manip Ther. 2026 Aug 29:1-12. doi: 10.1080/10669817.2026.2720771. Online ahead of print.

ABSTRACT

BACKGROUND: Road Traffic Injuries affect more than 50 million people each year. Whiplash-associated disorders (WAD) are among the most common musculoskeletal conditions resulting from these injuries, affecting up to 83% of individuals exposed to this type of trauma. Approximately 50% of affected individuals experience incomplete recovery. Although specific neck exercises are recommended, the effectiveness of device-guided craniocervical training administered via telerehabilitation for subacute grade I-II WAD remains unknown.

OBJECTIVE: To evaluate the preliminary effectiveness and feasibility of a device-guided craniocervical exercise program delivered via telerehabilitation on pain and disability in individuals with subacute grade I-II WAD.

METHODS: A multicentre, assessor-blinded, randomized pilot feasibility trial with a 1:1:1 allocation ratio was conducted. Thirty-three participants were randomized into three groups: device-guided training, active exercise or usual care. The exercise groups received 12 supervised online sessions over a 6-week period. Disability, pain, and eight self-reported outcome measures were assessed at baseline, 6 weeks, and 12 weeks.

RESULTS: Statistical analysis showed significant between-group differences in disability and pain intensity at T1 and T2 in favor of the device-guided training group (p < 0.05). No statistically significant between-group differences were found for secondary outcomes. Recruitment rate was 3.3 participants per month, adherence was 77%, and 16 mild transient adverse events were reported (27%). The estimated sample size for a future definitive trial was 94 participants.

CONCLUSIONS: A device-guided craniocervical exercise program delivered via telerehabilitation appears feasible, safe, and associated with greater reductions in disability and pain than conventional specific neck exercise and usual care in subacute WAD. While findings are preliminary, they support progression to a definitive multicentre randomized controlled trial currently underway to confirm effectiveness.Registration: ClinicalTrials.gov – NCT06580990.

PMID:42667605 | DOI:10.1080/10669817.2026.2720771

Eur J Prev Cardiol. 2026 Aug 29:zwag448. doi: 10.1093/eurjpc/zwag448. Online ahead of print.

ABSTRACT

INTRODUCTION: Sex differences in treatment with Statins after Myocardial Infarction (MI) are widely recognised. This study aimed to assess differences in statin treatment initiation after MI by sex, age groups, and year of MI.

METHOD: We conducted a cohort study in Denmark using registries for patients with a first-time MI between 1st January 2000 and 31st December 2024, excluding patients already treated with lipid lowering drugs up to 180 days before their MI. Descriptive statistics and multivariable Poisson regression were used to explore the effect of sex on treatment initiation.

RESULTS: A total of 154,591 patients were included in the study (37% females, median age 75 years for females and 65 years for men). Overall, 54% of females versus 72% of males had initiated statin treatment within 180 days (p < .001). For females ≥40 years, significantly lower proportions were found in every year interval (p < .001 for all). Within the age groups, the relative difference between the sexes increased from 2000-2002 until 2015-2019, whereafter a decrease was found from 2015-2019 to 2020-2024, except among 60-69-year-olds for whom the decrease began earlier, starting in 2010-2014. Females had a 25% lower relative risk (RR 0.75 [0.74;0.76]) of initiating treatment. These differences remained after adjusting for age groups and year interval (RR 0.87 [0.86;0.87]) and after further adjustment for baseline characteristics (RR 0.91 [0.85;99]).

CONCLUSION: A smaller proportion of females received statins than males after a MI. Disparities in treatment persisted over the years.

PMID:42667599 | DOI:10.1093/eurjpc/zwag448

J Clin Monit Comput. 2026 Aug 29. doi: 10.1007/s10877-026-01490-4. Online ahead of print.

ABSTRACT

Automated pupillometry provides a standardised, quantitative, highly reproducible measurement of the pupillary light reactivity and other pupillary variables. The Neurologic pupillary index (NPi) has shown good prognostic value in patients with acute brain injury and cardiac arrest. However, few data on the comparison of NPi with a recently introduced index (quantitative pupillary index, QPI) are available. To compare the performance of two commercially available automated pupillometry devices, and in particular QPI and NPi, in a cohort of neuro-critically ill patients. Single-center observational study, including adult (> 18 years) patients admitted to a neuro-intensive care unit over a 6-month period. Pupillary reactivity was assessed in both eyes of each patient using the two pupillometers currently available, the Neuroptics NPi-300 (Neuroptics, Irvine, CA, USA) and the NeuroLight (ID-Med, Marseilles, France). A total of 73 patients were included in the final analysis, with a median age of 65 years (interquartile range [IQR] 54-77). The mean bias between the two pupillometers was 0.44 mm (95% Limit of Agreement [LoA] – 0.43 mm to 1.31 mm) for pupil diameter, 0.57% (95% LoA – 7.63% to 8.77%) for pupillary reactivity, and – 0.82 (95% LoA – 2.70 to 1.05) for NPi vs. QPI comparison. A very strong correlation was found between the two devices in terms of pupil diameter measurement (ρ = 0.91; 95% Confidence Interval [CI] 0.86 to 0.95; p < 0.0001) and pupil reactivity (ρ = 0.92; 95% CI 0.87 to 0.95; p < 0.0001). NPi and QPI were well correlated (ρ = 0.75; 95% CI, 0.62-0.84; p < 0.0001). In this cohort study, a significant statistical correlation between the measurements provided by two available pupilometers was found; however, NPi and QPI might not be clinically interchangeable.

PMID:42667581 | DOI:10.1007/s10877-026-01490-4

J Clin Monit Comput. 2026 Aug 29. doi: 10.1007/s10877-026-01486-0. Online ahead of print.

ABSTRACT

The purpose was to describe patient monitor alarm burden in a cardiac surgical intensive care unit and explore whether routinely available patient characteristics are associated with alarm frequency, type, and duration. Secondary objectives were to assess indirect signs of alarm fatigue and compare alarm rates with two previous studies using identical monitors in different clinical units. We retrospectively collected patient-monitor alarm data and patient characteristics over four consecutive weeks in the cardiac surgical intensive care unit of Helsinki University Hospital. The study population comprised 81 patients. Alarm data were analysed descriptively and modelled using negative-binomial regression. Patients produced 45,044 alarms, with a median alarm rate of 6.8 [4.8 to 10.8] alarms per patient per hour. Older age was associated with fewer alarms (IRR = 0.90, 95% CI 0.83 to 0.98, P < 0.05). ASA 5 classification was associated with more low- ETCO2 alarms (IRR = 9.05, 95% CI 3.37 to 27.88, P < 0.05). Smoking was associated with more low invasive blood pressure alarms (IRR = 1.94, 95% CI 1.05 to 3.90, P < 0.05). Alarm load was high, clinician interaction with alarms was limited, and many alarms were momentary. Alarm rates were similar across three clinically different units using identical monitors. Routinely available patient characteristics were associated with selected alarm patterns, but the findings are hypothesis-generating. Similar alarm rates across different units suggest that default settings may not reflect unit- or patient-specific monitoring needs. The results suggest low positive predictive value and possible alarm fatigue, supporting unit-level alarm review that incorporates patient-level alarm patterns and signal-quality improvement, with prospective validation before patient-specific alarm-management changes.

PMID:42667580 | DOI:10.1007/s10877-026-01486-0

Obes Surg. 2026 Aug 29. doi: 10.1007/s11695-026-08918-5. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether documented preoperative mental health (MH) conditions were associated with early postoperative psychiatric events and metabolic outcomes after primary metabolic-bariatric surgery (MBS).

METHODS: A retrospective cohort study of adults who underwent primary MBS at a tertiary UK bariatric centre between April 2021 and March 2024 was conducted. Preoperative MH conditions and postoperative outcomes were identified via review of electronic health records. Comparisons between groups were analysed using Fisher’s exact test and regression models adjusted for age, sex, preoperative BMI, and surgery type.

RESULTS: Among 482 patients, 217 (45.0%) had at least one documented preoperative MH condition. During 2-year follow-up, suicidal ideation was recorded in 6/217 (2.8%) in the MH group versus 1/265 (0.4%) in the non-MH group and self-harm (including suicide attempt) in 5/217 (2.3%) versus 1/265 (0.4%), respectively. Preoperative MH conditions were associated with higher odds of postoperative suicidal ideation (OR 6.75, 95% CI 1.09-41.86; p = 0.0420), while the association with self-harm was directionally similar but not statistically significant (OR 5.10, 95% CI 0.80-32.72; p = 0.0860). Weight-loss and metabolic outcomes did not differ materially by baseline MH status.

CONCLUSIONS: In this single-centre cohort, patients with documented preoperative MH conditions achieved comparable metabolic benefit after surgery but had higher recorded early suicidality-related events. Although causality cannot be inferred, these findings support structured postoperative MH follow-up.

PMID:42667565 | DOI:10.1007/s11695-026-08918-5

HEC Forum. 2026 Aug 29. doi: 10.1007/s10730-026-09609-5. Online ahead of print.

ABSTRACT

Patients with serious illness hospitalized in the pediatric setting can receive support from Pediatric Palliative Care (PPC) and Ethics Consultation (EC). However, empirical data on dual PPC-EC involvement in pediatrics is limited. Therefore, we characterized ethical issues, contextual features, palliative care domains, and consultation timing for inpatients with dual PPC-EC involvement. We reviewed 135 EC from 2016 to 2023 at an academic children’s hospital to identify cases with PPC involvement. PPC notes, demographics, and admission, consultation and discharge dates were extracted from the medical record. Ethical issues, contextual features, and palliative domains were deductively coded using established frameworks. Analyses used descriptive statistics and compared EC-first, PPC-first, and combined cases. Sixty-two inpatients had dual PPC-EC involvement: of these, 33 (53%) were infants < 1 year, 52 (84%) in the Intensive Care Unit (ICU), and 21 (34%) were discharged alive. The primary ethical issue was Beneficence/Best-Interest Concerns (14; 23%), and the most common contextual feature was Communication Dispute/Conflict (25; 40%). Most PPC consultations addressed Communication of Treatment Goals/Plans (47; 76%). PPC was consulted first in 50 patients (81%). Median EC-to-PPC interval was six days, while PPC-to-EC was fifteen days. Dual PPC-EC involvement represents a distinct patient population, primarily infants in the ICU with high mortality, facing medical and ethical challenges with communication support from both services. PPC was usually consulted first, possibly from more familiarity of PPC and PPC’s role in proactive ethics. Later EC involvement indicates an area for further study for when EC is most beneficial in collaborative care.

PMID:42667532 | DOI:10.1007/s10730-026-09609-5