Category: Nevin Manimala

J Cosmet Dermatol. 2026 Feb;25(2):e70656. doi: 10.1111/jocd.70656.

ABSTRACT

BACKGROUND: Intradermal botulinum toxin injections have been shown to reduce sebaceous gland activity and improve skin texture in patients with oily and acne-prone skin. However, needle-based application is associated with discomfort and potential side effects.

OBJECTIVE: To evaluate the clinical efficacy and safety of transdermal delivery of botulinum toxin (150 kDa) using Transdermal Application (TDA) technology for the treatment of oily and acne-prone skin.

METHODS: In this single-center observational study, 19 participants (aged 20-50) underwent treatment with the DERMADROP MED TDA device according to the BIOBOTOX protocol. Objective assessments included Sebumeter measurements and 2D/3D skin imaging. Subjective evaluation was conducted using validated patient-reported outcome measures (OSIS, OSSAS) at baseline, 2 weeks, and 4 weeks posttreatment.

RESULTS: A statistically significant reduction in sebum levels was observed, accompanied by notable improvements in self-reported skin clarity and satisfaction. No adverse events were reported.

CONCLUSION: Transdermal application of botulinum toxin using TDA-based DERMADROP MED technology is a safe, well-tolerated, and effective noninvasive treatment modality for reducing sebaceous activity and improving the appearance of oily and acne-prone skin.

PMID:41652824 | DOI:10.1111/jocd.70656

Proc Inst Mech Eng H. 2026 Feb 6:9544119251411962. doi: 10.1177/09544119251411962. Online ahead of print.

ABSTRACT

Dental implantation is the most reliable method for replacing missing teeth. Success rate of dental implants is influenced by osseointegration. Surface roughness of implants influences osseointegration by altering surface area and texture, providing stimulation to cells. Sandblasting and acid-etching are common methods for making implant surfaces rough. Main goal of this study was to investigate effects of sandblasting and acid-etching variables, that is, blasting-pressure and acid-temperature, on surface roughness of implants to find the controlled values of variables for a favorable surface roughness. An acceptable surface roughness was assumed to have an arithmetic average height (Sa) between 1 and 2 µm, and an area developed ratio (Sdr) over 50%. Seventy-two titanium-made analogs were sandblasted with three different pressures, that is, 4, 5, and 6 MPa, and three different durations, that is, 15, 30, and 45 s, and then were etched with two different etching temperature, that is, 60°C and 80°C, and two exposure-time, that is, 5 and 10 min (two repetition for each combination). Surface roughness parameters were then measured using a profilometer. Multi-factorial ANOVA was used as statistical analysis method. Results showed that 14 groups demonstrated favorable Sa (1-2 µm), among which just four groups had acceptable Sdr (Sdr > 50%). Among four parameters stated above, which affect sandblasting and acid-etching processes, it was found that blasting duration is the most effective variable on implants roughness. This work highlights the importance of sandblasting and acid-etching parameters for a controlled titanium dental implant surface, which can achieve surface roughness parameters that correspond to those previously reported in the literature as favorable ones for osseointegration.

PMID:41652812 | DOI:10.1177/09544119251411962

J Endourol. 2026 Feb 6:8927790261420557. doi: 10.1177/08927790261420557. Online ahead of print.

ABSTRACT

BACKGROUND: This study evaluated the feasibility and success of advancing a guidewire alongside the nephrostomy tube instead of through it in patients undergoing endourological procedures who had nephrostomy tubes.

METHODS: 33 patients with nephrostomy tubes in place underwent endourological procedures over a 2-year period (2023-2025). Under fluoroscopic guidance, a guidewire was advanced alongside the nephrostomy tube, and success was defined by the wire reaching the renal pelvis or ureter. Outcomes were compared to the conventional technique of inserting the guidewire through the nephrostomy tube, and the influence of time since nephrostomy placement on success was assessed.

RESULTS: Guidewire passage alongside the nephrostomy tube succeeded in 27 of 33 cases (81.8%). Failures occurred in 6 cases (18.2%), mainly because of tortuous or calcified tracts requiring new access. The conventional through-tube approach succeeded in 32 of 33 cases (97%), but this difference was not statistically significant (p = 0.10). Notably, the alongside approach achieved ureteral/bladder access in a higher proportion of cases than the through-tube method (48.4% vs 12.1%, p = 0.003). Longer time intervals between nephrostomy placement and the procedure were associated with increased success (p = 0.002), with an optimal cutoff of ∼1.3 months identified.

CONCLUSIONS: Guidewire passage alongside an existing nephrostomy tube proved to be a safe, effective, and feasible technique for establishing antegrade access. Performing the procedure more than ∼1.3 months after nephrostomy placement was associated with higher success, suggesting that a well-matured tract improves outcomes.

PMID:41652811 | DOI:10.1177/08927790261420557

Pharm Stat. 2026 Mar-Apr;25(2):e70070. doi: 10.1002/pst.70070.

ABSTRACT

The estimand framework proposes different strategies to address intercurrent events. The treatment policy strategy seems to be the most favoured as it is closely aligned with the pre-addendum intention-to-treat principle. All data for all patients should ideally be collected; however, in reality patients may withdraw from a study leading to missing data. This needs to be dealt with as part of the estimation. A common intercurrent event we focus on is treatment discontinuation. Several areas of research have been conducted exploring models to estimate the estimand when intercurrent events are handled using a treatment policy strategy; however, the research is limited for binary endpoints. We explore different retrieved dropout models, where post-intercurrent event, the observed data can be used to multiply impute the missing post-intercurrent event data. We compare our proposed models to a simple imputation model that makes no distinction between the pre- and post-intercurrent event data, and assess varying statistical properties through a simulation study. We then provide an example of how retrieved dropout models were used in practice for Phase 3 clinical trials in rheumatoid arthritis. From the models explored, we conclude that a simple retrieved dropout model including an indicator for whether or not the intercurrent event occurred is the most pragmatic choice. However, at least 50% of observed post-intercurrent event data is required for these models to work well. Therefore, the suitability of implementing this model in practice will depend on the amount of observed post-intercurrent event data available and missing data.

PMID:41652801 | DOI:10.1002/pst.70070

Headache. 2026 Feb 6. doi: 10.1111/head.70056. Online ahead of print.

ABSTRACT

OBJECTIVES: The International Pediatric Headache Didactic Series (IPHDS) was developed to provide free, comprehensive pediatric headache education to healthcare professionals worldwide. The objective of this study was to describe the design, implementation, and impact of this prospective educational intervention.

BACKGROUND: Headache is the most common neurological symptom within the pediatric population. Yet, only nine fellowships are offered in pediatric headache medicine. Limitations in access to education and training are often cited as reasons for diagnostic and management barriers. To address this gap, the IPHDS was established in July 2022.

METHODS: IPHDS is a recurring series consisting of 23 biweekly lectures. Lectures are delivered virtually via Zoom and available for asynchronous learning on an open-access website. Lecture topics are based on the United Council for Neurologic Subspecialties’ curriculum recommendations. Pre- and post-surveys were developed collaboratively by content experts and administered to attendees. Quantitative data were analyzed using descriptive and inferential statistics, and qualitative data were analyzed using conventional qualitative content analysis.

RESULTS: From July 2022 to July 2023, over 480 people signed up for IPHDS. Lecture attendees represented a variety of clinical backgrounds including advanced practice providers (26.4%, n = 128/484), MD/DO headache providers (25.4%, n = 123/484), adult headache fellows (12.6%, n = 61/484), pediatric headache fellows (10.3%, n = 50/484), residents (8.1%, n = 39/484), clinical nurses (8.1%, n = 39/484), MD/DO neurology (non-headache) providers (2.1%, n = 10/484), researchers (1.6%, n = 8/484), medical students (1.4%, n = 7/484), orofacial pain providers (1.0%, n = 5/484), psychologists (<1%, n = 3/484), and pharmacists (<1%, n = 3/484). Lecture attendees represented nine countries and 31 US states. Median attendance for live lectures was 34.0 people [interquartile range: 28.3-42.5], and median viewership of the posted lectures to date was 79.0 views [interquartile range: 52.0-93.0]. Prior to attending IPHDS, only 56.7% (n = 230/406) of participants reported being competent or very competent in headache medicine knowledge. After attending IPHDS, 76.9% (n = 40/52) of participants reported being competent or very competent in knowledge of headache medicine, as indicated in their post-survey. Similarly, 78.8% (n = 41/52) of participants indicated that this didactic series moderately or significantly added to their knowledge of pediatric headache medicine.

CONCLUSION: This novel didactic series successfully delivered free pediatric headache education to healthcare professionals worldwide. Furthermore, this didactic series serves as a framework for other subspecialties looking to disseminate education from specialists in the field. IPHDS continues on an annual basis, following the academic calendar year, and now holds continuing medical education accreditation.

PMID:41652798 | DOI:10.1111/head.70056

Arthritis Res Ther. 2026 Feb 6. doi: 10.1186/s13075-026-03751-8. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with rheumatoid arthritis (RA) are at a higher risk for sarcopenia than the general population. Exercise therapy can improve muscle strength in older adults; however, its efficacy in older patients with RA has not been fully established. This study aimed to evaluate the efficacy of a personalized exercise program on physical function in older patients with RA at high risk for sarcopenia.

METHODS: A single-centre, parallel-group, two-arm, superiority randomized controlled trial was conducted in patients with RA aged 60-85 years who were at risk of sarcopenia. The intervention group (n = 69) underwent a 16-week personalized exercise program in addition to nutritional guidance and standard care, whereas the control group (n = 65) received only nutritional guidance and standard care. The primary outcome was the change in the total Short Physical Performance Battery (SPPB) scores from baseline to week 16.

RESULTS: A total of 140 patients were randomized. Of these, 134 initiated the assigned intervention. There was a 0.2-point difference in SPPB total score from baseline to week 16 between the intervention group (+ 0.4 points) and the control group (+ 0.2 points); 95% confidence interval: -0.1 to 0.5; p = 0.206. Regarding the secondary outcomes at week 16, there was a tendency for improvement in the chair-stand test, grip strength, and the mental component score.

CONCLUSION: The 16-week personalized exercise therapy did not improve the total SPPB scores. However, the intervention may improve standing ability, grip strength, and mental health-related quality of life in older patients with RA at high risk of sarcopenia.

TRIAL REGISTRATION: This study was registered with UMINCTR (trial number: UMIN000044930).

PMID:41652447 | DOI:10.1186/s13075-026-03751-8

Int J Equity Health. 2026 Feb 6. doi: 10.1186/s12939-026-02781-7. Online ahead of print.

ABSTRACT

BACKGROUND: Disability is a major public health concern worldwide, particularly in sub-Saharan Africa, including East African countries (EACs), where its prevalence remains high. Effective planning for inclusive health services requires reliable data on prevalence and distribution of disability. However, EACs lack sufficient empirical data on the issue, hindering social services planning. This study aimed to examine socioeconomic and national disparities in reporting disability among individuals aged 5 to 95 years across five EACs.

METHODOLOGY: This study utilised secondary data from the most recent Demographic and Health Surveys (DHS), comprising a weighted sample of 216,420 individuals. The five EACs included were Democratic Republic of Congo, Rwanda, Malawi, Kenya and Tanzania. The dependent variable was disability status, while independent variables included demographic and socioeconomic factors. Descriptive analysis, chi-square test, and multivariable modified Poisson regression were employed to assess associations, with p-values < 0.05 indicating a significant factor.

RESULTS: The overall prevalence of reporting disability in the five EACs, however, it varied across countries. was 15.4%. There was variation across countries; the highest prevalence (19.75%) recoded in Kenya and the lowest (9.94%) observed in the DRC. After controlling for other covariates, females (Adjusted prevalence ratio (APR);1.04;95%CI:1.35,1.80), individuals residing in rural areas (APR;1.10;95%CI:1.04,1.16), separated/widowed individuals (APR;1.27,95%CI:1.18,1.36), individuals from the poorest households (APR; APR;1.10; 95%CI: 1.04, 1.16), individuals who are covered by health insurance (APR;1.05;95%CI:1.01,1.09) and the female headed households (APR;1.14;95%CI:1.10,1.19) had higher prevalence ratio of reporting disability compared to their counterparts. Conversely, individuals from the Malawi had (APR;0.05;95%CI:0.40,0.67) lower prevalence ratio of people reporting disability compared to those who were from the DRC. In addition, there was interaction of age and education level in relation to disability. This implies that association between age and disability may be influenced differently depending on education level of an individual.

CONCLUSION: This study highlighted a significant disability prevalence in EACs. Its associated factors included female gender, poorer economic households, rural areas and separation. There was interaction of age and education level on influencing disability. These findings emphasize the need for targeted interventions and further research into underlying mechanisms to improve support systems for vulnerable populations.

PMID:41652445 | DOI:10.1186/s12939-026-02781-7

BMC Biol. 2026 Feb 6. doi: 10.1186/s12915-026-02541-7. Online ahead of print.

ABSTRACT

BACKGROUND: The formation of the Han Chinese is deeply rooted in the Neolithic cultures of the Yellow River basin, particularly the pivotal Longshan cultural sphere which bridged prehistoric societies and early dynastic civilization. However, the genetic impact of Longshan-era populations on subsequent historical groups remains largely unexplored due to a critical lack of ancient genomic data from this key transitional period. This gap hinders a clear understanding of how early cultural integration in the heartland shaped the genetic structure of later Chinese populations.

RESULTS: This study reports 28 newly sequenced ancient human genomes from the Han Dynasty Xujiacundong and Zhouhe archaeological sites in Shandong Province, which are integrated with previously published regional datasets to investigate the genetic legacy of Neolithic Longshan populations in the formation of Han Chinese ancestry. Our analyses reveal pronounced genetic differentiation between Longshan populations from the Central Plain and lower Yellow River basin during the Late Neolithic period. Most individuals from the Xujiacundong site exhibit mixed ancestry, predominantly derived from Central Plain Longshan-related ancestry (93.8%) with a minor contribution from southeastern coastal China-related ancestry (6.2%). In contrast, all individuals from the Zhouhe site exhibit genetic homogeneity with Central Plain Longshan-related ancestry. These results indicate substantial genetic heterogeneity within the lower Yellow River basin during the Han Dynasty. Moreover, we found a high degree of genetic homogeneity between ancient Han Dynasty populations and modern Han Chinese from Shandong. Admixture modeling and f-statistics further demonstrate that Longshan-related ancestries-particularly those associated with the Central Plain-played a dominant role in shaping the genetic structure of historical populations across a wide geographic range, including the Upper Yellow River, the West Liao River Basin, and Southwest China, etc. CONCLUSIONS: These findings underscore the profound and pervasive genetic influence of the Central Plain Longshan populations on surrounding regions, driving the demographic expansion and genetic homogenization of the Han Chinese. This interplay of population movements and cultural diffusion highlights the central role of Longshan-era demic expansion in shaping the genetic landscape and cohesion of the Han people.

PMID:41652444 | DOI:10.1186/s12915-026-02541-7

Biomed Eng Online. 2026 Feb 6. doi: 10.1186/s12938-026-01532-7. Online ahead of print.

ABSTRACT

BACKGROUND: The use of lower limb exoskeletons in clinical rehabilitation has expanded in recent years, offering potential benefits for walking recovery. However, current clinical evidence on their effectiveness remains inconclusive. Additionally, the way individuals adapt to these robotic devices and how this adaptation contributes to functional improvements is not yet fully understood. This study was intended to (1) investigate the safety and feasibility of the Fourier X2 exoskeleton for walking rehabilitation and (2) examine its effect on walking function following a rehabilitation program.

METHODS: A randomized controlled trial was undertaken with 46 individuals who had suffered a spinal cord injury (SCI) within the last year. Participants were randomly allocated into two groups: an intervention group (IG), which received gait training using the Fourier X2 exoskeleton, and a control group (CG), which underwent conventional gait training. Each participant completed 20 gait training sessions lasting one hour. The neurological impairment ranged from C2 to L4, with participants classified under the American Spinal Injury Association Impairment Scale (AIS) C or D. The treatment program involved 20 gait training sessions, each lasting one hour, utilizing the Fourier X2 exoskeleton. Safety was assessed by tracking adverse events, while pain and fatigue levels were measured using the Visual Analogue Scale (VAS). Functional outcomes were evaluated through the Lower Extremity Motor Score (LEMS), Walking Index for Spinal Cord Injury II (WISCI-II), Spinal Cord Independence Measure III (SCIM-III), and various walking assessments, including the 10-Meter Walk Test (10MWT), 6-Minute Walk Test (6MWT), and Timed Up and Go (TUG).

RESULTS: No major complications were observed during the study. Participants in the intervention group (IG) reported experiencing mild pain (1.7 cm, SD 1.1) and moderate fatigue (3.3 cm, SD 1.6) as measured by the Visual Analogue Scale (VAS, 0-10 cm range). Statistical analysis of WISCI-II scores showed notable progress in both the “group” effect (F = 17.82, p < 0.001) and the “group-time” interaction (F = 7.27, p = 0.03). Further post-hoc evaluations revealed that the IG achieved a significant improvement of 3.20 points (SD 2.16, p < 0.0001), whereas the control group (CG) demonstrated a minor, non-significant increase of 0.5 points (SD 1.31, p = 0.32). No other variables showed significant differences between the two groups.

CONCLUSIONS: The Fourier X2 exoskeleton is both safe and well-tolerated in clinical environments. Participants who received training with the device exhibited enhanced walking independence, as reflected in their WISCI-II scores.

TRIAL REGISTRATION: The Chinese Clinical Trial Register (ChiCTR) includes this study under registration number ChiCTR2000041186, dated December 21, 2020.

PMID:41652436 | DOI:10.1186/s12938-026-01532-7

Parasit Vectors. 2026 Feb 6. doi: 10.1186/s13071-026-07284-6. Online ahead of print.

ABSTRACT

BACKGROUND: Angiostrongylus cantonensis (rat lungworm) infection causes neuroangiostrongyliasis, a parasitic disease characterized by eosinophilic meningitis and meningoencephalitis. Within the central nervous system (CNS), larval migration and degeneration provoke neuroinflammation involving microglia and astrocytes. Albendazole (ABZ) is the mainstay treatment but may exacerbate inflammation through antigen release from dying worms. Doxycycline (DOX), a tetracycline antibiotic with anti-inflammatory and neuroprotective properties, can attenuate glial activation and matrix metalloproteinase activity. As a follow-up to our previous work on ABZ-DOX treatment outcomes, this study evaluated whether ABZ-DOX co-therapy (co) provides antiparasitic and neuroprotective benefits associated with interleukin (IL)-33/glial fibrillary acidic protein (GFAP) regulation in A. cantonensis-infected mice.

METHODS: A laboratory-maintained Taiwan strain of A. cantonensis was used to infect 7-8-week-old C57BL/6 and BALB/c mice (50 third-stage larvae/mouse). For terminal analyses (histopathology, western blotting, and enzyme-linked immunosorbent assay [ELISA]), animals were allocated to eight groups: uninfected control, infected untreated, early ABZ (7-21 days post infection [dpi]), late ABZ (14-21 dpi), early DOX (7-21 dpi), late DOX (14-21 dpi), early ABZ-DOX co-therapy (co; 7-21 dpi), and late co-therapy (co; 14-21 dpi); all were euthanized at 21 dpi. Parasite recovery was performed in an independent cohort following the early-treatment schedule. Magnetic resonance imaging (MRI; 7.0 T) was conducted in a separate longitudinal BALB/c cohort (infected untreated versus early co) scanned up to 28 dpi. Statistical analyses were conducted using t-tests.

RESULTS: In an independent cohort treated using the early schedule (7-21 dpi), ABZ-containing regimens reduced worm recovery to near-zero levels in both strains. Histopathology showed eosinophilic meningitis, perivascular inflammation, and hemorrhagic changes in infected brains; these lesions were reduced in treated groups, with the most consistent improvements observed in the early co-therapy group relative to infected untreated controls. In a separate longitudinal MRI cohort (BALB/c; infected untreated versus early co-therapy), T2-weighted images demonstrated reduced hyperintensity and edema-like signal changes after early co-therapy. Western blot analyses indicated infection-associated GFAP upregulation and IL-33 alterations across brain regions, whereas co-therapy shifted these markers toward uninfected levels in a region- and strain-specific manner. Serological ELISA showed increased A. cantonensis-specific immunoglobulin (Ig)A/G/M reactivity in infected mice, which was reduced in treated groups.

CONCLUSIONS: ABZ-DOX co-therapy was associated with reduced parasite recovery and multilevel improvements across pathology, MRI, and glial markers in mice neuroangiostrongyliasis. These findings support ABZ-DOX co-therapy as a candidate regimen for further investigation in the management of A. cantonensis-associated neuroinflammation.

PMID:41652430 | DOI:10.1186/s13071-026-07284-6