Category: Nevin Manimala

J Am Heart Assoc. 2026 Mar 25:e045222. doi: 10.1161/JAHA.125.045222. Online ahead of print.

ABSTRACT

BACKGROUND: Hospital length of stay (LOS) among patients with heart failure (HF) is relevant for patients, payers, and hospitals. Risk adjustment of LOS supports fair and equitable reimbursement for facilities that may experience more complex cases, oftentimes serving marginalized populations. We aimed to assess factors contributing to HF LOS, building on commonly available information across a wide range of facilities.

METHODS: A Fine and Gray Cox proportional hazards model was fitted to assess hospital LOS using a large US cohort of 89 621 patients with HF hospitalized during the fourth quarter of 2023, controlling for censoring among patients leaving against medical advice and for competing risks of in-hospital all-cause mortality. In our primary aim, we risk-adjusted HF LOS for patient-level sociodemographic and clinical episode characteristics as well as facility-level factors. Model performance was assessed via concordance statistics across derivation and validation cohorts, and risk adjustments were reported as subdistribution hazard ratios. As a secondary aim, we explored facility-level risk-adjusted idiosyncratic differences in LOS.

RESULTS: Sociodemographic, clinical episode, and facility-level characteristics can explain differences in hospital LOS among patients with HF, with most variables being statistically significant. The model exhibited moderate performance with similar results across the derivation (C=0.686 [95% CI, 0.682-0.691]) and validation (C=0.691 [95% CI, 0.686-0.695]) cohorts.

CONCLUSIONS: Excess LOS can be attributed to multiple characteristics at the sociodemographic, clinical episode, and facility levels. We demonstrate a HF LOS risk-adjustment method that does not rely on, though can be expanded with, extensive patient clinical information, supporting more equitable assessments of facility performance and reimbursement.

PMID:41878833 | DOI:10.1161/JAHA.125.045222

Appl Neuropsychol Adult. 2026 Mar 25:1-12. doi: 10.1080/23279095.2026.2645975. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was designed to examine the potential of process variables within the Hopkins Verbal Learning Test – Revised (HVLT-R) to serve as embedded performance validity tests (PVTs).

METHOD: Archival data were collected from 52 adults referred for neuropsychological testing. Performance validity was psychometrically operationalized using a combination of free-standing and embedded PVTs.

RESULTS: Seven HVLT-R process variables individually correctly classified on average 77-79% of the sample. The process variables were combined into a single validity composite (PRO-7), which produced statistically and clinically superior signal detection performance, correctly classifying 83-85% of the sample. The PRO-7 was unrelated to performance on tests of cognitive ability but had extremely strong linear relationship with composite PVTs. Male sex and lower levels of education was associated with failing the PRO-7.

CONCLUSIONS: HVLT-R process variables were statistically and clinically significant predictors of psychometrically operationalized invalid performance and were associated with implausibly low (non-credible) scores on a range of neuropsychological tests. The PRO-7 is a promising alternative approach to traditional PVTs based on the method of threshold. Generalizability of the findings is constrained by the small sample size. Replications are needed to further examine the utility of HVLT-R process variables as PVTs.

PMID:41878828 | DOI:10.1080/23279095.2026.2645975

J Leukoc Biol. 2026 Mar 25:qiag042. doi: 10.1093/jleuko/qiag042. Online ahead of print.

ABSTRACT

Gut microbiota have been increasingly implicated in osteoarthritis (OA), but causal pathways remain unclear. Using the Gut-Immune-Joint Axis framework, we analyzed publicly available genome-wide association study (GWAS) summary statistics from one primary and two secondary datasets to evaluate genetically predicted associations between gut microbiota and OA and to test immune cells as potential mediators. Bidirectional Mendelian randomization (MR) identified five bacterial genera genetically associated with OA in the primary dataset, with no evidence of reverse causality. Two-step MR highlighted Bilophila and the immune cell subtype CD45 on CD33dim HLA DR+ CD11b- as being associated with OA (P < 0.05), and multivariable MR suggested partial mediation by this immune cell (20.0%, P = 0.003). In secondary analyses, two genera were associated with knee OA (KOA) and five with hip OA (HOA), again without reverse genetic effects. Terrisporobacter, the HLA DR+ CD4+ to T cell ratio, and the HLA DR+ CD4+ to lymphocyte ratio were associated with KOA (all P < 0.05), with mediation by the HLA DR+ CD4+ to T cell ratio (-12.0%, P = 0.001). Roseburia and Myeloid DC AC were associated with HOA (all P < 0.05). Collectively, these findings support causal links between specific gut microbial genera and OA and implicate immune-cell traits as mediators, strengthening the Gut-Immune-Joint Axis concept and highlighting potential therapeutic targets.

PMID:41878816 | DOI:10.1093/jleuko/qiag042

Folia Morphol (Warsz). 2026;85:e01726031. doi: 10.5603/fm.110558.

ABSTRACT

BACKGROUND: To evaluate the morphological characteristics of the pterygoid process – including pneumatization and sclerosis – alongside vidian canal (VC) type and length in patients with nasopharyngeal carcinoma (NPC) compared to healthy controls using computed tomography (CT).

MATERIALS AND METHODS: This retrospective study included 200 subjects, comprising 38 patients with histopathologically confirmed NPC and 162 age- and sex-matched healthy controls. All CT scans were acquired using a standardized protocol with thin-slice axial images and multiplanar reconstructions. Evaluated features included pterygoid process pneumatization and sclerosis, VC type (classified as Type 1-3), and VC length bilaterally.

RESULTS: Pterygoid process pneumatization showed no statistically significant difference between the NPC and control groups (right: 21.1% vs 24.7%, p = 0.794; left: 21.1% vs 18.5%, p = 0.898). In contrast, right-sided pterygoid plate sclerosis was significantly more frequent in NPC patients (68.4%) than in controls (4.9%) (p < 0.005). Significant differences in VC types were found between groups. Type 3 canals were more common in NPC patients (right: 39.5%, left: 39.5%) than in controls (right: 21.0%, left: 23.5%), while Type 2 was reduced in the NPC group (right and left: 15.8%) vs controls (right: 33.3%, left: 34.6%); significant for both sides (right: p = 0.024; left: p = 0.038). VC length was also significantly greater in the NPC group (right: 14.18 mm; left: 13.08 mm) compared to controls (right: 12.25 mm; left: 12.35 mm). The VC length positively correlated with age (right: r = 0.267; left: r = 0.339).

CONCLUSIONS: Sclerosis of the right pterygoid plate and an increased prevalence of Type 3 VCs were significantly associated with NPC. Anatomical variations in VC type and length may have diagnostic implications in radiological interpretation and radiotherapy planning in NPC patients.

PMID:41878812 | DOI:10.5603/fm.110558

Hypertension. 2026 Mar 25. doi: 10.1161/HYPERTENSIONAHA.125.26213. Online ahead of print.

ABSTRACT

BACKGROUND: Sex differences influence cardiovascular risk assessment and management; however, their role in aldosterone-mediated cardiac remodeling in primary aldosteronism remains incompletely understood.

METHODS: We conducted a retrospective study of 547 patients with primary aldosteronism, including 249 men and 298 women. Clinical and echocardiographic data were collected at baseline and 1 year following aldosterone-targeted therapies.

RESULTS: The mean age was 53.8 years in men and 54.6 years in women. At baseline, men had a higher left ventricular mass index (LVMI), whereas women had a higher prevalence of left ventricular (LV) hypertrophy and worse diastolic function, as indicated by a higher ratio of early diastolic transmitral to mitral annular velocity (E/e’) and left atrial volume index. In multivariable analyses, plasma aldosterone concentration was associated with baseline LVMI in both sexes. Associations between plasma aldosterone concentration and baseline diastolic indices, including E/e’ and left atrial volume index, were observed in men but not in women in sex-stratified models. However, formal interaction testing did not demonstrate significant sex-by- plasma aldosterone concentration interactions for left atrial volume index, E/e’, or LAVI. After 1 year of treatment, LVMI reduction was comparable between sexes. Improvement in E/e’ was significantly less pronounced in women. LAVI decreased significantly in men but not in women, although between-sex differences in change were not statistically significant.

CONCLUSIONS: Sex-specific differences in cardiac remodeling and diastolic function were observed in patients with primary aldosteronism. Despite lower baseline LVMI, women exhibited a more adverse cardiac phenotype, with a higher prevalence of left ventricular hypertrophy and worse diastolic function. Following aldosterone-targeted therapies, structural regression was similar between sexes, whereas diastolic function improved to a lesser extent in women.

PMID:41878808 | DOI:10.1161/HYPERTENSIONAHA.125.26213

Public Health Nutr. 2026 Mar 25:1-36. doi: 10.1017/S1368980026102195. Online ahead of print.

ABSTRACT

OBJECTIVE: Child hunger is a significant global health concern prioritised by multiple global public health organisations. In 2006, the United States Committee on National Statistics (CNSTAT) highlighted the need for clarity and consistency in the operationalisation and measurement of child hunger. This review examines whether these recommendations have been implemented in child nutrition programming over the past two decades. In addition, we explore how child hunger is currently conceptualised and measured across different contexts.

DESIGN: We conducted a pre-registered rapid review of studies that define or measure ‘child hunger’. Six electronic databases (Web of Science, MEDLINE, Embase, PsycINFO, Social Science Database, and ERIC) and websites of 20 public health organisations were searched for reports that mentioned the term “child hunger” or “child” near “hunger” published after 2006.

SETTING: There were no restrictions on study settings.

PARTICIPANTS: Studies focusing on children under the age of 18 years were included.

RESULTS: Sixty-seven articles measured child hunger and were therefore eligible for inclusion. Of these, only 23 provided a definition of child hunger. Definitions commonly described child hunger as a consequence of, or as a subcategory of household ‘food insecurity’. Most scales used in the included studies examined the quantity or amount of food intake by children, while few measures also assessed the quality of food consumed. The physiological dimension of hunger was not measured by any of the questionnaires.

CONCLUSIONS: The findings underscore the need for more comprehensive and standardised approaches that account for the multidimensional nature of child hunger.

PMID:41878797 | DOI:10.1017/S1368980026102195

Int Health. 2026 Mar 25:ihaf161. doi: 10.1093/inthealth/ihaf161. Online ahead of print.

ABSTRACT

This study estimated the pooled prevalence of visual acuity (VA) outcomes and potentially blinding cataract surgery complications in Nigeria. Ethical clearance was waived by the Ethical Review Board of the Kano State Ministry of Health. We searched PubMed, African journals online, Embase, MEDLINE and Google Scholar to identify relevant studies from January 1990 to February 2025. Data on presenting and best-corrected visual acuities at ≥6 weeks after cataract surgery, intraoperative posterior capsular rupture with vitreous loss and postoperative endophthalmitis were extracted from included studies. I2 statistics were used to assess heterogeneity across studies. Articles were systematically reviewed and a random effects meta-analysis model was applied to estimate the pooled effect size across studies. All statistical analyses were performed using Stata version 17.0 software. Sixteen studies, with a total of 3631 cataract-operated eyes, were included in the review. A total of 80.0% of all operated eyes had a preoperative VA of <3/60. At ≥4 weeks the percentage with good presenting VA ranged from 8% to 86%, with evidence of improved outcomes over time (95% confidence interval [CI] 45.0 to 67.0, I2=96.7%). With the best correction, 75% (95% CI 66.0 to 83.0, I2=98%) had a good outcome at ≥6 weeks postoperatively. The pooled prevalence of posterior capsular ruptures with vitreous loss was 4.0%, while 1.0% had postoperative endophthalmitis. In this review, the VA outcome after cataract surgery in Nigeria is well below the World Health Organization-recommended benchmark of >90% for a good result, with a higher rate of potentially blinding complications. The findings of this review suggest the need for improvement in modern surgical techniques, quality biometry and stocking of intraocular lenses of different powers and types to improve visual outcome and reduce complication rates.

PMID:41878785 | DOI:10.1093/inthealth/ihaf161

Public Health Nutr. 2026 Mar 25:1-28. doi: 10.1017/S1368980026102262. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the Indigenous Nourishment Scales (INS), a set of community-developed strengths-based measures of nourishment, for psychometric validity and reliability through community-based research with two urban American Indian/Alaska Native (AI/AN) communities.

DESIGN: Cross-sectional survey of health measures and INS. Descriptive statistics, exploratory factor analysis (EFA), correlation analysis, and regression were used to determine the psychometric properties of the INS and their relationship with Physical (Fruit and Vegetable Intake), Spiritual (Spiritual Wellbeing), Emotional (Emotional Wellbeing), and Relational (Social Wellbeing) health outcomes.

SETTING: Two urban cities in the U.S.

PARTICIPANTS: 249 urban AI/AN adults.

RESULTS: EFA revealed two unidimensional scales (Connectedness to Food; Indigenous Food Identity), and one two-factor scale (Access to and Participation in Indigenous Foodways). The INS demonstrated strong internal consistency reliability and convergent construct validity as evidenced by their association with fruit and vegetable intake and other related concepts. Regression models showed that Access to Indigenous Foodways and Participation in Indigenous Foodways were significantly and positively associated with all four domains of wellbeing. Food Connectedness was positively and significantly associated with spiritual, emotional, and relational wellbeing, while Indigenous Food Identity was positively and significantly associated with spiritual and emotional wellbeing.

CONCLUSIONS: Positive associations between scale scores and multiple domains of wellbeing indicate the potential relevance of Indigenous nourishment as a meaningful determinant of health. By establishing the psychometric validity of community-developed measures, this study offers a pathway for Indigenizing assessments of nutrition and wellbeing among AI/AN peoples.

PMID:41878784 | DOI:10.1017/S1368980026102262

Front Microbiol. 2026 Mar 9;17:1782552. doi: 10.3389/fmicb.2026.1782552. eCollection 2026.

ABSTRACT

Current subtyping methods are often restricted by labor intensity and high costs. To address this, this study integrated matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) with whole-genome sequencing (WGS) to characterize Salmonella isolates and investigate the correlation between spectral features and genomic data. Between 2023 and 2024, 96 Salmonella isolates from Yixing, Jiangsu Province, China, underwent serotyping, WGS, and MALDI-TOF MS profiling. Serotyping and Multilocus Sequence Typing (MLST) analysis resolved 25 serovars and 21 sequence types. Machine learning models based on spectral features achieved area under the curve (AUC) values exceeding 0.90 for Salmonella typhimurium, ST11, ST155, ST19, and ST34. Specific discriminatory mass peaks were identified, and their correlations with genomic annotations were investigated through peak-gene co-occurrence analysis. The findings indicate that discriminatory MALDI-TOF MS peaks can serve as statistical indicators for specific genomic features, reflecting underlying genomic differences. This study proposes a machine learning-based classification strategy that enables rapid analysis of MALDI-TOF MS spectra in routine diagnostics, thereby extending the application of mass spectrometry in Salmonella subtyping. This strategy functions as a high-throughput pre-filter to concentrate WGS efforts on high-risk clones for accelerated outbreak investigation.

PMID:41878745 | PMC:PMC13006217 | DOI:10.3389/fmicb.2026.1782552

Front Microbiol. 2026 Mar 9;17:1791871. doi: 10.3389/fmicb.2026.1791871. eCollection 2026.

ABSTRACT

Environmental microorganism recognition from microscopic images is crucial for environmental monitoring and ecological analysis. In practical scenarios, microorganism categories often evolve over time, and newly emerging classes usually have only a few labeled samples due to high annotation costs. This combination naturally gives rise to the few-shot class-incremental learning (FSCIL) problem. FSCIL requires models to incrementally learn new classes under severe data scarcity while effectively retaining knowledge of previously learned ones. In this work, we propose a unified FSCIL framework for environmental microorganism recognition. The proposed method is composed of three complementary components. First, a contrastive-inspired fine-grained representation learning strategy is introduced in the base session. This strategy enhances intra-class compactness by mining prediction-consistent augmented samples, without introducing explicit contrastive losses. Second, a prototype rectification mechanism is designed to stabilize the representations of incremental classes by leveraging semantic structures learned from base classes. Third, a dual-graph knowledge distillation framework is proposed to preserve both instance-level and class-level relational knowledge during incremental learning. This process is guided by a teacher model updated via exponential moving average. Experiments conducted on the EMDS-7 dataset demonstrate the effectiveness of the proposed approach. Compared with state-of-the-art FSCIL methods, our method achieves the highest average accuracy of 78.19% and maintains the best final-session accuracy of 65.36%. Meanwhile, strong base-session performance is consistently preserved. These results indicate that the proposed framework effectively mitigates catastrophic forgetting and enables robust adaptation to new microorganism categories in real-world incremental recognition scenarios.

PMID:41878735 | PMC:PMC13006286 | DOI:10.3389/fmicb.2026.1791871