Nevin Manimala

Cureus. 2026 Feb 11;18(2):e103403. doi: 10.7759/cureus.103403. eCollection 2026 Feb.

ABSTRACT

OBJECTIVE: This pilot study investigated the dosimetric impact of artificial intelligence (AI)-generated seminal vesicle (SV) autocontouring (AC) compared with manual contouring (MC) in high-risk prostate cancer volumetric-modulated arc therapy planning.

METHODS: We retrospectively analyzed treatment plans for 15 patients with high-risk prostate cancer who received 76 Gy in 38 fractions in intensity-modulated radiation therapy. Three plans were created for each patient: MC, AC with slice-adjustment to a clinical standard (2 cm from the prostate base), and unadjusted AC. Subsequently, three groups were made for each contouring method: the adjusted AC group, the unadjusted AC group, and the MC group, each including 15 plans. Primary endpoints were dose coverage of the planning target volume (PTV) and clinical target volume (CTV), evaluated by Dmax, Dmin, Dmean, D95, D98, D99, and V95%. Statistical analysis was performed using Dunnett’s test, and multiple comparisons were made by selecting the MC as the control group.

RESULTS: CTV Dmean showed a tendency to be lower in the unadjusted AC group compared with the MC group, but did not reach statistical significance (difference: -58.7 cGy, 95% confidence interval (CI): -123.0 to 5.5 cGy, p = 0.077, Hedges’ g = 0.78). PTV Dmean also showed a decreasing tendency in the unadjusted AC group, but similarly did not reach statistical significance (difference: -92.8 cGy, 95% CI: -193.6 to 8.0 cGy, p = 0.075, g = 0.67). In the adjusted AC group, there was a slight tendency for a decrease in CTV Dmean, but this did not reach statistical significance (difference: -41.3 cGy, p = 0.254, g = 0.63). Effect size assessment revealed a moderate effect in both the unadjusted and the adjusted AC groups. No statistically significant differences were observed among the three groups in any dose volume histogram parameters.

CONCLUSION: This preliminary study (n = 15) suggests no statistically significant dosimetric differences between AI autocontoured and manually contoured SVs, with dose differences <1% of the prescription. However, given the small sample size, validation in larger cohorts is needed before clinical implementation.

PMID:41835785 | PMC:PMC12983348 | DOI:10.7759/cureus.103403

Actas Urol Esp (Engl Ed). 2026 Mar 13:501966. doi: 10.1016/j.acuroe.2026.501966. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess long-term mortality trends for male genital organ (MGO) cancers in Spain from 1999 to 2023, stratified by age group and tumour type.

METHODS: A retrospective, population-based ecological study was conducted using mortality records from the Spanish National Institute of Statistics. Deaths were classified by ICD-10 codes: penile (C60), prostate (C61), testicular (C62), and other/unspecified (C63). Age-standardised mortality rates (ASMRs) were calculated using the 2013 European Standard Population. Temporal trends were evaluated with Joinpoint regression to estimate annual percentage change (APC) and average annual percentage change (AAPC). Analyses were stratified by early-onset (<50 years) and late-onset (≥50 years) disease.

RESULTS: From 1999 to 2023, 147,917 MGO-related deaths were recorded; prostate cancer comprised approximately 97%, predominantly in men aged ≥50 years. Crude mortality increased slightly over time due to population ageing, whereas prostate cancer ASMR decreased from 49.61 to 27.26 per 100,000 (AAPC – 2.5%; 95% CI – 2.7 to -2.3). A joinpoint in 2016 indicated a slowing decline thereafter (APC – 1.3%). Testicular cancer mortality remained low and stable (AAPC – 0.4%), with a minor reduction in older men but stable or slightly increasing patterns among younger men. Penile cancer mortality showed persistently low and unchanged rates (AAPC – 0.8%). Early-onset prostate and penile cancer mortality was rare and exhibited stable trends.

CONCLUSIONS: MGO cancer mortality in Spain is overwhelmingly driven by prostate cancer, which has declinedC markedly over 25 years but has plateaued since 2016. Mortality from testicular and penile cancers remains low with limited age-specific variability.

PMID:41833724 | DOI:10.1016/j.acuroe.2026.501966

Can J Cardiol. 2026 Mar 13:S0828-282X(26)00256-4. doi: 10.1016/j.cjca.2026.02.054. Online ahead of print.

ABSTRACT

BACKGROUND: The burden of cardiovascular events remains substantial under current care, highlighting the clinical importance of identifying high-risk populations. Sarcopenia, affecting 10%-27% of older adults worldwide, is modifiable but under-recognised in cardiovascular prevention due to unclear risk associations. We aimed to clarify the association between sarcopenia and cardiovascular events risk.

METHODS: PubMed, Embase, and Web of Science were searched for longitudinal studies reporting associations between sarcopenia or its related traits with cardiovascular events risk until January 2024. The primary outcome was a composite of cardiovascular events, encompassing cardiovascular diseases (such as coronary heart disease, heart failure, and stroke) and cardiovascular mortality. Data pooled by random-effects models are presented as risk ratios (RRs) and 95% confidence intervals (CIs).

RESULTS: One hundred longitudinal studies (approximately 2.3 million participants) were included. Sarcopenia was associated with higher risk of cardiovascular events (unadjusted risk ratio [uRR]=1.92, 95% CI 1.59 to 2.32; adjusted risk ratio [aRR]=1.63, 1.30 to 2.04) and cardiovascular diseases (uRR=1.69, 1.39 to 2.04; aRR=1.28, 1.12 to 1.46), whereas the association with cardiovascular mortality was significant only in unadjusted analyses (uRR=2.28, 1.56 to 3.33; aRR=1.61, 0.98 to 2.64). Similar associations with cardiovascular events were observed for low muscle mass (uRR=1.61, 1.32 to 1.97; aRR=1.43, 1.23 to 1.68) and low grip strength (uRR=2.04, 1.72 to 2.44; aRR=1.46, 1.37 to 1.56).

CONCLUSION: Sarcopenia, defined using heterogeneous criteria, was associated with an increased risk of cardiovascular events later in life. These findings suggest that sarcopenia and related traits may serve as markers of elevated subsequent cardiovascular risk.

PMID:41833723 | DOI:10.1016/j.cjca.2026.02.054

J Subst Use Addict Treat. 2026 Mar 13:209942. doi: 10.1016/j.josat.2026.209942. Online ahead of print.

ABSTRACT

INTRODUCTION: Methadone is an effective medication for the treatment of opioid use disorder, yet barriers to treatment access exist. Community pharmacies are more accessible than opioid treatment programs (OTPs) and are utilized in countries other than the United States to observe methadone dosing and dispense take-home doses. The purpose of this study was to assess North Carolina OTP staff perceptions towards community pharmacy-based methadone dispensing.

METHODS: A cross-sectional online survey was used to assess the perceived acceptability, appropriateness, and feasibility of community pharmacy-based methadone dispensing among OTP staff using validated measures. Survey distribution occurred from April to June 2025. Descriptive statistics were used to identify potential benefits, negative consequences, and barriers to pharmacy-based methadone dispensing.

RESULTS: The response rate was 72.7% (56 of 77). Perceived acceptability, appropriateness, and feasibility of observed dosing and dispensing methadone take-home doses in the community pharmacy were low among OTP staff. Perceived negative consequences of pharmacy-based methadone dispensing were loss of counseling and care coordination provided by the OTP. Lack of community pharmacist training on methadone dispensing and community pharmacist stigma were the greatest perceived barriers to pharmacy-based dispensing. Over 25% of respondents did not think there were any potential benefits to pharmacy-based methadone dispensing.

CONCLUSION: OTP staff in North Carolina are, in general, not supportive of pharmacy-based methadone dispensing. With low perceived appropriateness, acceptability, and feasibility of observed methadone dosing and dispensing methadone take-home doses in the community pharmacy, further work to implement pharmacy-based methadone dispensing may be stifled by OTP resistance. If policy-based efforts to increase methadone access through community pharmacies continue to be pursued, researchers and other key informants should seek to mitigate concerns identified by OTP staff to ensure people with OUD can receive high quality, patient-centered care in the pharmacy setting.

PMID:41833712 | DOI:10.1016/j.josat.2026.209942

Int J Biol Macromol. 2026 Mar 13:151399. doi: 10.1016/j.ijbiomac.2026.151399. Online ahead of print.

ABSTRACT

Pheromone perception is crucial for mating behaviour in insects, and its manipulation can significantly influence the reproductive outcomes. In this study, a total of 156 chemosensory genes were identified from the transcriptome of the heads along with antennae of both male and female Leucinodes orbonalis. These included 35 sequences belonging to odorant-binding proteins (OBPs) including four pheromone binding proteins (PBPs) and three general odorant binding proteins (GOBPs), 73 odorant receptors (ORs), 20 ionotropic receptors (IRs), 25 chemosensory proteins (CSPs), and 3 sensory neuron membrane proteins (SNMPs). Expression analysis revealed male-biased expression of PBP1, PBP2, and PBP3, whereas PBP4 showed predominant expression in females. To investigate the molecular interaction with the pheromone compound, three-dimensional (3D) structures of the four identified PBPs were modelled. Molecular docking followed by 100 ns Molecular Dynamics (MD) simulations with the species-specific sex pheromone revealed that hydrophobic and hydrogen-bond interactions between the ligand and conserved residues play a crucial role in stabilizing PBP-ligand binding. Functional validation using RNA interference demonstrated that silencing of PBPs using dsRNA significantly reduced the pheromone sensitivity, as confirmed by electroantennogram (EAG) recordings performed after dsRNA-induction. Further, silencing of individual PBPs led to the overexpression of others, suggesting compensatory functional adaptation in L. orbonalis. In addition, simultaneous silencing of different combinations of PBP genes followed by behavioral assays using a Y-tube olfactometer showed a marked reduction in pheromone response. These findings highlight the crucial role of PBPs in pheromone-mediated mate recognition and suggest potential target for pest management strategies.

PMID:41833667 | DOI:10.1016/j.ijbiomac.2026.151399

J Affect Disord. 2026 Mar 13:121626. doi: 10.1016/j.jad.2026.121626. Online ahead of print.

ABSTRACT

BACKGROUND: Non-suicidal self-injury (NSSI) constitutes a major public health concern among adolescents. Although impulsivity is a recognized risk factor, its specific role in value-based decision-making remains elusive. This study examined delay and probability discounting patterns in adolescents with NSSI compared to healthy controls across both gain and loss domains, identifying specific decision-making alterations associated with self-injurious behavior.

METHODS: Eighty-two adolescents (42 with NSSI absent of psychiatric comorbidities and 40 healthy controls) completed computerized delay and probability discounting tasks. Both tasks assessed decision-making using hypothetical monetary gains and losses. Discounting rates were quantified using area under the curve analyses.

RESULTS: For delay discounting, adolescents with NSSI discounted delayed gains more steeply than healthy controls, reflecting a stronger preference for immediate rewards. In contrast, group differences for delayed losses were non-significant and statistically equivalent to zero. Furthermore, no significant group differences emerged for either gains or losses in the probability discounting task.

LIMITATIONS: The cross-sectional design, the modest sample size, and the reliance on hypothetical rather than real-world monetary outcomes limit ecological validity and constrain causal inference.

CONCLUSIONS: These preliminary findings suggest that NSSI in adolescents may be associated with a preferential sensitivity to reward immediacy, rather than generalized deficits across all decision-making domains. This behavioral profile supports models conceptualizing NSSI as an emotion-regulation strategy prioritizing immediate relief over long-term benefits, highlighting delay tolerance as a potential target for intervention.

PMID:41833610 | DOI:10.1016/j.jad.2026.121626

J Vasc Surg. 2026 Mar 13:S0741-5214(26)00215-6. doi: 10.1016/j.jvs.2026.02.042. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the impact of aneurysmal sac regression versus failure to regress on perioperative and long-term outcomes after endovascular aortic aneurysm repair (EVAR).

METHODS: Article screening was conducted using Medline, Embase, and the Cochrane databases. The primary outcome was overall survival; secondary outcomes included reintervention-free survival, endoleak during follow-up, aneurysmal rupture and reintervention during follow-up. End points were compared using risk ratio (RR) for binary outcomes and hazard ratio (HR) for long-term outcomes. For all outcomes, 95% confidence intervals were calculated. Subgroup analysis was done for studies including F/BEVAR patients and for studies comparing sac regression to sac stability. A trial sequential analysis was done for the short-term outcomes. Heterogeneity was assessed through the I² statistic. GRADE assessment of the findings was performed.

RESULTS: Twenty-seven studies comprising 36,822 patients were included. Sac regression was associated with improved overall survival in the overall analysis (HR 0.70; 95% CI 0.61-0.80; p < .00001). In the F/BEVAR subgroup, sac regression was associated with a numerically lower hazard of death; however, this association did not reach statistical significance (HR 0.87; 95% CI 0.49-1.53; p = .62). This association persisted for endoleak during follow-up, with lower risk observed in the overall analysis (RR, 0.55; 95% CI, 0.41-0.72; p < .0001) and in the F/BEVAR subgroup (RR, 0.55; 95% CI, 0.41-0.75; p = .0001). Patients with sac regression also demonstrated better reintervention-free survival (HR, 0.37; 95% CI, 0.27-0.53; p < .00001) and a lower incidence of reintervention during follow-up and aneurysm rupture; however, these latter outcomes were not statistically significant within the F/BEVAR subgroup. Statistical significance persisted across all outcomes in the subgroup analysis comparing sac regression with stable sac.

CONCLUSION: Sac regression after EVAR confers superior outcomes compared with failure to regress. Our findings underscore the importance of sac behaviour as a key indicator in post-EVAR surveillance and long-term risk stratification.

PMID:41833592 | DOI:10.1016/j.jvs.2026.02.042

J Vasc Surg. 2026 Mar 13:S0741-5214(26)00217-X. doi: 10.1016/j.jvs.2026.02.043. Online ahead of print.

ABSTRACT

OBJECTIVES: While SVS guidelines support revascularization in select patients with lifestyle-limiting intermittent claudication (IC), infrapopliteal intervention is discouraged due to questionable benefit and potential harm. Retrograde tibial/pedal access is increasing in peripheral vascular interventions (PVI) in general, but its use and appropriateness in IC has not been studied or codified. This study aims to analyze national practice patterns of tibial access in PVI for IC, and its potential association with tibial interventions.

METHODS: Elective IC cases from the VQI PVI module between 2010 and 2024 were identified. Cases were stratified into femoral-only cases and those involving any tibial access. Patient demographics, procedural setting, and interventional details were compared using descriptive statistics. Multivariable logistic regression was used to identify independent predictors of tibial intervention, and specifically assess the contribution of tibial access to this practice.

RESULTS: Of 107,822 cases, 4,204 involved any tibial access (3.9%) and 103,618 (96.1%) were performed with femoral-only access, with tibial access increasing over time at a rate of 0.62% per year (R2=0.95). Tibial access was more frequently utilized in ambulatory and office-based settings compared to hospital (8.2% vs. 3.2%; p<0.001). Tibial access was less commonly used in females than males (3.2% vs. 4.3%, p<0.001), and more commonly in Hispanic (5.4%) and Non-Hispanic Black (4.9%) than Non-Hispanic White (3.6%) and Non-Hispanic Asian (2.8%) patients (p<0.001). Compared to femoral-only access patients, those with tibial access more frequently underwent femoropopliteal (91% vs. 66%) and below-knee interventions (39% vs. 12%), but fewer aortoiliac interventions (9.1% vs. 40%; all p<0.001). Tibial access more frequently involved treatment of multiple vessels (50% vs. 41%, p<0.001). Multivariable regression adjusting for demographics, relevant comorbidities and procedural factors demonstrated tibial access to be independently and highly predictive of tibial intervention (OR 4.65, 95% CI 4.28-5.05). Among tibial interventions, atherectomy and stenting were more prevalent in patients who had tibial access.

CONCLUSIONS: Retrograde tibial access for IC has increased over time and is most prevalent in outpatient settings. Tibial access appears to be highly predictive of tibial intervention, with higher rates of atherectomy and stenting, raising the critical question of whether this is leading to inappropriate use and deviation from evidence-based societal guidelines.

PMID:41833590 | DOI:10.1016/j.jvs.2026.02.043

Microbiologyopen. 2026 Apr;15(2):e70266. doi: 10.1002/mbo3.70266.

ABSTRACT

Not susceptible to methicillin Staphylococcus aureus (MRSA), is a potentially harmful bacteria that is resistant to the most important antimicrobial agents. Because MRSA is so resistant to many antibiotics, it can cause illnesses by forming biofilms. The aim of this study was to assess the nasal carriage rate of biofilm-producing methicillin-resistant Staphylococcus aureus (MRSA) and its associated factors among HealthCare Workers at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Central Ethiopia. This cross-sectional study, carried out at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Central Ethiopia from August 1 to November 30, 2023. Nasal swab samples from 294 healthcare workers (HCWs) were obtained using sterile cotton swabs. Bacterial isolates were identified using standard culture methods on Mannitol Salt and Blood Agar, while antimicrobial susceptibility testing and biofilm formation assessments followed the CLSI 2023 (M100, 33rd edition) guidelines via the Kirby-Bauer disk diffusion methods. All laboratory analyses were performed in triplicate to ensure consistency. Data were double-entered into Epi Data version 4.6 and cross-checked for accuracy. Missing or inconsistent data were verified against original laboratory records and latterly then, exported to SPSS V25 for analysis. Descriptive statistics and logistic regression were applied for statistical evaluation, with a p-value of ≤ 0.05 regarded as statistically significant. In this study, the occurrence rates of S. aureus, MRSA, and biofilm-producing MRSA were 98 out of 294 isolated strains (33.4%), 41 out of 294 isolated strains (13.9%), and 28 out of 294 isolated strains (9.5%), respectively. The MRSA strains exhibited high sensitivity to linezolid, rifampicin, and vancomycin while showing resistance to cefoxitin, cotrimoxazole, and ciprofloxacin. A history of prior hospitalization (length of stay in the hospital) was statistically significant for the colonization of biofilm-producing MRSA, with an adjusted odds ratio of 10.00 (95% CI: 1.36-73.3; P = 0.024). MRSA and MRSA that produces biofilms were found to be 41.8% and 68.3% prevalent overall in the study area, respectively. Biofilm-producing MRSA is a potential cause of healthcare-associated diseases. Therefore, these findings emphasize the urgent need for improved infection-prevention practices and routine screening of healthcare workers to mitigate the risk of healthcare-associated infections.

PMID:41833560 | DOI:10.1002/mbo3.70266

Int J Stroke. 2026 Mar 15:17474930261435194. doi: 10.1177/17474930261435194. Online ahead of print.

ABSTRACT

BackgroundPregnancy-associated stroke (PAS) is a rare but clinically important complication of pregnancy. Despite its clinical significance, nationwide data on PAS are lacking in South Korea, a representative country with advanced maternal age.AimsThis study aimed to investigate the incidence, temporal trends, and risk factors of PAS in South Korea.MethodsWe retrospectively analyzed nationwide data from the Korean National Health Insurance Service (NHIS) to identify women of reproductive age (15-49 years) who delivered between 2014 and 2021. PAS was defined as an ischemic or hemorrhagic stroke occurring during pregnancy or within 6 weeks postpartum. Multivariable logistic regression analysis was performed to identify independent predictors of PAS.ResultsOf 2,000,110 deliveries between 2014 and 2021, 909 first-ever strokes occurred during pregnancy or within six weeks postpartum, including 500 ischemic (55%) and 409 hemorrhagic (45%) strokes. The overall incidence of PAS was 45.6 per 100,000 deliveries (95% confidence interval [CI], 42.7-48.6) and increased from 41.5 in 2014 to 51.0 in 2021 (P = 0.049), mainly driven by ischemic stroke. PAS occurred predominantly during the postpartum period (P <0.0001) and among older women (P for trend <0.0001). In multivariable analysis, advanced maternal age (odds ratio [OR] per year, 1.02; 95% CI, 1.01-1.05), hypertension (OR, 2.04; 95% CI, 1.37-3.04), migraine (OR, 1.33; 95% CI, 1.02-1.74), gestational hypertension (OR, 1.49; 95% CI, 1.04-2.12), preeclampsia/eclampsia (OR, 5.00; 95% CI, 3.59-6.96), and peripartum cardiomyopathy (OR, 14.26; 95% CI, 4.48-45.42) were identified as independent predictors of PAS.ConclusionsThe incidence of PAS is increasing in South Korea, with advanced maternal age, vascular risk factors, and pregnancy-related complications serving as independent predictors. These findings underscore the clinical importance of heightened awareness of PAS, as well as early identification and proactive management of high-risk women.Data access statementData are available from the NHIS upon reasonable request and with permission of the NHIS.

PMID:41833554 | DOI:10.1177/17474930261435194