Nevin Manimala

Disaster Med Public Health Prep. 2026 Apr 1;20:e77. doi: 10.1017/dmp.2026.10342.

ABSTRACT

The COVID-19 pandemic overwhelmed New York City’s healthcare infrastructure, prompting rapid adaptations to expand critical care capacity. Montefiore Medical Center’s Hutchinson Metro Center (the Hutch), a standalone ambulatory surgical center (ASC), was converted into an ICU within 5 days to address the surge in COVID-19 cases. This was done by repurposing 16 operating rooms and 60 post-anesthesia care unit beds into 14 ICU and 60 floor beds. A 5-step framework guided the conversion process, including: (1) feasibility of conversion, (2) critical structural logistics, (3) essential supplies and technology, (4) Clinical criteria, and (5) staffing. Key challenges were oxygen supply limitations, staffing shortages, and logistical hurdles such as medication and equipment procurement. This report highlights the potential of ASCs as adaptable overflow facilities during public health crises and provides a blueprint for future pandemic preparedness.

PMID:41919403 | DOI:10.1017/dmp.2026.10342

Int J STD AIDS. 2026 Apr 1:9564624261441374. doi: 10.1177/09564624261441374. Online ahead of print.

ABSTRACT

BackgroundTransgender women experience a disproportionate burden of HIV. National-level trend analyses in South Africa remain limited. This study asked whether modelled HIV prevalence among transgender women changed between 2022 and 2026, and whether disparities relative to the national population and adult females had narrowed over this period.MethodsA quantitative ecological analysis was conducted using modelled estimates from the Thembisa model (version 4.8) (2022-2026). Annual HIV prevalence and 95% confidence intervals were extracted. Estimates for 2022 and 2023 reflect retrospective modelled outputs, while estimates for 2024 to 2026 incorporate model projections. A Mann-Kendall trend test was conducted to assess the statistical significance of observed changes. Absolute differences and prevalence ratios were calculated.ResultsHIV prevalence among transgender women declined from 43% in 2022 to 40% in 2026. National prevalence remained stable (13%). The absolute gap decreased from 30 to 27 percentage points. In 2026, HIV prevalence among transgender women remained more than three times higher than national prevalence. The Mann-Kendall trend test confirmed a statistically significant downward trend (τ = -1.00, p = 0.017).ConclusionDespite modest declines, substantial disparities persist. Continued monitoring and targeted HIV strategies remain essential. These findings carry direct implications for South Africa’s National Strategic Plan on HIV and for the National Department of Health’s key population programming.

PMID:41919395 | DOI:10.1177/09564624261441374

Nucleosides Nucleotides Nucleic Acids. 2026 Apr 1:1-13. doi: 10.1080/15257770.2026.2649863. Online ahead of print.

ABSTRACT

Pancreatic ductal adenocarcinoma (PDAC) is among the most treatment-resistant malignancies, characterized by aggressive progression and limited drug penetration reducing chemotherapeutic efficacy. Gemcitabine, a pyrimidine nucleoside analog and standard-of-care therapy for PDAC, remains clinically important but is limited by the emergence of resistant tumor cell populations that underscore the need for strategies that enhance cytotoxic efficacy and overcome adaptive resistance mechanisms. Ultrasound-stimulated microbubble (USMB) therapy has emerged as a noninvasive, mechanically driven approach capable of transiently perturbing cellular membranes and enhancing therapeutic responses. We hypothesized that gemcitabine-induced metabolic and structural alterations may sensitize PDAC cells to subsequent disruption by USMB, resulting in enhanced cell death. To test this hypothesis, we assessed changes in proliferation, morphology, and cell death following gemcitabine and USMB treatments administered individually and in sequence to PANC-1 cells. Gemcitabine treatment alone (2 µM for 48h) significantly reduced cell proliferation by approximately 22% and induced pronounced morphological remodeling, including statistically increased average cell diameter from ∼19 µm to ∼22 µm, consistent with cytoplasmic expansion and structural reorganization. Notably, when gemcitabine-treated cells were subsequently exposed to USMB (1 MHz, 770 kPa negative pressure for 1 min), cell death increased dramatically to >80%, significantly exceeding the effects observed with either gemcitabine or USMB monotherapy indicating that gemcitabine pretreatment induces a mechanically vulnerable cellular state that can be exploited by USMB to achieve synergistic cytotoxicity. Therefore, the proposed combined biochemical-biophysical strategy offers a promising approach to suppress the rapid compensatory growth and therapeutic resistance commonly associated with monotherapy failure in PDAC cells.

PMID:41919380 | DOI:10.1080/15257770.2026.2649863

Health Serv Res. 2026 Apr;61(2):e70109. doi: 10.1111/1475-6773.70109.

ABSTRACT

OBJECTIVE: To examine the plausibly causal effect of Medicaid home- and community-based services (HCBS) use on Medicare community-initiated home health care (CIHHC) utilization among dual-eligible older adults and to provide evidence on whether access to home-based long-term care (LTC) reduces use of Medicare home health care, with potential implications for whether Medicare home health care is used as a substitute for LTC services when they are not or less accessible.

STUDY SETTING AND DESIGN: To address the endogeneity of Medicaid HCBS use, we employ an instrumental variable, the proportion of Medicaid HCBS enrollment in other counties within the same state in the previous quarter, in conjunction with a state-border design in estimating the effect of Medicaid HCBS use on Medicare CIHHC and its heterogeneity.

DATA SOURCES AND ANALYTIC SAMPLE: We use national Medicare and Medicaid claims data along with home health and nursing home assessment data from 2016 to 2019. Our sample consists of 36,955,226 beneficiary-quarter-level observations of older adults (65+) dually enrolled in Medicaid and Medicare and residing in contiguous state-border counties.

PRINCIPAL FINDINGS: Medicaid HCBS use reduces Medicare CIHHC utilization by approximately 1.02 percentage points (95% CI: -1.73 to -0.32), representing about 44% of the sample mean. This effect is concentrated among beneficiaries enrolled in Medicare-Medicaid integrated care plans and those living in urban counties. Moreover, the reduction is most pronounced among older adults who live alone and have around-the-clock assistance needs.

CONCLUSIONS: Our findings suggest a substitution between Medicaid HCBS and Medicare CIHHC among dual-eligible older adults at the margin of using Medicaid HCBS, a relationship that should be taken into account when evaluating either program. These findings also align with the hypothesis that Medicare CIHHC is being used as a substitute for LTC, and the availability of home-based LTC may help to alleviate this potentially inefficient use.

PMID:41919377 | DOI:10.1111/1475-6773.70109

Orthop Surg. 2026 Apr 1. doi: 10.1111/os.70302. Online ahead of print.

ABSTRACT

OBJECTIVE: Subtrochanteric shortening osteotomy (SSO) with autogenous cortical plate grafting is a critical but technically demanding procedure in total hip arthroplasty for Crowe type IV developmental dysplasia of the hip. Conventional instruments often result in inaccurate osteotomies and unstable graft fixation. This study aimed to evaluate a novel surgical instrumentation system designed to address these challenges.

METHODS: A retrospective cohort study was conducted on 49 patients (60 hips) with Crowe type IV DDH who underwent primary THA with SSO. The control group included 25 patients (30 hips) treated with conventional instruments. The novel instrumentation group included 24 patients (30 hips) treated with the newly developed system. All surgeries were performed by a single senior surgeon. Demographic and clinical data were analyzed, and all patients completed the 24-month postoperative follow-up. Statistical analysis was performed using t-tests and chi-squared tests as appropriate.

RESULTS: The mean operative time was significantly shorter in the novel instrumentation group than in the control group (t = 2.123, p = 0.040). The novel instrumentation system was estimated to reduce the time required for the autogenous cortical plate technique by 43%. Patients in the novel instrumentation group also reported significantly less intraoperative blood loss (t = 3.078, p = 0.003). The satisfaction rate regarding autogenous graft and wire positions was significantly higher in the novel instrumentation group (χ² = 5.455, p = 0.020). No significant differences were observed in clinical scores between the two groups during the 24-month follow-up. No severe perioperative or postoperative complications occurred in either group.

CONCLUSION: The novel surgical instrumentation system demonstrated advantages over conventional devices in terms of operating time, blood loss, and satisfaction with autogenous graft and wire positioning. It represents an ideal set of surgical tools for Crowe type IV DDH patients undergoing THA with SSO.

LEVEL OF EVIDENCE: Level III, retrospective study.

PMID:41919348 | DOI:10.1111/os.70302

J Dermatolog Treat. 2026 Dec;37(1):2650070. doi: 10.1080/09546634.2026.2650070. Epub 2026 Apr 1.

ABSTRACT

BACKGROUND: The emergence of systemic targeted therapies for atopic dermatitis (AD) has significantly transformed the treatment landscape.

OBJECTIVE: This network meta-analysis aims to systematically evaluate the relative efficacy of approved systemic targeted therapies in adult patients with moderate-to-severe AD.

METHODS: Phase 3 or 4 randomized controlled trials (RCTs) assessing approved systemic targeted therapies for moderate-to-severe AD published up to July 29, 2025, were systematically identified. A Bayesian network meta-analysis was performed to analyze the proportion of patients achieving key efficacy indicators, including EASI-75, EASI-90, IGA 0/1, and NRS response.

RESULTS: A total of 27 reports encompassing 33 trials and 16,334 participants were included. The network meta-analysis demonstrated that Upadacitinib 30 mg consistently exhibited the highest probability of achieving each clinical endpoint. While pairwise comparisons revealed statistically significant differences among multiple targeted therapies, no significant differences were observed between dupilumab 300 mg and stapokibart 300 mg, or between ivarmacitinib 8 mg and upadacitinib 15 mg.

CONCLUSION: Among currently approved targeted systemic therapies, upadacitinib 30 mg once daily ranked highest across all evaluated efficacy outcomes. However, these findings are derived primarily from indirect comparisons, and head-to-head randomized trials are needed to confirm the relative effectiveness of these therapies.

PMID:41919337 | DOI:10.1080/09546634.2026.2650070

Turk J Orthod. 2026 Mar 31;39(1):35-42. doi: 10.4274/TurkJOrthod.2026.2025.141.

ABSTRACT

OBJECTIVE: To evaluate the scientific literature on impacted canines using bibliometric and altmetric analyses.

METHODS: A systematic search of the Web of Science Core Collection was performed using keywords related to impacted canines. Three independent reviewers identified, screened, and evaluated the 100 most-cited articles. Citation data were cross-verified with Scopus and Google Scholar. Extracted information included citation counts, study design, publication year, authors, institutions, journals, and countries. Bibliometric mapping was conducted using VOSviewer, and altmetric indicators were obtained from dimensions. Statistical analysis was performed using Spearman’s rank correlation, with significance set at p<0.05.

RESULTS: The 100 most-cited articles received 10,429 citations in the Web of Science, and citation counts were strongly correlated across databases (p<0.001). Most studies were observational (69%), followed by narrative reviews (12%) and interventional studies (10%). Research topics primarily addressed the etiology, radiographic assessments, and associated anomalies. The most cited article in the Web of Science database was Ericson and Kurol’s 1988 study on the interceptive extraction of primary canines. Publications were concentrated in orthodontic specialty journals, with the USA, Italy, and Israel being the leading countries.

CONCLUSION: Analysis of the 100 most-cited articles revealed that influential research on impacted canines is predominantly, focusing on etiology and diagnosis. Areas such as mandibular impactions, periodontal outcomes, and long-term treatment effects remain underexplored.

PMID:41919331 | DOI:10.4274/TurkJOrthod.2026.2025.141

Public Health Nutr. 2026 Apr 1:1-26. doi: 10.1017/S1368980026102316. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the association between dietary patterns and MetS in western China, which has not been previously reported.

DESIGN: A population based cross-sectional study design. Dietary intake was assessed using a semi-quantitative food frequency questionnaire. Principal component analysis identified dietary patterns, and multivariate logistic regression evaluated their associations with MetS.

SETTING: Population-based Cohort Study of Chronic Diseases in Xinjiang (PCCDX), conducted in 2022.

PARTICIPANTS: A total of 3 208 individuals from PCCDX (mean age: 53.1 ± 10.8 years; 49.1% male).

RESULTS: MetS was diagnosed in 1 762 participants (54.9%). Four distinct dietary patterns were identified, with the refined grain-animal products dietary pattern being the dominant one. After adjusting for general demographic and lifestyle factors, a higher score in the refined grain-animal product pattern was associated with an increased risk of MetS. The odds ratios for the second, third, and fourth quartiles of the dietary score were 1.07 (95% CI: 0.860∼1.322), 1.14 (0.923∼1.413), and 1.48 (1.189∼1.853), with a statistically significant trend (P = 0.003). Higher dietary scores in this pattern were also associated with increased risks of elevated waist circumference, high triglycerides, and low high-density lipoprotein cholesterol (HDL-C) (P < 0.05). Mediation analysis showed that visceral fat percentage partially mediated the association between the refined grain-animal product dietary pattern and low HDL-C, accounting for 17.2% of the total effect (indirect effect = 0.005, P = 0.006). The other three dietary patterns showed no significant associations with MetS or its components.

CONCLUSIONS: This study highlights the high prevalence of MetS in western China and links a refined grains-animal products diet to poorer metabolic health, emphasizing the need for region-specific dietary strategies.

PMID:41919321 | DOI:10.1017/S1368980026102316

Psychol Med. 2026 Apr 1;56:e87. doi: 10.1017/S0033291726103717.

ABSTRACT

BACKGROUND: Parental violent offending and offspring suicidal behavior are associated, but a deeper understanding of the risk within this population is needed to best identify and support those most in need. This study examined the risk of suicidal behavior among offspring of parents with violent convictions, primarily aiming to identify high-risk subgroups.

METHODS: The study included 2,956,465 individuals born in Sweden 1977-2010, and their parents. Data were obtained from nationwide registers available until the end of 2020. The authors examined the risk of suicidal behavior among offspring with none, one, or both parents with violent convictions by offspring’s age 10, and further investigated the risk among exposed offspring by parental psychiatric disorders, child-parent coresiding, and other factors. Children-of-siblings analyses were conducted to better understand the nature of the association.

RESULTS: There were 254,793 (8.6%) and 11,777 (0.4%) offspring with one or both parents with violent convictions. Absolute risk of suicidal behavior was highest among those with both parents convicted; 14.3% (95% CI, 13.0-15.7) of male and 16.6% (95% CI, 15.3-18.0) of female offspring engaged in suicidal behavior by age 30, compared to 4%-4.5% of offspring of parents without convictions. The more adversities accumulated in families with parental offending, the higher the cumulative incidence of suicidal behavior. Genetic factors partly accounted for the association.

CONCLUSIONS: Offspring of parents with violent convictions are a group at high risk of suicidal behavior in need of early identification, multiagency coordination, and measures to reduce the risk of self-harm and suicide.

PMID:41919313 | DOI:10.1017/S0033291726103717

Int J Paediatr Dent. 2026 Apr 1. doi: 10.1111/ipd.70087. Online ahead of print.

ABSTRACT

BACKGROUND: Epidermolysis bullosa (EB) is a rare disorder characterized by recurrent blisters on the skin and oral mucosa, occurring spontaneously or after minor trauma.

AIM: Evaluate the oral health status of children with EB and parents’ perceptions of its impact on their child’s and family’s quality of life.

DESIGN: A cross-sectional study with age-matched groups was conducted with 42 children (14 with EB and 28 without EB), aged 2-10 years, along with their parents/guardians. Participants were recruited from a reference center and a school clinic. Data demographic and socioeconomic were collected. Oral health-related quality of life (OHRQoL) was measured using the Parental-Caregiver Perceptions Questionnaire (P-CPQ-short form) and Family Impact Scale (FIS). Oral examination included evaluation of gingival condition, malocclusions, dental caries, and oral lesions. Statistical analysis included Chi-square, Mann-Whitney, t-test, and Kruskal-Wallis tests (α = 5%).

RESULTS: Children with EB had significantly higher gingival and plaque indices (p = 0.001; p < 0.001). Parents reported worse OHRQoL for children with EB, especially in “oral symptoms” and “functional limitations” (p < 0.001). FIS scores were similar between groups (p > 0.05). Oral lesions were significantly associated with poorer OHRQoL (p = 0.001).

CONCLUSIONS: Oral lesions were responsible for impacts experienced in children’s daily lives, with significant negative effects occurring through symptoms.

PMID:41919311 | DOI:10.1111/ipd.70087