Nevin Manimala

ACS Appl Mater Interfaces. 2026 Jul 25. doi: 10.1021/acsami.6c12660. Online ahead of print.

ABSTRACT

3D printing has enabled the development of patient-specific drug delivery systems and medical devices. Here, we report the fabrication of microneedle arrays using visible light-mediated photoinduced electron/energy-transfer-reversible addition-fragmentation chain transfer (PET-RAFT) polymerization via digital light processing (DLP) 3D printing. A series of formulations based on poly(ethylene glycol) diacrylate (PEGDA), N,N-dimethylacrylamide (DMA), and the RAFT agent 2-(n-butyltrithiocarbonate)-propionic acid (BTPA) were systematically investigated by varying formulation composition and exposure conditions to evaluate their effects on printability and material properties. The results show that both formulation composition and exposure time influence the successful fabrication of stable microneedle structures. Optimized formulations produced well-defined microneedle arrays with tunable mechanical properties, exhibiting Young’s modulus values of 6-13 MPa and fracture forces of 0.15-0.38 N per needle, exceeding the threshold required for skin penetration. Controlled insertion tests, supported by optical microscopy and optical coherence tomography (OCT), confirmed effective penetration without structural failure. In addition, drug-loaded microneedles demonstrated rapid hydration and diffusion-controlled release while maintaining comparable mechanical integrity after drug incorporation. In vitro biocompatibility studies using human dermal fibroblasts showed no statistically significant reduction in cell viability or metabolic activity following exposure to the printed microneedles. Collectively, these findings demonstrate the potential of visible light-mediated PET-RAFT DLP printing for the fabrication of mechanically robust and functionally tunable microneedle systems for transdermal drug delivery.

PMID:42504440 | DOI:10.1021/acsami.6c12660

Cureus. 2026 Jun 25;18(6):e111524. doi: 10.7759/cureus.111524. eCollection 2026 Jun.

ABSTRACT

Introduction Advance Care Directives and Resuscitation Plans support patient-centred care for high-risk inpatients, particularly when clinical deterioration or end-of-life decision-making is anticipated. This audit aimed to evaluate compliance with Resuscitation Plan documentation requirements among patients who experienced an in-hospital cardiac arrest at a regional Australian hospital. Methods A retrospective clinical audit was conducted involving adult inpatients who experienced a cardiac arrest attended by the Medical Emergency Team over a 3.5-year period at a regional Australian hospital. Patients were identified from the ICU cardiac arrest logbook, and demographic, clinical, and documentation data were extracted from electronic medical records. Descriptive statistics were used to summarise documentation rates, comorbidities, admitting teams, Medical Emergency Team (MET) calls, and survival outcomes. Results Forty-seven inpatients experienced a cardiac arrest during the study period, with a mean age of 72.7 years and a mean pre-arrest length of hospital stay of 3.4 days. Only 17% had a documented Resuscitation Plan at the time of arrest, while 83% had none. Cardiovascular comorbidity was present in 85% of patients, and 23% had a MET response call before arrest; only three of these patients had a subsequent Resuscitation Plan documented. Eighteen patients survived their cardiac arrest, but only five had a Resuscitation Plan completed post-arrest. Conclusions Resuscitation Plan documentation was low in this elderly, high-risk inpatient cohort despite substantial comorbidity and a history of clinical deterioration in many patients. These findings suggest missed opportunities for earlier goals-of-care discussions and support targeted education and system-level interventions to improve documentation compliance.

PMID:42504382 | PMC:PMC13401669 | DOI:10.7759/cureus.111524

Cureus. 2026 Jun 26;18(6):e111526. doi: 10.7759/cureus.111526. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: Child sexual abuse (CSA) remains a pervasive public health and human rights concern in India, with healthcare professionals occupying a critical position in early identification, reporting, and legal compliance. Adequate awareness of CSA and familiarity with the Protection of Children From Sexual Offences (POCSO) Act remain essential for effective child protection.

OBJECTIVES: This study assessed awareness regarding the status of CSA and evaluated knowledge of the POCSO Act among medical and paramedical students in a government medical college in central India.

METHODS: A cross-sectional, questionnaire-based study was conducted among 278 medical and paramedical students. A validated, structured tool comprising two sections assessed awareness of CSA and knowledge of the POCSO Act. Responses were scored and categorized into predefined levels. Descriptive statistical analysis was performed.

RESULTS: Awareness of CSA remained inadequate across both groups, with no participant demonstrating complete awareness. Most medical students exhibited inadequate awareness, while a substantial proportion of paramedical students remained unaware. Knowledge of the POCSO Act was predominantly moderate, with medical students demonstrating comparatively better understanding than paramedical students. Gaps were evident in knowledge related to mandatory reporting, legal procedures, and disclosure dynamics, despite high recognition of the Act’s existence.

CONCLUSION: The findings reveal significant deficiencies in awareness and legal preparedness among future healthcare professionals. Integrating structured, practical, and legally oriented training on CSA and the POCSO Act within medical and paramedical curricula is imperative to strengthen early detection, reporting, and child protection outcomes.

PMID:42504360 | PMC:PMC13401671 | DOI:10.7759/cureus.111526

Adv Sci (Weinh). 2026 Jul 26:e76432. doi: 10.1002/advs.76432. Online ahead of print.

ABSTRACT

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is considered a highly complex, heterogeneous, fatal disease with a high unmet medical need that affects multiple pathophysiological pathways and has no known singular cause. Oxidative stress, however, is implicated as a central player in the progression of ALS and other neurodegenerative diseases. To date, only two FDA-approved drugs, Edaravone, an antioxidant, and Riluzole, an antiglutamatergic, have been widely used clinically, albeit with modest effects on the clinical course of ALS disease progression. Additionally, preclinical studies of both drugs in ALS mouse models have not shown any significant survival benefit, although some abatement in disease progression is observed and translated from preclinical animal models to clinical human studies.

METHODS: Using a trifunctional boron-based drug design strategy, we have synthesized a pyrazole small molecule called Borsantrazole (BSZ) and evaluated BSZ in cell-based experiments, acute and chronic toxicity models, and the SOD1-G37R ALS mouse model. We have also evaluated untargeted global proteomic and phosphoproteomic changes induced by BSZ.

RESULTS: Borsantrazole (a small molecule that can selectively target oxidative stress) with favorable CNS drug like properties (low ER values of 0.9 and 1.0 at 1 and 10 µm, respectively, suggesting lower Pgp efflux liability and the LogD at pH 7.4 was within the range of 1.2 to 3.1, suggesting BSZ is lipophilic at pH 7.4.) shows no signs of treatment associated toxicity (acute or chronic (120 days)), significantly increases survival (whole animals, 15.1 days (p = 0.0326); males, 16.5 days; females, 13.7 days), rescued weight loss (27.1% control, 18.3% BSZ, p < 0.0001), delays symptom onset (whole animals, 24.9 days (p = 0.0011); males, 23.3 days; females, 26.4 days), delays disease onset (whole animals, 25.5 days (p = 0.0001); males, 21.1 days; females, 29.8 days) and affects global proteomic changes in the SOD1-G37R mouse model of ALS. In total, 51 proteins were found to be significantly differentially expressed (p < 0.05), including Ca3, Gan, Cplx2, Lrp4, Sqstm1, and 29 phosphorylation sites were differentially expressed and considered statistically significant, including T317 and T72 for neurofilaments light and heavy chain, respectively.

CONCLUSIONS: Herein, we report that BSZ has demonstrated a favorable safety profile and compelling proof-of-concept efficacy in a ALS mouse model and has the potential to become a disease-modifying ALS therapeutic following further clinical development. Within a broader perspective of treatments for neurodegenerative diseases, BSZ offers a new paradigm for trifunctional small molecule targeting of oxidative stress that can mitigate neuronal deterioration and serve as a potential treatment.

PMID:42503607 | DOI:10.1002/advs.76432

J Nurs Scholarsh. 2026 Jul;58(4):e70116. doi: 10.1111/jnu.70116.

ABSTRACT

INTRODUCTION: Menopause affects nearly one-third of women’s lives and is associated with a wide range of physical and psychological symptoms-including sleep disturbances, mood fluctuations, and reduced quality of life-that represent a significant public health concern. While pharmacological treatments carry well-documented risks, evidence-based non-pharmacological interventions such as Mindfulness-Based Stress Reduction (MBSR) remain understudied in this population, particularly with respect to multiple psychosocial outcomes.

PURPOSE: This study aimed to evaluate the effects of a Mindfulness-Based Stress Reduction (MBSR) program on quality of life, life satisfaction, sleep quality, and mental well-being among menopausal women.

DESIGN: A randomized controlled trial with a pretest-posttest control group design.

METHODS: The study was conducted between February 28 and December 22, 2025, at a primary healthcare center in Türkiye. A total of 84 menopausal women were included (intervention: n = 43; control: n = 41). Data were collected using the Utian Quality of Life Scale, Riverside Life Satisfaction Scale, Pittsburgh Sleep Quality Index, and Warwick-Edinburgh Mental Well-Being Scale. The intervention group participated in an 8-week MBSR program, while the control group received no intervention. Data were analyzed using IBM SPSS Statistics (version 26.0).

FINDINGS: Compared with the control group, participants in the MBSR group demonstrated significant improvements in quality of life, life satisfaction, and mental well-being, along with significant reductions in sleep disturbances (p < 0.001). Within-group analyses showed significant improvements across all outcomes in the intervention group (p < 0.001), whereas no significant changes were observed in the control group (p > 0.05).

CONCLUSIONS: The MBSR program was associated with improvements in psychosocial well-being and sleep quality among menopausal women. These findings suggest that MBSR may be a beneficial non-pharmacological approach for managing menopausal symptoms.

PMID:42503602 | DOI:10.1111/jnu.70116

J Obstet Gynaecol Res. 2026 Aug;52(8):e70423. doi: 10.1111/jog.70423.

ABSTRACT

BACKGROUND: To compare the transvaginal natural orifice transluminal endoscopic surgery (vNOTES) approach versus conventional laparoscopy in bilateral tubal ligation for interval sterilization regarding perioperative outcomes, postoperative pain, and sexual function.

METHODS: This retrospective cohort study at a tertiary center included 88 women who underwent elective tubal ligation between February 2024 and October 2025 (vNOTES: n = 39; laparoscopy: n = 49). Women aged 18-45 years seeking permanent contraception with American Society of Anesthesiologists (ASA) physical status classification ≤ 3 were included. Primary outcomes included operative time and estimated blood loss (assessed by hemoglobin/hematocrit changes). Secondary outcomes included length of hospital stay, postoperative pain assessed using a visual analog scale (VAS) at 6 and 24 h postoperatively, total amount of analgesic requirements and sexual function evaluated using the Female Sexual Function Index (FSFI) preoperatively and at 1 and 6 months postoperatively. Statistical analysis used t-test/Mann-Whitney U test and chi-square/Fisher’s exact test (α = 0.05).

RESULTS: Baseline characteristics were comparable between groups (vNOTES: n = 39; laparoscopy: n = 49). No significant differences were found in hemoglobin changes or operative time. vNOTES demonstrated significantly shorter hospital stay (14.90 ± 7.27 vs. 20.10 ± 3.96 h, p < 0.001), lower postoperative total amount of analgesic requirements (1.72 ± 0.76 vs. 4.88 ± 1.63 doses, p < 0.001), and reduced VAS pain scores at 6 and 24 h. No intraoperative conversions occurred. Complication rates were similar between groups (p > 0.999). FSFI scores showed no significant differences at baseline, 1, or 6 months postoperatively.

CONCLUSION: vNOTES for tubal ligation offers significant advantages in postoperative pain reduction, decreased analgesic requirements, and shorter hospital stay while maintaining comparable operative times, safety, and sexual function outcomes.

PMID:42503601 | DOI:10.1111/jog.70423

Anim Sci J. 2026 Jan-Dec;97(1):e70226. doi: 10.1111/asj.70226.

ABSTRACT

This study characterized the association between the ventral and dorsal ruminal pH in cows. The experiment was conducted with six nonlactating rumen-cannulated Holstein cows fed either a grain-rich diet (65% concentrate in dry matter) or a forage-only diet. The dorsal and ventral ruminal pHs were measured in each cow using two identical indwelling systems, which recorded pH every 5 min. Furthermore, the volatile fatty acid concentrations and osmolality were determined in free ruminal liquid (FRL) of the ventral rumen and dorsal mat particle-associated ruminal liquid (PARL) and in feces. Precision and accuracy properties of dorsal ruminal pH and ventral ruminal pH as a measure of reproducibility were statistically evaluated. Data showed that the concordance correlation coefficient, representing the strength of the relationship between the ventral and dorsal ruminal pHs, was high when feeding the grain-rich diet (0.857), but low when feeding the forage-based diet (0.467), with accuracy of 0.917 and 0.525, and precision 0.935 and 0.890 for grain-rich diet and forage-based diet, respectively. The study established a relationship between ventral and dorsal ruminal pHs showing that ventral pH can serve as a proxy for dorsal pH, though this relationship demonstrated higher reproducibility only when feeding grain-rich diets.

PMID:42503600 | DOI:10.1111/asj.70226

Sports Med. 2026 Jul 26. doi: 10.1007/s40279-026-02506-4. Online ahead of print.

ABSTRACT

BACKGROUND: The annual incidence of Achilles tendon ruptures has increased by almost 3%. Despite the large amount of data available on post-injury treatment, there is a lack of evidence-based criteria to guide return to running after surgery.

OBJECTIVE: The aim of this study was to reach a consensus among experts on the criteria for resuming running following surgery for Achilles tendon rupture.

METHODS: Thirty-five international Achilles tendon experts were invited to participate in this modified Delphi study. The study was conducted in three rounds, with a threshold of 75% agreement (or disagreement) required for an item to achieve consensus. Sixteen clinical criteria were submitted to the expert panel. A five-point Likert scale was used. The study was conducted between January and June 2025.

RESULTS: Eight criteria achieved consensus after three rounds: seven criteria reached consensus for inclusion, and one criterion reached consensus for exclusion (calf circumference symmetry). The seven criteria were (1) the absence of pain in daily life; (2) the absence of pain during and after rehabilitation sessions; (3) walking without limping; (4) the ability to walk on tiptoes; (5) the ability to perform ten single-leg heel rises; (6) good single-leg balance; and (7) the patient feeling psychologically ready to resume running.

CONCLUSION: An expert consensus on the criteria to return to running after surgery for Achilles tendon rupture has been developed. These criteria, agreed by experts, may inform clinical decision making regarding return to running, but they require prospective validation before they can be used as decision rules. Further studies are needed to refine these criteria and evaluate their impact on functional outcomes during the return-to-running phase.

PMID:42503592 | DOI:10.1007/s40279-026-02506-4

Clin Rheumatol. 2026 Jul 27. doi: 10.1007/s10067-026-08318-1. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate whether the first-year cumulative vascular damage index (VDI) could serve as an independent predictor of relapse in patients with granulomatosis with polyangiitis (GPA).

METHODS: We retrospectively analysed 39 patients with GPA enrolled in a single-centre cohort. The first-year cumulative VDI was calculated as the area under the curve (AUC) of VDI scores during the first year using the trapezoidal rule. The earliest VDI, defined as the first VDI recorded ≥ 3 months after AAV diagnosis or AAV symptom onset, was also assessed as a contextual reference. Relapse was defined as the recurrence or new onset of vasculitic manifestations after ≥ 3 months of remission. The predictive accuracy for relapse was assessed using receiver operating characteristic (ROC) curves. Multivariable Cox proportional hazard models were performed to assess whether the first-year cumulative VDI is independently associated with the risk of relapse.

RESULTS: During a median follow-up of 40.6 (13.9-64.7) months, relapse occurred in 18 (46.2%) patients. The first-year cumulative VDI (AUC = 0.817) showed a significant predictive value for relapse, with a numerically higher accuracy than the earliest VDI (AUC = 0.734), although the difference was not statistically significant (p = 0.272). In the multivariable Cox model, the first-year cumulative VDI was significantly associated with relapse risk (adjusted hazard ratio [HR] = 6.536, 95% confidence interval [CI] = 1.746-24.460, p = 0.005), whereas the earliest VDI was not (adjusted HR = 1.358, 95% CI = 0.976-1.889, p = 0.070).

CONCLUSION: The first-year cumulative VDI independently predicts relapse in GPA, and outperformed early single time-point damage assessment. Our findings suggest that early cumulative damage evaluation may improve relapse risk stratification. Key Points • We assessed whether VDI can predict relapse in patients with GPA. • The first-year cumulative VDI was found to independently predict relapse in GPA. • Early cumulative damage evaluation may improve relapse risk stratification.

PMID:42503589 | DOI:10.1007/s10067-026-08318-1

Alzheimers Dement. 2026 Jul;22(7):e71686. doi: 10.1002/alz.71686.

ABSTRACT

INTRODUCTION: Sleep disturbance is common in dementia, impacting daytime function and care. Compared with Alzheimer’s disease (AD), sleep in frontotemporal dementia (FTD) is poorly characterized.

METHODS: We assessed sleep using the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index in 58 people with primary progressive aphasia (PPA) and right temporal variant FTD, 32 with AD, and 36 cognitively healthy older volunteers. All participants had cognitive and behavioral assessments. Groups were compared using non-parametric statistics and correlations assessed sleep versus other indices.

RESULTS: Subjective sleep duration was increased in all syndromic groups. AD and semantic PPA were associated with increased daytime somnolence. Reported sleep quality varied between syndromes. Across the disease cohort, somnolence correlated with behavioral and empathy deficits; in AD, poorer sleep quality correlated additionally with self-monitoring deficits.

DISCUSSION: FTD and AD syndromes have distinct sleep phenotypes, and sleep alterations are associated with behavior. Standard sleep scales require careful interpretation in dementia.

PMID:42503587 | DOI:10.1002/alz.71686