Nevin Manimala

World J Surg Oncol. 2026 Feb 27. doi: 10.1186/s12957-026-04198-6. Online ahead of print.

ABSTRACT

Triple therapy of hepatic arterial infusion chemotherapy (HAIC) combined with immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) achieves satisfactory clinical efficacy in advanced hepatocellular carcinoma (HCC). However, the optimal therapeutic strategy to improve prognosis in this patient population remains controversial. The objective of this retrospective study was to evaluate the efficacy and safety of HAIC-based therapy, either sequentially (SE) or concurrently (Con) combined with targeted immunotherapy, in patients with Barcelona Clinic Liver Cancer (BCLC) stage C HCC. This retrospective study analyzed 235 patients with advanced HCC who received FOLFOX-based HAIC in combination with ICIs and TKIs either concurrently or sequentially at the Affiliated Hospital of North Sichuan Medical College from January 2020 to December 2024. Propensity score matching (PSM) was performed at a 1:1 ratio to eliminate potential imbalances in confounding factors. Patients were categorized into the sequential group (SE) and concurrent group (Con) based on whether the interval between the completion of HAIC and the initiation of systemic therapy exceeded three weeks. Following PSM, each group contained 85 patients. Statistical comparisons of Overall Survival (OS) (via Kaplan-Meier and log-rank tests) revealed a significantly longer median survival in the Con group (14.5 months) versus the SE group (11.2 months, P < 0.01). Furthermore, the median Progression-Free survival (PFS) in the Con group (7.9 months) was also longer than that in the SE group (6.2 months). Treatment responses and adverse events (AEs) profiles were documented. Upon analysis according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST), the objective response rate (ORR) of the SE regimen was lower than that of the Con regimen. The Con group had a generally higher AE incidence, with significantly higher rates of hyperbilirubinemia (44.7% vs. 24.7%, p = 0.04 < 0.05) and anemia (43.5% vs. 16.5%, p = 0.005 < 0.05) than the SE group. No grade 5 severe and life-threatening AEs were reported in either group.

PMID:41749226 | DOI:10.1186/s12957-026-04198-6

BMC Nurs. 2026 Feb 26. doi: 10.1186/s12912-026-04470-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The triage system is a process that is used to prioritise patient-care based on the urgency of their medical need. The triage system helps to expedite the delivery of time-critical treatment for patients with life-threatening conditions, to ensure that all patients are appropriately prioritised according to their medical urgency, improve patient flow, and improve patient satisfaction. However, based on our knowledge there’s no developed tool that assesses Clinical Triage Readiness and Practice among midwives, particularly in our context.

AIM: This study aims to primarily develop the clinical triage readiness and practice assessment tool for midwives, and second, to use the scale to identify and describe factors influencing clinical triage readiness and practices among midwives in resource-constrained district hospitals in Mpumalanga Province.

METHODS: A quantitative, cross-sectional, and descriptive research design underpinned this study. A stratified random sampling approach was used to select participants from a population of 300 midwives working in the maternity units. Data were collected using a self-developed questionnaire, and only 150 questionnaires were returned filled. The data were organised and analysed using the Statistical Package for Social Sciences (SPSS) version 29.0 computer software. Exploratory factor analysis using principal component analysis was conducted to determine the underlying dimensional structure of the instrument, followed by Cronbach’s alpha to assess the internal consistency of each extracted dimension. Logistic regression analysis was used to identify factors influencing triage practices.

RESULTS: The factor analysis illuminates that clinical triage readiness and practices can be assessed by six factors. Among the factors are knowledge and usefulness, organisational and policy readiness for triage, midwives’ skills and teamwork, patient-related challenges, and resource and infrastructure constraints. The study further yields that knowledge and usefulness, and organizational support/staff well-being are positively associated with good practice.

CONLUSION: This study developed the clinical triage readiness and practice assessment tool to assess factors influencing clinical triage readiness and practices among midwives in maternity units. The tool demonstrated acceptable reliability and a clear multidimensional structure, capturing individual, organisational, patient-related, and health system influences on triage. The study underscored that knowledge and usefulness, organisational support and staff well-being is positively associated with good practice. Therefore, theses findings advocates for an clinical environment that supports the psychological well-being of midwives to enhance quality triage practice.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41749222 | DOI:10.1186/s12912-026-04470-w

BMC Med Educ. 2026 Feb 27. doi: 10.1186/s12909-026-08875-8. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Academic resilience is a critical determinant of progress. Nursing students face significant stress due to both theoretical and clinical challenges. This study aimed to identify the level of academic resilience and its statistically associated factors among nursing students using self-report measures.

METHODS: In this correlational study, 375 undergraduate nursing students from three major medical universities in Tehran were selected via stratified random sampling (proportional to strata size) during April-May 2025. Data collection utilized the Academic Resilience Scale (ARS) and a researcher-developed questionnaire (validated via content and face validity). Data were analyzed using descriptive statistics, non-parametric tests, and multiple linear regression, with careful monitoring of residual diagnostics and multicollinearity (VIF).

RESULTS: The students’ mean academic resilience score was 89.89 ± 12.49, indicating a moderate-to-high level. Regression analysis identified seven significant statistical predictors: gender, health status, living situation, satisfaction with major, support resources, nutrition, and non-smoking. These factors collectively explained 19.6% (Adjusted R²) of the variance in resilience.

CONCLUSION: While several individual and social factors are associated with resilience, the cross-sectional nature of the study limits causal inferences. Interventions focusing on lifestyle and support systems may enhance resilience.

PMID:41749219 | DOI:10.1186/s12909-026-08875-8

Popul Health Metr. 2026 Feb 26. doi: 10.1186/s12963-026-00461-w. Online ahead of print.

ABSTRACT

While Poverty-Free Life Expectancy captures the average number of years individuals are expected to live above the poverty threshold, it fails to account for disparities in the distribution of these years across the population. Inspired by recent developments in the measurement of Healthy Lifespan Inequality, we propose a new indicator: Poverty-Free Lifespan Inequality. This paper introduces the formal definition of Poverty-Free Lifespan Inequality, elaborates its mathematical foundations, and discusses its policy relevance. Using Sullivan-type methods and age-specific poverty prevalence data, we derive the distribution of exit from poverty-free life and compute inequality using the Gini index. We demonstrate that Poverty-Free Lifespan Inequality provides critical insights into the heterogeneity of economic well-being over the life course.

PMID:41749198 | DOI:10.1186/s12963-026-00461-w

BMC Health Serv Res. 2026 Feb 26. doi: 10.1186/s12913-026-14059-3. Online ahead of print.

NO ABSTRACT

PMID:41749191 | DOI:10.1186/s12913-026-14059-3

BMC Med Educ. 2026 Feb 27. doi: 10.1186/s12909-026-08870-z. Online ahead of print.

NO ABSTRACT

PMID:41749190 | DOI:10.1186/s12909-026-08870-z

BMC Oral Health. 2026 Feb 26. doi: 10.1186/s12903-026-07977-5. Online ahead of print.

NO ABSTRACT

PMID:41749184 | DOI:10.1186/s12903-026-07977-5

J Cosmet Dermatol. 2026 Mar;25(3):e70755. doi: 10.1111/jocd.70755. Epub 2026 Feb 24.

ABSTRACT

BACKGROUND: Numerous retinoid‐based skincare products are available over‐the‐counter for photodamaged and photoaged skin, but are associated with objective (e.g., erythema, dryness, flaking, edema) and subjective (e.g., itching, tingling, stinging, burning) tolerability issues. A novel retinal formulation was developed using an engineered biomimetic vegan exosome as a delivery system. The formulation also contains proprietary and potent hyaluronic acid, as well as plant‐based actives commonly used in traditional herbal medicines for their anti‐inflammatory and antioxidant properties.

AIMS: Evaluate the efficacy and tolerability of this biomimetic exosome‐encapsulated retinal product for treatment of mild‐to‐moderate facial photodamage.

PATIENTS/METHODS: Twenty females aged 35 to 65 years, with Fitzpatrick skin types I‐VI, mild‐to‐moderate facial fine lines and wrinkles, and mild‐to‐moderate facial photodamage, were assessed at screening/baseline and weeks 2, 4, 8, and 12. Investigator‐ and participant‐assessed evaluations were performed at each visit. The primary objective was to demonstrate a decrease in the appearance of fine lines and wrinkles, erythema, as well as a reduction of overall facial photodamage after a 12‐week topical regimen. The secondary objective was to measure the frequency of adverse events throughout the study.

RESULTS: Statistically significant improvements in erythema, skin tone, skin texture, and lines/wrinkles were observed at all follow‐up visits, compared to baseline. At weeks 8 and 12, all participants (100%) displayed improvements in facial aesthetics. Most participants (19/20; 95.00%) were satisfied with the product and would recommend it to others. No product‐related adverse events were reported.

CONCLUSIONS: Daily use of this “hydrating retinal” improved signs of facial photodamage with none to mild signs of skin irritation.

PMID:41735774 | PMC:PMC12932260 | DOI:10.1111/jocd.70755

Sports Med Open. 2026 Feb 24;12:14. doi: 10.1186/s40798-026-00987-1. eCollection 2026 Dec.

ABSTRACT

BACKGROUND: Rugby union is a popular contact sport during which high impact collisions frequently occur. There is concern for the overall brain health of those playing the game, as concussion is a potential outcome of high impact collisions. Repeated sub-concussive collisions may compromise rugby players’ neurological integrity, but little is known about the effects on young brains. The brain is still developing during adolescence and may generally be more susceptible to injury, but minimal objective research data are available regarding head acceleration events experienced by junior players.

RESULTS: Forty-one adolescent male rugby players underwent pre- and post-season MRI scans and neuro-cognitive assessments. Participants were fitted with instrumented mouthguards to record head acceleration events experienced during the season. Post-season processing of MRI scans focused on within-subject analysis of pre- to post-season changes in white matter as measured by diffusion tensor imaging. Linear mixed models were used to investigate correlations between neurological changes and cumulative head impact loading recorded by the mouthguards. MRI results indicated a non-significant difference between pre- and post-season for data relating to brain structure and function, including white matter microstructure, in response to one season of contact training and match play for under-16 male rugby players, as measured by diffusion tensor imaging. These results held irrespective of level of exposure.

CONCLUSIONS: Our data suggest that exposure to one season of rugby does not appear to result in neurological compromise. The statistical non-significance reported for the main outcome measure also held when controlling for variables, such as training age and headgear use. Although pre- to post-season differences were statistically non-significant, the long-term effects of high exposure may be of clinical significance going forward. Further research, particularly using longitudinal designs, is needed to further elucidate the potential for microstructural neurological changes in adolescent rugby players.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40798-026-00987-1.

PMID:41733814 | PMC:PMC12932775 | DOI:10.1186/s40798-026-00987-1

Ann Noninvasive Electrocardiol. 2026 Feb 24;31(2):e70162. doi: 10.1111/anec.70162. eCollection 2026 Mar.

ABSTRACT

OBJECTIVE: This study compared the accuracy of three transthoracic echocardiographic (TTE) techniques—fractional shortening (FS), left ventricular outflow tract velocity‐time integral (LVOT/VTI), and Simpson’s method—for measuring cardiac output (CO) and stroke volume (SV) in hemodynamically unstable patients (systolic pressure < 90 mmHg), using pulse index continuous cardiac output (PiCCO) as the reference.

METHODS: A retrospective analysis was conducted involving 12 patients admitted to an Emergency Intensive Care Unit between October 2023 and October 2024, who underwent a total of 54 echocardiographic examinations. The median length of hospital stay is 14 days. CO and SV values obtained using the three TTE methods as part of routine assessment were compared with simultaneous PiCCO measurements. The median number of examinations for patients is 4. Statistical analysis was performed using correlation methods.

RESULTS: All three TTE methods demonstrated the capability to estimate CO and SV. The VTI method showed the highest overall accuracy (CO‐VTI vs. CO‐PiCCO: r = 0.950, p< 0.001). Under reduced CO conditions, correlations between echocardiographic and PiCCO‐derived measurements decreased for all methods; however, the VTI method maintained superior reliability (r = 0.606, p = 0.006). In contrast, the Simpson’s method did not accurately reflect CO in this setting (SV‐Simpson vs. SV‐PiCCO: r = 0.408, p = 0.083). Notably, the performance of the VTI method remained consistent regardless of SV or heart rate variations (SV‐VTI vs. SV‐PiCCO: overall r = 0.970; with heart rate > 100 bpm, r = 0.946; with heart rate ≤ 100 bpm, r = 0.988).

CONCLUSION: The LVOT/VTI method exhibits the highest accuracy and consistency for measuring SV and CO, making it the preferred non‐invasive technique for hemodynamic evaluation in critically ill patients.

PMID:41735802 | PMC:PMC12932115 | DOI:10.1111/anec.70162