Nevin Manimala

Dev Neurorehabil. 2026 Apr 25:1-7. doi: 10.1080/17518423.2026.2665085. Online ahead of print.

ABSTRACT

BACKGROUND & OBJECTIVE: Dynamic balance is a fundamental component of early motor development and is essential for functional movement and postural control in childhood. The Functional Reach Test (FRT) is widely used as a simple clinical measure of dynamic balance in pediatric populations; however, its relationship with objective postural control parameters, such as center of pressure (COP) displacement, remains unclear in preschool-aged children. The objective of this study was to examine the association between the FRT and forward COP displacement to explore the clinical utility of the FRT in healthy Japanese preschool-aged children.

METHODS: This cross-sectional study included 98 typically developing Japanese children aged 3-6 years. Each participant performed two FRT trials while standing on a force platform, during which COP data were recorded simultaneously. The mean values of the two trials were used for analysis. Correlation analyses were conducted to evaluate the association between FRT performance and forward COP displacement. Data normality was confirmed prior to statistical analysis.

RESULTS: A moderate positive correlation was observed between FRT performance and forward COP displacement (r = 0.566, p < .001). In age-stratified analyses, significant associations were maintained in the 3-, 4-, and 6-year-old groups, while the association was not statistically significant in the 5-year-old group. Children with greater reach distances tended to exhibit larger anterior COP excursions during the reaching task, indicating a meaningful association between clinical FRT performance and objective postural control measures.

CONCLUSIONS: These findings provide supportive evidence regarding the clinical utility of the Functional Reach Test as a simple and clinically practical measure of dynamic balance in preschool-aged children. The FRT may serve as a useful screening tool for assessing balance development in early childhood, particularly in settings where laboratory-based posturography is not available.

PMID:42033140 | DOI:10.1080/17518423.2026.2665085

Nurs Crit Care. 2026 May;31(3):e70505. doi: 10.1111/nicc.70505.

ABSTRACT

BACKGROUND: Timely recognition of cardiac arrhythmias is essential in Intensive Care Units (ICUs). Electrocardiogram (ECG) interpretation is a core component of nursing practice, yet international studies show persistent gaps. In Greece, limited evidence exists regarding ICU nurses’ interpretation, educational preparedness and role perception in ECG interpretation.

AIM: The aim of this study was to evaluate ICU nurses’ knowledge, attitudes and self-perceived preparedness regarding ECG interpretation and to investigate whether these outcomes were associated with demographic and professional characteristics.

STUDY DESIGN: A descriptive, cross-sectional web-based survey was conducted among ICU nurses in Greece between October 2024 and February 2025. The instrument included demographic variables, 10 true/false knowledge items and 10 Likert-scale attitude items. Internal consistency was acceptable (α = 0.81-0.87). Data analysis included descriptive statistics, chi-squared tests and multivariable logistic regression (p < 0.05).

RESULTS: A total of 100 ICU nurses participated in the study. The mean knowledge score was 6.1 ± 1.8/10, with high accuracy on basic items (88%) but low performance on complex patterns (24%). Prior ECG training was the only independent predictor of adequate knowledge (OR = 2.85, 95% CI: 1.12-7.26, p = 0.028). The mean attitude score was 38.4 ± 6.2/50; although 96% recognised ECG interpretation as essential, 49% reported limited knowledge. Positive attitudes were linked to prior training, ICU experience and frequency of ECG evaluation, whereas 25% expressed ambiguity about whether ECG interpretation falls within nursing responsibilities.

CONCLUSIONS: ICU nurses demonstrated moderate theoretical ECG knowledge but variable preparedness and role clarity. Prior training, ICU type and clinical experience were key determinants. Standardised, simulation-based training and clearer responsibility delineation could strengthen cardiac monitoring safety.

RELEVANCE TO CLINICAL PRACTICE: Targeted ECG education and explicit clarification of nurses’ responsibilities in cardiac monitoring are essential to strengthen arrhythmia recognition and timely intervention in ICUs. Implementing structured training pathways and ongoing assessment of ECG interpretation skills may support safer cardiac monitoring practices and more autonomous, confident intensive care nursing.

PMID:42033131 | DOI:10.1111/nicc.70505

Int J Gynaecol Obstet. 2026 Apr 25. doi: 10.1002/ijgo.71038. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess racial and ethnic disparities in preterm delivery in the US and evaluate whether insurance type modifies these associations.

METHODS: We analyzed National Center for Health Statistics natality data (2018-2024) comprising 24,918,700 singleton live births. Preterm delivery was defined as birth before 37 completed weeks of gestation. Multivariable logistic regression with robust variance was used to estimate adjusted odds ratios, predicted probabilities, and absolute risk differences across race/ethnicity and insurance categories, adjusting for maternal sociodemographic, clinical, and obstetric factors.

RESULTS: Overall, 2,134,329 of 24,918,700 singleton live births (8.6%) were preterm during the study period, with annual rates remaining stable between 8.23% and 8.75%. In multivariable-adjusted analyses, non-Hispanic Black women had the highest odds of preterm delivery (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI]: 1.39-1.40), compared with non-Hispanic White women. Racial and ethnic disparities persisted across all insurance strata; among uninsured women, non-Hispanic Black women had the largest absolute risk difference relative to non-Hispanic White women (5.74 percentage points; 95% CI: 5.52-5.96), which was attenuated but remained significant among Medicaid (2.38 percentage points; 95% CI: 2.33-2.43) and privately insured women (2.66 percentage points; 95% CI: 2.60-2.73). Insurance coverage attenuated but did not eliminate these disparities.

CONCLUSION: Racial and ethnic disparities in preterm delivery persist in the US despite insurance coverage, underscoring the need for policies that address both healthcare access and structural determinants of maternal health.

PMID:42033123 | DOI:10.1002/ijgo.71038

Muscle Nerve. 2026 Apr 25. doi: 10.1002/mus.70258. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Quantitative analysis should be useful to all electrodiagnostic medical consultants (EMC). We tested a beta version of the audio-visual electromyography (AVEMG) method that quantifies the audio and visual characteristics of the interference pattern (IP) signal assessed by the EMC.

METHODS: IP was recorded from multiple sites in 10 commonly tested upper and lower limb muscles. For each 200 ms epoch, AVEMG measured its Amplitude, Fullness and Pitch. Pitch reflects the sound characteristics, e.g., dull, sharp. The firing rate of motor units and discreteness of the pattern was also assessed. Reference (RVs) values were defined for Amplitude and Pitch based on Fullness of the pattern using recordings from 10 to 14 normal subjects. Normal and abnormal muscles were tested in 36 patients referred to the laboratory (139 muscles). The concordance between subjective assessment and AVEMG was assessed by a χ² test.

RESULTS: AVEMG successfully rejected most epochs with noise, interference, spontaneous activity, insertional activity and needle artifacts. RVs differed among muscles. As example, the first dorsal interosseous and triceps had the highest Amplitude in upper limb muscles. AVEMG was abnormal in 80% of studies considered abnormal by subjective assessment. The association between subjective assessment and AVEMG was statistically significant (χ² (1, N = 139) = 59, p < 0.0001).

DISCUSSION: AVEMG provides real time quantitation in the background and does not interfere with workflow or add examination time or complexity to the routine needle EMG examination. It will be of interest to further assess its value by refining RVs and performing multicenter studies with operators having different skill levels.

PMID:42033101 | DOI:10.1002/mus.70258

Alzheimers Dement. 2026 Apr;22(4):e71383. doi: 10.1002/alz.71383.

ABSTRACT

INTRODUCTION: The role of life-course socioeconomic position (SEP) in cognitive aging remains unclear. We assessed the association between life-course SEP with cognitive change and prevalent mild cognitive impairment (MCI).

METHODS: We used data from the Hispanic Community Health Study/Study of Latinos (2008 to 2011) and its Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) ancillary study (2015 to 2018, n = 6351; aged ≥45 years). Weighted linear and logistic regression analyses estimated the association between childhood and adult SEP (low and high) and socioeconomic mobility (enduring high or low SEP, upward or downward mobility) with change in cognitive function and prevalent MCI, respectively.

RESULTS: Childhood SEP was associated with greater adverse cognitive change but was not associated with prevalent MCI. Low adult SEP, downward mobility, and enduring low SEP were associated with greater adverse cognitive change. Enduring low SEP was additionally associated with higher odds of MCI.

DISCUSSION: Life-course SEP is associated with changes in cognitive aging in middle-aged and older Hispanic/Latino adults.

PMID:42033094 | DOI:10.1002/alz.71383

Alzheimers Dement. 2026 Apr;22(4):e71370. doi: 10.1002/alz.71370.

ABSTRACT

INTRODUCTION: National Veterans Affairs electronic health records were used to examine the association between traumatic brain injury (TBI) severity and four dementia phenotypes ranging from narrow (strict AD) to broad (all-cause dementia).

METHODS: Veterans with TBI (n = 91,753) and a propensity score-matched comparison group of veterans without TBI (n = 183,506) were included. Four validated dementia phenotypes defined using International Classification of Diseases (ICD) codes were evaluated. The association between TBI severity and each dementia phenotype was examined using adjusted logistic regression.

RESULTS: TBI severity was significantly associated with increased odds of developing dementia across the three broader dementia phenotypes in a dose-response manner (moderate/severe/penetrating TBI > mild TBI). Those with unclassified TBI had disease risk falling in between mild and more severe TBI. In contrast, TBI was associated with decreased risk of strict AD across all severity levels.

DISCUSSION: Findings support a dose-response relationship between TBI severity and broader dementia risk but raise questions regarding the TBI-AD link.

PMID:42033091 | DOI:10.1002/alz.71370

Clin Chem Lab Med. 2026 Apr 20. doi: 10.1515/cclm-2026-0435. Online ahead of print.

ABSTRACT

OBJECTIVES: Large language models (LLMs) show promise for interpreting laboratory reports, yet real-world validation remains limited. This study evaluated five advanced LLMs in interpreting urinalysis reports for kidney diseases using real-world clinical data, providing empirical evidence for the utility of LLM-assisted result interpretation.

METHODS: We retrospectively collected 120 urinalysis reports from patients with primary glomerular diseases and secondary nephropathies. The testing platforms included the Sysmex UF5000 and Mindray EU8600. Five LLMs (ChatGPT-5, Claude-4.5, Gemini-2.5, DeepSeek-V3.1, Qwen-3) were tasked with interpreting reports across five functional dimensions. Four certified laboratory technologists and four licensed physicians evaluated outputs using a 5-point Likert scale across six quality dimensions. Statistical analyses employed Friedman and Wilcoxon signed-rank tests.

RESULTS: All five LLMs demonstrated clinical utility in interpreting urinalysis reports. Proprietary LLMs achieved higher overall scores (Claude-4.5: 4.78 ± 0.47; ChatGPT-5: 4.73 ± 0.50; Gemini-2.5: 4.69 ± 0.54) compared to open-source LLMs (DeepSeek-V3.1: 4.58 ± 0.66; Qwen-3: 4.57 ± 0.69). Across functional dimensions, the models performed proficiently in identifying abnormal parameters and analyzing their correlations, but suboptimally in interpreting instrument flags. Instrument-dependent variability was observed (Sysmex vs. Mindray, p<0.001). In quality assessments, Claude-4.5 exhibited the best overall performance, ChatGPT-5 excelled in accuracy and clarity, and Gemini-2.5 demonstrated strong practicality. Regarding safety, Claude-4.5 exhibited the lowest hallucination rate (7.5 %). Common hallucinations included misinterpretation, definition errors, and over-interpretation.

CONCLUSIONS: LLMs demonstrate significant capability in urinalysis interpretation, though proprietary models currently excel in reasoning and hallucination resistance. Instrument-specific flag interpretation and hallucination mitigation remain critical challenges requiring Retrieval-Augmented Generation (RAG) integration and human oversight.

PMID:42033087 | DOI:10.1515/cclm-2026-0435

Cancer Med. 2026 May;15(5):e71837. doi: 10.1002/cam4.71837.

ABSTRACT

BACKGROUND: Allostatic load (AL) reflects the cumulative physiological burden of chronic stress across cardiovascular, metabolic, immune, and renal systems. While AL has been implicated in cancer development, evidence in Asian populations remains limited. We examined sociodemographic and lifestyle factors of AL and its association with colorectal cancer (CRC) risk in a multiethnic Asian cohort.

METHODS: Data were drawn from 30,443 Chinese, Malay, and Indian adults (≥ 18 years) between 2004 and 2016. Participants were followed from baseline assessment until CRC diagnosis, death, or end of follow-up, whichever occurred first (median follow-up: 7.2 years). AL was derived from nine biomarkers, with high-risk cutoffs set at the 75th percentile (≤ p25 for HDL). High AL was defined as a score ≥ 3. CRC incidence was ascertained through linkage with the Singapore Cancer Registry. Modified Poisson regression was used to identify factors associated with high AL, and Cox proportional hazards models assessed associations with incident CRC. CRC incidence was ascertained through linkage with the Singapore Cancer Registry.

RESULTS: During follow-up, 162 CRC cases were observed; 60.3% of participants had high AL. Older age, male sex, Malay and Indian ethnicity, lower education, unemployment, diabetes, low physical activity, and prolonged sitting were significantly associated with higher AL scores. High AL was associated with increased CRC risk after adjustment for age, sex, ethnicity, and cohort (aHR = 1.53; 95% CI = 1.10, 2.14). The association remained similar in models additionally adjusting for SES, smoking, history of diabetes, or physical activity and sitting time.

DISCUSSION: These findings are consistent with prior research in Western populations and highlight AL as a potential biomarker for identifying individuals at increased CRC risk. Incorporating AL into population health strategies may support earlier detection and targeted prevention in Asian settings.

PMID:42033061 | DOI:10.1002/cam4.71837

Physiol Rep. 2026 Apr;14(8):e70887. doi: 10.14814/phy2.70887.

ABSTRACT

Heart rate variability (HRV) is widely used to assess cardiac health, yet uncertainty persists regarding HRV variations across the menstrual cycle and their association with reproductive hormones. Few studies have evaluated the full spectrum of HRV parameters, and most estimated menstrual phases from the last menstrual period without considering individual cycle length. This study aimed to compare HRV parameters across three menstrual phase groups, using accurate cycle tracking based on the next menstrual period and actual cycle length, and to correlate HRV with estradiol, progesterone, and the estradiol/progesterone (E/P) ratio. In 112 healthy women with regular cycles, HRV parameters were measured using a heart rate sensor, and serum hormone levels were obtained. Menstrual phase groups were defined using back-extrapolation from the next cycle. Data from 99 participants were analyzed: menstruation (n = 38), periovulatory (n = 30), and premenstrual phase (n = 31). HF was significantly higher during the peri-ovulatory phase, while estradiol and progesterone peaked premenstrually. The E/P ratio was highest pre-ovulatory. Estradiol correlated with most HRV measures; however, only the mean RR-interval in the premenstrual phase was statistically significant, with estradiol emerging as a negative independent predictor. These findings conclude notable HRV variation across menstrual phases and suggest that estradiol fluctuations may influence autonomic regulation.

PMID:42033060 | DOI:10.14814/phy2.70887

Angew Chem Int Ed Engl. 2026 Apr 24:e2407356. doi: 10.1002/anie.2407356. Online ahead of print.

ABSTRACT

Infrared nonlinear optical (NLO) materials are essential for laser and photonic technologies, limited by fragmented material systems, lengthy development cycles, and trial-and-error synthesis. To overcome these barriers, we developed an integrated computational-experimental framework integrating first-principles high-throughput calculations, machine learning, and targeted synthesis. We establish a multidimensional properties dataset of 1807 non-centrosymmetric compounds and define a comprehensive figure of merit (CFOM) Q based on the statistical average of this dataset to quantify performance trade-offs. Multidimensional statistical analysis uncovers composition-structure-performance relationships, and reveals superior structure and chemical compositions governing enhanced NLO performance. A Q-based crystal graph neural network classifier is developed, achieving strong predictive accuracy (AUC = 0.95). We identify 12 unreported candidates (Q > 2) from 5105 compounds combining high-throughput calculation and machine learning. Experiments confirm that defect-chalcopyrite HgAl₂Q₄ (Q = S, Se, Te) shows wide band gaps (1. 55-2.82 eV), suitable birefringence (0.06-0.08), and strong NLO responses (2.2-5 × AGS). This work provides an effective pathway for accelerating the discovery of high-performance optoelectronic materials.

PMID:42033040 | DOI:10.1002/anie.2407356