Nevin Manimala

Cureus. 2026 Jun 7;18(6):e110395. doi: 10.7759/cureus.110395. eCollection 2026 Jun.

ABSTRACT

Background Healthcare workers (HCWs) faced substantial psychological pressure during the COVID-19 pandemic. Evidence from Indian tertiary care settings during the acute phase of the outbreak remains limited. This study examined the prevalence of anxiety, depression, and stress among doctors and nurses at a New Delhi tertiary care hospital during the early pandemic period. Methods An anonymous, cross-sectional online survey was conducted among 100 HCWs (84 doctors, 16 nurses) at Moolchand Hospital, New Delhi. The Depression, Anxiety and Stress Scale-21 (DASS-21) was used to quantify psychological morbidity. Sociodemographic and occupational data, including infection-control training adequacy, trust in personal protective equipment (PPE) supply, and perceived social support, were collected via a structured questionnaire. Descriptive statistics were used to characterise the cohort and the prevalence of psychological symptoms. Results The cohort comprised 53 (53.0%) male and 47 (47.0%) female participants; the majority (40, 40.0%) were aged 31-40 years. Anxiety was the most prevalent psychological outcome (65, 65.0%), followed by depression (20, 20.0%) and stress (15, 15.0%). Insomnia was the most frequently reported individual symptom (43, 43.0%). Participants commonly reported inadequate infection control training, limited trust in PPE adequacy, and self-imposed isolation from family members to reduce transmission risk. Fear of infecting family members and perceived stigma were recurrent qualitative themes. Conclusions Psychological morbidity, particularly anxiety, was highly prevalent among doctors and nurses at a New Delhi tertiary hospital during the acute phase of the COVID-19 pandemic. Modifiable factors such as infection control training, PPE provision, and social support emerged as important considerations for institutional response. These findings contribute to the evidence base informing mental health preparedness frameworks for future infectious disease outbreaks, particularly in lower-middle-income country settings.

PMID:42416930 | PMC:PMC13340416 | DOI:10.7759/cureus.110395

Cureus. 2026 Jun 7;18(6):e110379. doi: 10.7759/cureus.110379. eCollection 2026 Jun.

ABSTRACT

Objectives To compare the short- and mid-term surgical outcomes in patients undergoing mini-thoracotomy (MT) and conventional open thoracotomy (COT) as anterior approaches to the thoracic spine. Methods Data were collected for adults who underwent thoracic spine procedures via an anterior surgical approach for various indications at the Department of Neurosurgery, Queen Elizabeth Hospital Birmingham (QEHB), between 2016 and 2021. Electronic medical records and clinical imaging of the patients enrolled on the study were reviewed. Primary outcomes measured were complications and post-operative pain levels. Secondary outcomes included the lengths of hospitalisation and intensive care unit (ICU) stays, estimated blood loss (EBL), duration and output of the post-operative chest drain, operation time, and radiation exposure. These outcomes were then compared between the MT and COT cohorts. The software, IBM SPSS Statistics, version 28 (IBM Corp., Armonk, NY, USA), alongside parametric and non-parametric tests, was used, with a p-value set at <0.05. Results A total of 31 patients (18 females and 13 males) with an average age of 53±15 were included. Fourteen underwent MT, while 17 had COT. There were no significant demographic differences between the cohorts. MT resulted in fewer complications, but the difference was not statistically significant. Pain levels were lower at 48 hours post-operation but higher on discharge in MT. Secondary outcome results yielded that the MT group had a statistically significant 80% shorter post-operative ICU stay than the COT group (p=0.034). Duration of the procedure and EBL were comparable in both groups. The differences between duration and output of the chest drain and post-operative opioid use favoured MT, but were not statistically significant. Conclusion Based on our study, MT is non-inferior to COT. MT seemed related to shorter post-operative ICU stay and is potentially positively associated with the other outcomes. However, studies involving larger patient cohorts are required to verify the statistical significance and clinical relevance of these observations.

PMID:42416929 | PMC:PMC13338813 | DOI:10.7759/cureus.110379

Poult Sci. 2026 Jul 3;105(10):107393. doi: 10.1016/j.psj.2026.107393. Online ahead of print.

ABSTRACT

This study evaluated a microencapsulated blend of organic acids and cinnamon extract (OAs-C) as a natural alternative to antibiotic growth promoters. A total of 360 day-old male Ross 308 chicks were assigned to four dietary treatments: a negative control (NC), a positive control with antibiotics (PC), and two supplement levels at 1.5 or 3.0 g/kg. The 3.0 g/kg dose significantly increased body weight gain (BWG; P = 0.005) and improved the cumulative FCR (P = 0.014). Feed intake (FI), Newcastle disease virus antibody (NDV) titers or serum antioxidant parameters, specifically malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) remained statistically unaffected by the OAs-C treatments (P > 0.05). Morphometric analysis of the jejunum revealed that villus height (VH) and villus width (VW) were not significantly influenced by the 1.5 and 3 g/kg OAs-C. The PC and 1.5 g/kg groups significantly reduced jejunal crypt depth (CD; P = 0.033). Compared to the control, birds supplemented with 1.5 g/kg OAs-C achieved the highest VH/CD ratio (quadratic P-value = 0.021). Furthermore, the 3.0 g/kg inclusion level significantly expanded the villus surface area (VSA) with linear (P = 0.030) trend. Apparent ileal Ash digestibility showed significant linear (P = 0.041) and quadratic (P = 0.038) effects. Supplementation with 3.0 g/kg OAs-C induced significant linear and quadratic increases (P < 0.01) in the digestibility of crude protein (CP) and calcium (Ca). Regarding apparent ileal phosphorus (P) digestibility, a significant quadratic response (P < 0.001) was observed, with the 1.5 g/kg dose providing the optimal result. In conclusion, the microencapsulated OAs-C blend enhances broiler growth and feed efficiency primarily by optimizing intestine morphology and improving nutrient utilization.

PMID:42413181 | DOI:10.1016/j.psj.2026.107393

J Contam Hydrol. 2026 Jun 29;282:105035. doi: 10.1016/j.jconhyd.2026.105035. Online ahead of print.

ABSTRACT

Groundwater contamination associated with legacy landfills is a major environmental concern in rapidly urbanising regions. This study investigates the seasonal hydrogeochemical characteristics of groundwater surrounding the Ghazipur landfill in East Delhi, India, using an integrated framework that combines compositional data analysis (CoDA), entropy-weighted water quality indexing (EWQI), multivariate statistics, hydrochemical facies analysis, and hydrogeological interpretation. Groundwater samples collected during the pre-monsoon (n = 14) and monsoon (n = 60) seasons of 2023 were analysed for major ions and physicochemical parameters. Hydrochemical facies analysis, Gibbs plots, bivariate relationships, and CLR-transformed PCA collectively indicate that groundwater chemistry is predominantly influenced by anthropogenic salinity enrichment associated with landfill leachate and urban contamination. Strong near-stoichiometric Na⁺-Cl^– relationships suggest conservative dissolved-ion transport within the shallow aquifer system, whereas NO₃^– exhibited spatially heterogeneous behaviour independent of the dominant salinity system, indicating mixed anthropogenic nitrogen inputs potentially associated with landfill-derived nitrogen transformation, sewage leakage, urban wastewater, and regional slaughterhouse-related organic waste activities. Monte Carlo sensitivity analysis confirmed that the nitrate dominant PCA structure remained statistically robust despite unequal seasonal sample sizes. Spatial EWQI mapping revealed substantial monsoonal expansion of groundwater-quality deterioration, particularly within downgradient southeastern sectors of the study area. The study demonstrates that monsoonal recharge enhances contaminant redistribution and modifies hydrochemical structure within shallow urban aquifers rather than simply diluting groundwater chemistry. The integrated CoDA-based framework implemented in this study provides an effective approach for evaluating complex groundwater contamination processes in landfill-affected urban environments.

PMID:42413164 | DOI:10.1016/j.jconhyd.2026.105035

J Am Med Dir Assoc. 2026 Jul 7;27(9):106371. doi: 10.1016/j.jamda.2026.106371. Online ahead of print.

ABSTRACT

OBJECTIVES: The diagnosis of depression may be challenging in older adults with dementia because of atypical symptoms and overlap with other comorbidities. While the Cornell Scale for Depression in Dementia (CSDD) is the gold standard for screening, the Saint Louis University-Appetite, Mood, Sleep, Activity, and Thoughts of Death (SLU-AMSAD), another brief screening tool designed to assess late-life depression, seems to be more practical than the CSDD, with a shorter test duration.

DESIGN: Cross-sectional validation study.

SETTING AND PARTICIPANTS: In this study, conducted at a geriatric outpatient clinic, a total of 111 patients with dementia were enrolled, and both depression and dementia were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria.

METHODS: The SLU-AMSAD was administered to both patients and caregivers, along with the CSDD. Spearman’s rank correlation coefficient was used to assess the correlation between the SLU-AMSAD and CSDD. The diagnostic accuracy of the SLU-AMSAD was evaluated using receiver operating characteristic analysis, with the area under the curve (AUC).

RESULTS: Caregiver-reported SLU-AMSAD scores demonstrated a strong correlation with CSDD (r = 0.875; P < .001), whereas patient-reported SLU-AMSAD scores exhibited a moderate positive correlation (r = 0.384; P < .001). With an optimal cutoff of ≥3, diagnostic performance was substantially stronger for the caregiver-reported SLU-AMSAD-achieving 95.3% sensitivity and 93.6% specificity (AUC, 0.984; 95% CI, 0.965-1.000; P < .001)-whereas the patient-reported SLU-AMSAD yielded a sensitivity of 59.4% and a specificity of 83% (AUC, 0.731; 95% CI, 0.638-0.823; P < .001).

CONCLUSIONS AND IMPLICATIONS: The SLU-AMSAD is a valid and practical screening tool for depression in older adults with dementia. Given the shorter duration and strong caregiver-reported performance, it should be integrated into clinical dementia assessment, facilitating early detection and intervention for depression in such a vulnerable patient group.

PMID:42413154 | DOI:10.1016/j.jamda.2026.106371

J Am Med Dir Assoc. 2026 Jul 7;27(8):106342. doi: 10.1016/j.jamda.2026.106342. Online ahead of print.

ABSTRACT

OBJECTIVES: To examine the short-term within-individual changes in residents’ depressive and behavioral symptoms following the March 2020 lockdown in US nursing homes.

DESIGN: Retrospective cohort study.

SETTING AND PARTICIPANTS: Nursing home residents in US nursing homes operating from 2019 to 2020.

METHODS: Residents in 2020 were considered exposed to the lockdown, and residents in 2019 were considered not exposed to the lockdown. Using the national Minimum Data Set 3.0, outcomes included changes in depressive symptoms (Patient Health Questionnaire [PHQ]-9 or PHQ-10-OV) and behavioral symptoms (Agitated and Reactive Behavior Scale), examined as continuous score changes and binary adverse severity changes between baseline and follow-up (PHQ-9: n₂₀₂₀ = 499,984, n₂₀₁₉ = 514,378; PHQ-10-OV: n₂₀₂₀ = 47,371, n₂₀₁₉ = 51,398; Agitated and Reactive Behavior Scale: n₂₀₂₀ = 628,332, n₂₀₁₉ = 641,403). Mixed-effects models with facility random intercepts estimated changes in symptom scores and generalized estimating equations with a log link to estimate the risk ratios of adverse severity changes. Statistical interactions between the lockdown and resident cognitive impairment, facility ownership, size, overall ratings, and staffing levels were examined. Sensitivity analyses were conducted among residents in states with state-level visitation bans.

RESULTS: No clinically meaningful within-individual, short-term changes in depressive or behavioral symptom scores were observed. Associations did not meaningfully differ across resident cognitive impairment levels, facility characteristics, or states with visitation bans. For residents with minimal or mild depressive symptoms at baseline, those exposed to the lockdown were 22% and 39% more likely to experience worsening symptoms than those unexposed, whereas those with very severe behavioral symptoms at baseline were 7% less likely to show no improvement. These associations were slightly stronger in states with visitation bans.

CONCLUSIONS AND IMPLICATIONS: Findings should be interpreted with measurement sensitivity, residents’ lived experiences, and nursing home efforts to address social isolation in mind, underscoring the need for more responsive and timely assessments and for balanced approaches that consider both infection control and residents’ psychosocial well-being.

PMID:42413137 | DOI:10.1016/j.jamda.2026.106342

Biomedica. 2026 Apr 28;46(Sp. 1):118-128. doi: 10.7705/biomedica.8220.

ABSTRACT

Introducción. Las infecciones virales, bacterianas y fúngicas constituyen un importante problema de salud, asociado a un incremento significativo de la morbimortalidad de las enfermedades respiratorias. Objetivo. Caracterizar las infecciones respiratorias y sus agentes etiológicos en pacientes de los dos hospitales de tercer nivel de Guayaquil (Ecuador) durante los primeros seis meses del 2024. Materiales y métodos. Estudio observacional, transversal y prospectivo de dos hospitales, entre el 1° de enero y el 30 de junio del 2024. Se recopilaron los datos demográficos, clínicos y microbiológicos (fechas, edad, sexo, tipo de muestra, resultados y diagnósticos), los cuales fueron analizados mediante el programa estadístico IBM SPSS™ Statistics 27.0. Resultados. De los 56 pacientes incluidos, 35 presentaron infecciones respiratorias, con predominio del sexo femenino y con una edad promedio de 49 años. Se identificaron los siguientes agentes: rinovirus-enterovirus, virus de la influenza A, coronavirus, virus de la parainfluenza y virus respiratorio sincitial. Entre las bacterias más frecuentes se encontraron: Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenzae, Enterobacter cloacae, Escherichia coli, Proteus spp., Stenotrophomonas maltophilia, Serratia marcescens, Streptococcus agalactiae y Streptococcus pneumoniae. Asimismo, se detectaron genes de resistencia de las bacterias como CTX-M, KPC, mecA/mecC y MREJ, NDM, Oxa48-like y VIM. En el caso de infecciones fúngicas, se aislaron Candida albicans y C. glabrata. La mayoría de los pacientes con enfermedad respiratoria evolucionaron a neumonía intrahospitalaria. Conclusión. Durante el período estudiado, las infecciones respiratorias en las unidades de cuidados intensivos se asociaron principalmente con bacterias patógenas, destacándose la gran frecuencia de neumonías intrahospitalarias y la detección de genes de resistencia antimicrobiana.

PMID:42413100 | DOI:10.7705/biomedica.8220

Psychol Sci. 2026 Jul 7:9567976261459011. doi: 10.1177/09567976261459011. Online ahead of print.

ABSTRACT

Researchers have long debated whether self-esteem is associated with aggression. In this preregistered research, we tested the effects of self-esteem on aggression by using statistical models that control for unmeasured time-invariant confounders. Data came from a multi-wave longitudinal study of 674 Mexican-origin families, including multi-informant assessments of children, mothers, and fathers at 1- or 2-year intervals. There was no evidence of systematic self-esteem effects on aggression, and the results held when we controlled for narcissism and when the influence of shared-method variance could be ruled out. Also, there was little evidence for effects in the reverse direction, that is, from engaging in aggression on self-esteem. One limitation was that in most cases it was not possible to test whether the self-esteem effects were curvilinear because of the nonconvergence of these models. Overall, the findings do not support either low or high self-esteem as a risk factor for aggression.

PMID:42413080 | DOI:10.1177/09567976261459011

J Clin Oncol. 2026 Jul 7:JCO2601147. doi: 10.1200/JCO-26-01147. Online ahead of print.

NO ABSTRACT

PMID:42413068 | DOI:10.1200/JCO-26-01147

JCO Oncol Pract. 2026 Jul 7:OP2501376. doi: 10.1200/OP-25-01376. Online ahead of print.

ABSTRACT

PURPOSE: Social determinants of health (SDOH) shape cancer treatment access, adherence, and outcomes, yet their collection and use within National Clinical Trials Network (NCTN) studies remain poorly defined. This study examined how demographic and SDOH-related variables were historically collected and published to identify gaps that constrain the study of social context within NCTN trials.

METHODS: Participant-level data from completed phase III trials for gastrointestinal (GI) cancers conducted by the Alliance for Clinical Trials in Oncology (Alliance) or its legacy groups from 1999 to 2018 were pooled. Thirteen measures were assessed: four demographic and nine SDOH-related. The proportion of individual participants with data collected for each measure was evaluated. Data utilization was evaluated for all primary articles and via targeted review of related publications using the number either reporting subgroups or publishing analyses for each measure.

RESULTS: A total of 12,701 participants across 11 trials were included. All trials collected demographic measures (<2% of patients missing), insurance status (1% missing), and ZIP code (3% missing). Education level was collected in two trials (28% missing) with marital and employment status collected in one trial (41% missing for both). No trials collected data on other SDOH-related measures. Education level was the only SDOH-related measure reported in primary articles, and none reported analysis of SDOH-related measures. Of the 149 related publications, <2% reported or analyzed any SDOH-related measure.

CONCLUSION: Across Alliance and NCTN legacy group phase III trials for GI cancers, demographic variables have been consistently collected and frequently reported or analyzed, whereas SDOH-related measures are inconsistently collected and rarely published in the literature. These findings demonstrate a historical absence of routine SDOH data capture and utilization within NCTN trials.

PMID:42413064 | DOI:10.1200/OP-25-01376