Nevin Manimala

CJEM. 2026 Jul 27. doi: 10.1007/s43678-026-01247-7. Online ahead of print.

ABSTRACT

OBJECTIVES: Historically, traumatic cardiac arrest studies have described poor survival rates and argued that resuscitation is futile. However, recent reports have demonstrated that survival rates may be higher than previously appreciated. Our objectives were to determine survival rates in traumatic cardiac arrest patients and assess for factors associated with survival to hospital discharge.

METHODS: We conducted a registry review study of adult traumatic cardiac arrest patients (≥ 17 years old) in Nova Scotia over a 16-year period (2007-2023). Data were collected from the paramedic electronic Patient Care Record and the Nova Scotia Trauma Registry. The primary outcome was survival to hospital discharge. We compared characteristics between survivors and non-survivors and assessed for predictors of survival. Descriptive statistics, t-tests, chi-square analysis, and multivariable logistic regression models were used.

RESULTS: A total of 1042 patients were included in the analysis. Ages ranged from 17 to 96 years (mean 50.03 ± 19.2), and 80.7% were male. Most injuries were blunt trauma (71.7%, 747/1042). The overall survival rate was 1.9% (20/1042). Compared to non-survivors, patients who survived to hospital discharge had lower mean Injury Severity Score (17.8 ± 11.1 vs. 34.4 ± 21.3, p < 0.001). On multivariate analysis, survival to discharge was associated with critical care transport (OR 27.16, 95%CI 7.32-103.86) and direct transport to final facility (OR 4.10, 95%CI 1.37-11.80), while increasing Injury Severity Score (OR 0.93, 95%CI 0.88-0.97) was associated with mortality.

CONCLUSIONS: Survival to hospital discharge was observed in 1.9% of traumatic cardiac arrest patients. Critical care transport and direct transport to the final facility were associated with patient survival. The identified predictors of survival may help inform prehospital triage and resuscitation strategies for patients experiencing traumatic cardiac arrest.

PMID:42507326 | DOI:10.1007/s43678-026-01247-7

Infection. 2026 Jul 27. doi: 10.1007/s15010-026-02880-1. Online ahead of print.

NO ABSTRACT

PMID:42507325 | DOI:10.1007/s15010-026-02880-1

Infection. 2026 Jul 27. doi: 10.1007/s15010-026-02881-0. Online ahead of print.

NO ABSTRACT

PMID:42507324 | DOI:10.1007/s15010-026-02881-0

Infection. 2026 Jul 27. doi: 10.1007/s15010-026-02900-0. Online ahead of print.

NO ABSTRACT

PMID:42507323 | DOI:10.1007/s15010-026-02900-0

Infection. 2026 Jul 27. doi: 10.1007/s15010-026-02868-x. Online ahead of print.

ABSTRACT

PURPOSE: Infants too young for primary vaccination face the highest risk of severe pertussis and death. While maternal vaccination is the primary protective strategy, the real-world vaccine effectiveness (VE) of acellular pertussis (aP) vaccines in Thailand (including recombinant aP (aP_gen)) remains unknown. We aimed to evaluate the VE of the aP vaccine in protecting infants under 3 months of age against symptomatic pertussis.

METHODS: This case-control study was conducted in the Narathiwat Province, Thailand, during a pertussis outbreak between September 2023 and October 2024. Participants included 33 symptomatic, polymerase chain reaction (PCR)-confirmed cases, 330 asymptomatic, community-matched controls (for primary comparison), and 41 symptomatic, test-negative controls (for sensitivity simulation). Maternal vaccination with aP vaccine during pregnancy was evaluated against no pertussis vaccination. The main outcome measures were symptomatic PCR-confirmed pertussis. VEs were estimated using a logistic regression model with inverse probability of treatment weighting.

RESULTS: All vaccinated mothers (98 of 404) received aP_gen (94% for standalone aP_gen). The VE of the maternal aP_gen vaccination against symptomatic-PCR confirmed pertussis was 95.3% (95% CI: 64.7%, 99.4%; p = 0.003). A post-hoc E-value sensitivity analysis indicated that it was unlikely that any residual or unmeasured confounders could explain away the statistically significant VE suggesting a robustness of the observed VE.

CONCLUSION: Maternal aP_gen vaccination during pregnancy was highly likely to provide robust VE against symptomatic-PCR confirmed pertussis in infants during the first three months of life. These findings support the maternal pertussis vaccination with recombinant aP vaccines as effective strategy in Thailand and could be considered for other regions.

PMID:42507321 | DOI:10.1007/s15010-026-02868-x

Int J Health Plann Manage. 2026 Jul 27. doi: 10.1002/hpm.70120. Online ahead of print.

ABSTRACT

Healthcare providers worldwide face challenges in maintaining a delicate balance between rising demand and limited resources. Decision-makers often struggle with planning and implementing new services, leading to costly consequences and hindering efficiency, patient outcomes, and staff well-being. Current systems lack a comprehensive modelling approach that encompasses all aspects of the hospital and fails to generate crucial outputs. Moreover, these tools often require expert modelers, limiting their usability for end users such as service managers, clinicians, and management. To address this gap, a user-friendly decision support tool (DST) is developed that empowers key decision-makers to assess the impact of interventions across all hospital operations. Our DST utilises a discrete event simulation model, encompassing specialties and interconnections among hospital services. The model incorporates a dataset of 360 input parameters and statistical distributions, providing a holistic understanding of operations. Through scenarios from 2023-2027, our DST generated diverse outputs, including activity levels, bed and clinic requirements, theatre utilization, and financial implications. Notably, implementing a virtual ward reduced patient backlogs and eased strain on resources from 113% to 80%. Our adaptable DST enables informed decision-making, enhancing patient outcomes and optimising resource utilization. This user-friendly tool revitalises hospital operations for improved efficiency and effectiveness.

PMID:42504764 | DOI:10.1002/hpm.70120

Stat Med. 2026 Aug;45(18-19):e70681. doi: 10.1002/sim.70681.

ABSTRACT

Group testing is widely recognized for its ability to reduce time and cost in screening for rare diseases. However, with limited samples, the parameter estimation from group-testing data might be inefficient. In some scenarios, the external summary statistics are available. To make full use of them, we propose a multiple-source knowledge transfer method. The resulting prevalence estimator is consistent and more efficient than the conventional estimator based on the target group-testing data alone. We establish the asymptotic normality of the proposed estimator. In addition, we develop a data-driven screening procedure to identify the transferable sources. We extend this framework to Dorfman’s two-stage group testing design and show that integrating the retesting data yields efficiency gains. The asymptotic normality of the corresponding estimator is also established. Extensive simulations and a real-data application support the theoretical results and demonstrate the favorable finite-sample performance of the proposed method.

PMID:42504761 | DOI:10.1002/sim.70681

Dev Psychopathol. 2026 Jul 27:1-12. doi: 10.1017/S0954579426101771. Online ahead of print.

ABSTRACT

Early (before age 6) potentially traumatic events (PTEs) may interact with hypothalamic-pituitary-adrenal (HPA) axis functioning to shape outcomes involving externalizing problems and anxiety. However, directions of effects remain unclear. This study examined associations between aspects of HPA axis reactivity, anxiety, and externalizing problems over two years by early PTE exposure history, while statistically capturing the co-occurrence of symptom domains. Youth (N = 189; M_age = 10.96 years, SD = 2.51, Range = 8-15; 52.4% female, 47.1% male; 50.3% White, 35.4% Black/African American, 6.4% Other; 7.4% Hispanic/Latine) were included if they had early PTE exposure (n = 107) or had never experienced a PTE (n = 82). HPA axis reactivity to social stress was calculated using area under the curve with respect to ground (AUCg) and increase (AUCi). For youth with early PTE exposure, higher AUCg was concurrently associated with more externalizing symptoms and greater predominance of externalizing over anxiety. Blunted AUCi predicted increasing predominance of externalizing for the early PTE group, but elevated AUCi predicted increases in anxiety for the no PTE group. Findings highlight distinct roles of overall and reactive HPA axis functioning in shaping outcomes following early trauma.

PMID:42504721 | DOI:10.1017/S0954579426101771

Addiction. 2026 Jul 27. doi: 10.1111/add.70554. Online ahead of print.

ABSTRACT

AIMS: To examine the efficacy of a mobile phone-based brief intervention aimed at reducing driving under the influence of cannabis among emerging adult cannabis users in the context of a randomized 3-group randomized clinical trial (RCT).

DESIGN: Phase II, 3-arm RCT conducted from October 2022 to September 2025, with participants randomized to one of three conditions.

SETTING: Participants were recruited from Western Kentucky University in Bowling Green, KY, and the surrounding community within a 60-mile radius. All interventions were delivered remotely via mobile phone.

PARTICIPANTS: 149 emerging adults who reported driving under the influence of cannabis at least three times in the past 3 months were enrolled in the RCT.

INTERVENTION AND COMPARATOR: Participants in the personalized feedback and motivational interviewing text messaging group (PF + MIT; n = 45) received personalized feedback on substance-impaired driving plus a series of interactive, motivational interviewing-style text messages delivered by a trained graduate student over a single session. Participants in the personalized feedback group (PF; n = 50) received personalized feedback only. The information control group (IC; n = 54) received standard, non-personalized substance use information.

MEASUREMENTS: The primary outcome was the number of times driving under the influence of cannabis in the past 3 months, which was self-reported via mobile web survey during follow-up assessments at 3 and 6 months post-intervention. The secondary outcome was the number of times driving after simultaneous alcohol and cannabis use in the past 3 months.

FINDINGS: Negative binomial mixed models analyses indicated that participants in the PF + MIT group showed statistically significantly greater reductions in driving under the influence of cannabis at 3 months compared with the IC group [incidence rate ratio (IRR) = 0.34, 66% reduction; P < 0.001] and maintained reductions at 6 months (IRR = 0.40, 60% reduction; P < 0.001). Participants in the PF group demonstrated statistically significant reductions in driving under the influence of cannabis at 6 months relative to the IC group (IRR = 0.25, 75% reduction; P < 0.001). No statistically significant differences over time between groups were found for the number of times driving after simultaneous use of alcohol and cannabis.

CONCLUSIONS: A randomized clinical trial found that personalized feedback and motivational interviewing text messaging accelerated reductions in driving under the influence of cannabis at 3-month follow-up compared with controls, and personalized feedback alone showed delayed reductions in driving under the influence of cannabis at 6-month follow-up compared with controls.

PMID:42504715 | DOI:10.1111/add.70554

Acta Oncol. 2026 Jul 27;65:624-631. doi: 10.2340/1651-226X.2026.45981.

ABSTRACT

BACKGROUND AND PURPOSE: To compare follow-up preferences and health-related quality of life between newly operated endometrial cancer patients and those already enrolled in a traditional hospital-based follow-up program, and to explore whether preferences differ depending on follow-up experience. Patient/material and methods: In this prospective cross-sectional study, patients who underwent primary surgery for endometrial cancer in northern Sweden were included. Group 1 consisted of newly operated patients recruited before entering follow-up, and Group 2 included patients already participating in the standard hospital-based follow-up program. Participants completed questionnaires on sociodemographic characteristics, follow-up preferences, and quality of life (EORTC QLQ-C30). Clinical data were obtained from medical records. The primary outcome was follow-up preference; secondary outcomes included quality of life and associations with clinical and demographic variables.

RESULTS: Of the 121 invited patients, 92 (76%) responded, and 90 were included in the analysis (48 in Group 1; 42 in Group 2). The groups were comparable in baseline characteristics. Newly operated patients demonstrated more diverse follow-up preferences, with 51.1% preferring physician-led hospital visits compared to 82.9% in Group 2 (p = 0.035). Global quality of life did not differ significantly (p = 0.165), although Group 1 reported lower functional scores, particularly in role and emotional functioning. Appetite loss was the only symptom that differed significantly between groups.

INTERPRETATION: Newly operated patients are more open to alternative follow-up models despite similar overall quality of life. Integrating patient preferences into follow-up care may enhance personalization and sustainability.

PMID:42504700 | DOI:10.2340/1651-226X.2026.45981