Nevin Manimala

J Affect Disord. 2026 Mar 13:121626. doi: 10.1016/j.jad.2026.121626. Online ahead of print.

ABSTRACT

BACKGROUND: Non-suicidal self-injury (NSSI) constitutes a major public health concern among adolescents. Although impulsivity is a recognized risk factor, its specific role in value-based decision-making remains elusive. This study examined delay and probability discounting patterns in adolescents with NSSI compared to healthy controls across both gain and loss domains, identifying specific decision-making alterations associated with self-injurious behavior.

METHODS: Eighty-two adolescents (42 with NSSI absent of psychiatric comorbidities and 40 healthy controls) completed computerized delay and probability discounting tasks. Both tasks assessed decision-making using hypothetical monetary gains and losses. Discounting rates were quantified using area under the curve analyses.

RESULTS: For delay discounting, adolescents with NSSI discounted delayed gains more steeply than healthy controls, reflecting a stronger preference for immediate rewards. In contrast, group differences for delayed losses were non-significant and statistically equivalent to zero. Furthermore, no significant group differences emerged for either gains or losses in the probability discounting task.

LIMITATIONS: The cross-sectional design, the modest sample size, and the reliance on hypothetical rather than real-world monetary outcomes limit ecological validity and constrain causal inference.

CONCLUSIONS: These preliminary findings suggest that NSSI in adolescents may be associated with a preferential sensitivity to reward immediacy, rather than generalized deficits across all decision-making domains. This behavioral profile supports models conceptualizing NSSI as an emotion-regulation strategy prioritizing immediate relief over long-term benefits, highlighting delay tolerance as a potential target for intervention.

PMID:41833610 | DOI:10.1016/j.jad.2026.121626

J Vasc Surg. 2026 Mar 13:S0741-5214(26)00215-6. doi: 10.1016/j.jvs.2026.02.042. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the impact of aneurysmal sac regression versus failure to regress on perioperative and long-term outcomes after endovascular aortic aneurysm repair (EVAR).

METHODS: Article screening was conducted using Medline, Embase, and the Cochrane databases. The primary outcome was overall survival; secondary outcomes included reintervention-free survival, endoleak during follow-up, aneurysmal rupture and reintervention during follow-up. End points were compared using risk ratio (RR) for binary outcomes and hazard ratio (HR) for long-term outcomes. For all outcomes, 95% confidence intervals were calculated. Subgroup analysis was done for studies including F/BEVAR patients and for studies comparing sac regression to sac stability. A trial sequential analysis was done for the short-term outcomes. Heterogeneity was assessed through the I² statistic. GRADE assessment of the findings was performed.

RESULTS: Twenty-seven studies comprising 36,822 patients were included. Sac regression was associated with improved overall survival in the overall analysis (HR 0.70; 95% CI 0.61-0.80; p < .00001). In the F/BEVAR subgroup, sac regression was associated with a numerically lower hazard of death; however, this association did not reach statistical significance (HR 0.87; 95% CI 0.49-1.53; p = .62). This association persisted for endoleak during follow-up, with lower risk observed in the overall analysis (RR, 0.55; 95% CI, 0.41-0.72; p < .0001) and in the F/BEVAR subgroup (RR, 0.55; 95% CI, 0.41-0.75; p = .0001). Patients with sac regression also demonstrated better reintervention-free survival (HR, 0.37; 95% CI, 0.27-0.53; p < .00001) and a lower incidence of reintervention during follow-up and aneurysm rupture; however, these latter outcomes were not statistically significant within the F/BEVAR subgroup. Statistical significance persisted across all outcomes in the subgroup analysis comparing sac regression with stable sac.

CONCLUSION: Sac regression after EVAR confers superior outcomes compared with failure to regress. Our findings underscore the importance of sac behaviour as a key indicator in post-EVAR surveillance and long-term risk stratification.

PMID:41833592 | DOI:10.1016/j.jvs.2026.02.042

J Vasc Surg. 2026 Mar 13:S0741-5214(26)00217-X. doi: 10.1016/j.jvs.2026.02.043. Online ahead of print.

ABSTRACT

OBJECTIVES: While SVS guidelines support revascularization in select patients with lifestyle-limiting intermittent claudication (IC), infrapopliteal intervention is discouraged due to questionable benefit and potential harm. Retrograde tibial/pedal access is increasing in peripheral vascular interventions (PVI) in general, but its use and appropriateness in IC has not been studied or codified. This study aims to analyze national practice patterns of tibial access in PVI for IC, and its potential association with tibial interventions.

METHODS: Elective IC cases from the VQI PVI module between 2010 and 2024 were identified. Cases were stratified into femoral-only cases and those involving any tibial access. Patient demographics, procedural setting, and interventional details were compared using descriptive statistics. Multivariable logistic regression was used to identify independent predictors of tibial intervention, and specifically assess the contribution of tibial access to this practice.

RESULTS: Of 107,822 cases, 4,204 involved any tibial access (3.9%) and 103,618 (96.1%) were performed with femoral-only access, with tibial access increasing over time at a rate of 0.62% per year (R2=0.95). Tibial access was more frequently utilized in ambulatory and office-based settings compared to hospital (8.2% vs. 3.2%; p<0.001). Tibial access was less commonly used in females than males (3.2% vs. 4.3%, p<0.001), and more commonly in Hispanic (5.4%) and Non-Hispanic Black (4.9%) than Non-Hispanic White (3.6%) and Non-Hispanic Asian (2.8%) patients (p<0.001). Compared to femoral-only access patients, those with tibial access more frequently underwent femoropopliteal (91% vs. 66%) and below-knee interventions (39% vs. 12%), but fewer aortoiliac interventions (9.1% vs. 40%; all p<0.001). Tibial access more frequently involved treatment of multiple vessels (50% vs. 41%, p<0.001). Multivariable regression adjusting for demographics, relevant comorbidities and procedural factors demonstrated tibial access to be independently and highly predictive of tibial intervention (OR 4.65, 95% CI 4.28-5.05). Among tibial interventions, atherectomy and stenting were more prevalent in patients who had tibial access.

CONCLUSIONS: Retrograde tibial access for IC has increased over time and is most prevalent in outpatient settings. Tibial access appears to be highly predictive of tibial intervention, with higher rates of atherectomy and stenting, raising the critical question of whether this is leading to inappropriate use and deviation from evidence-based societal guidelines.

PMID:41833590 | DOI:10.1016/j.jvs.2026.02.043

Microbiologyopen. 2026 Apr;15(2):e70266. doi: 10.1002/mbo3.70266.

ABSTRACT

Not susceptible to methicillin Staphylococcus aureus (MRSA), is a potentially harmful bacteria that is resistant to the most important antimicrobial agents. Because MRSA is so resistant to many antibiotics, it can cause illnesses by forming biofilms. The aim of this study was to assess the nasal carriage rate of biofilm-producing methicillin-resistant Staphylococcus aureus (MRSA) and its associated factors among HealthCare Workers at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Central Ethiopia. This cross-sectional study, carried out at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Central Ethiopia from August 1 to November 30, 2023. Nasal swab samples from 294 healthcare workers (HCWs) were obtained using sterile cotton swabs. Bacterial isolates were identified using standard culture methods on Mannitol Salt and Blood Agar, while antimicrobial susceptibility testing and biofilm formation assessments followed the CLSI 2023 (M100, 33rd edition) guidelines via the Kirby-Bauer disk diffusion methods. All laboratory analyses were performed in triplicate to ensure consistency. Data were double-entered into Epi Data version 4.6 and cross-checked for accuracy. Missing or inconsistent data were verified against original laboratory records and latterly then, exported to SPSS V25 for analysis. Descriptive statistics and logistic regression were applied for statistical evaluation, with a p-value of ≤ 0.05 regarded as statistically significant. In this study, the occurrence rates of S. aureus, MRSA, and biofilm-producing MRSA were 98 out of 294 isolated strains (33.4%), 41 out of 294 isolated strains (13.9%), and 28 out of 294 isolated strains (9.5%), respectively. The MRSA strains exhibited high sensitivity to linezolid, rifampicin, and vancomycin while showing resistance to cefoxitin, cotrimoxazole, and ciprofloxacin. A history of prior hospitalization (length of stay in the hospital) was statistically significant for the colonization of biofilm-producing MRSA, with an adjusted odds ratio of 10.00 (95% CI: 1.36-73.3; P = 0.024). MRSA and MRSA that produces biofilms were found to be 41.8% and 68.3% prevalent overall in the study area, respectively. Biofilm-producing MRSA is a potential cause of healthcare-associated diseases. Therefore, these findings emphasize the urgent need for improved infection-prevention practices and routine screening of healthcare workers to mitigate the risk of healthcare-associated infections.

PMID:41833560 | DOI:10.1002/mbo3.70266

Int J Stroke. 2026 Mar 15:17474930261435194. doi: 10.1177/17474930261435194. Online ahead of print.

ABSTRACT

BackgroundPregnancy-associated stroke (PAS) is a rare but clinically important complication of pregnancy. Despite its clinical significance, nationwide data on PAS are lacking in South Korea, a representative country with advanced maternal age.AimsThis study aimed to investigate the incidence, temporal trends, and risk factors of PAS in South Korea.MethodsWe retrospectively analyzed nationwide data from the Korean National Health Insurance Service (NHIS) to identify women of reproductive age (15-49 years) who delivered between 2014 and 2021. PAS was defined as an ischemic or hemorrhagic stroke occurring during pregnancy or within 6 weeks postpartum. Multivariable logistic regression analysis was performed to identify independent predictors of PAS.ResultsOf 2,000,110 deliveries between 2014 and 2021, 909 first-ever strokes occurred during pregnancy or within six weeks postpartum, including 500 ischemic (55%) and 409 hemorrhagic (45%) strokes. The overall incidence of PAS was 45.6 per 100,000 deliveries (95% confidence interval [CI], 42.7-48.6) and increased from 41.5 in 2014 to 51.0 in 2021 (P = 0.049), mainly driven by ischemic stroke. PAS occurred predominantly during the postpartum period (P <0.0001) and among older women (P for trend <0.0001). In multivariable analysis, advanced maternal age (odds ratio [OR] per year, 1.02; 95% CI, 1.01-1.05), hypertension (OR, 2.04; 95% CI, 1.37-3.04), migraine (OR, 1.33; 95% CI, 1.02-1.74), gestational hypertension (OR, 1.49; 95% CI, 1.04-2.12), preeclampsia/eclampsia (OR, 5.00; 95% CI, 3.59-6.96), and peripartum cardiomyopathy (OR, 14.26; 95% CI, 4.48-45.42) were identified as independent predictors of PAS.ConclusionsThe incidence of PAS is increasing in South Korea, with advanced maternal age, vascular risk factors, and pregnancy-related complications serving as independent predictors. These findings underscore the clinical importance of heightened awareness of PAS, as well as early identification and proactive management of high-risk women.Data access statementData are available from the NHIS upon reasonable request and with permission of the NHIS.

PMID:41833554 | DOI:10.1177/17474930261435194

Pest Manag Sci. 2026 Mar 15. doi: 10.1002/ps.70731. Online ahead of print.

ABSTRACT

BACKGROUND: Climate change and the spread of herbicide-resistant weeds pose increasing risks to global food security. Eleusine indica (goosegrass) is a globally invasive species characterized by broad geographic distribution, high ecological plasticity, and multiple resistance mechanisms. This study evaluated the current and future climatic suitability of E. indica at a global scale under climate change scenarios.

RESULTS: Ensemble ecological niche models calibrated with georeferenced occurrence records and climatic predictors showed excellent performance (area under the receiver operating characteristic curve (AUC) = 0.999; true skill statistic (TSS)/kappa = 0.980), with low omission rates and high spatial agreement among algorithms (Bioclim, Random Forest, Support Vector Machines, and Maxent). Current projections indicate widespread suitability across tropical and subtropical regions, particularly in South America, Africa, and Southeast Asia. Future projections under SSP245 and SSP585 for 2050 and 2090 suggest a gradual expansion toward higher latitudes, with increased suitability in temperate regions such as the US Corn Belt, the Mediterranean Basin, and East Asia, especially under SSP585 by 2090. Overlap analyses identified substantial vulnerability in major soybean-producing regions, including Brazil, Argentina, the United States, and Southeast Asia.

CONCLUSION: Climate change is expected to facilitate the poleward expansion of E. indica, increasing invasion risk in key agricultural regions while maintaining broad climatic stability across its current range. These findings emphasize the need for early detection, continuous monitoring, and integrated weed management strategies to mitigate long-term agronomic and food security risks posed by this globally invasive species. © 2026 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

PMID:41833552 | DOI:10.1002/ps.70731

J Magn Reson Imaging. 2026 Mar 15. doi: 10.1002/jmri.70297. Online ahead of print.

ABSTRACT

BACKGROUND: Biparametric MRI (bpMRI) was interpreted using Prostate Imaging Reporting and Data System (PI-RADS) version 2.1, a system associated with relatively low specificity. Selective size imaging using filters via diffusion times MRI (SSIFT-MRI) is a novel imaging technique that may improve diagnostic performance.

PURPOSE: To compare the diagnostic performance of bpMRI versus SSIFT-MRI for diagnosing clinically significant prostate cancer (csPCa).

STUDY TYPE: Prospective.

POPULATION: Hundred and eighteen men (age: 70 ± 7 years) with suspected csPCa.

FIELD STRENGTH/SEQUENCE: Pulsed and oscillating gradient spin-echo sequences at 3 T. BpMRI included three-plane T2-weighted imaging and diffusion-weighted imaging.

ASSESSMENT: csPCa status was pathologically determined via ultrasound-guided biopsy or prostatectomy. Three radiologists assessed bpMRI and SSIFT-MRI for identifying csPCa lesions, and we further compared the performance of combining PI-RADS with SSIFT-MRI against that of bpMRI.

STATISTICAL TESTS: Area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for diagnostic performance; bootstrap resampling for comparing AUC; McNemar’s test for comparing sensitivity, specificity, PPV, NPV, and accuracy. A p-value < 0.05 was considered significant.

RESULTS: Per-patient accuracy was significantly higher for SSIFT-MRI (reader 1: 85% vs. 68%; reader 2: 80% vs. 64%; reader 3: 77% vs. 65%). Per-patient specificity (reader 1: 71% vs. 27%; reader 2: 58% vs. 11%; reader 3: 58% vs. 20%) and PPV (reader 1: 84% vs. 67%; reader 2: 78% vs. 64%; reader 3: 77% vs. 65%) were significantly higher for SSIFT-MRI. Combining PI-RADS with SSIFT-MRI yielded significantly higher AUCs and accuracy than bpMRI alone (AUC and accuracy for reader 1: 0.89% and 83%; reader 2: 0.80% and 73%; reader 3: 0.75% and 72%).

DATA CONCLUSION: SSIFT-MRI for csPCa had similar or higher diagnostic performance compared with bpMRI. The combination approach provided significantly higher AUC and accuracy than bpMRI.

EVIDENCE LEVEL: 1.

STAGE OF TECHNICAL EFFICACY: 2.

PMID:41833541 | DOI:10.1002/jmri.70297

Eur J Dent Educ. 2026 Mar 15. doi: 10.1111/eje.70133. Online ahead of print.

ABSTRACT

INTRODUCTION: The “Code Blue” system is a standardised emergency response protocol designed to ensure rapid intervention in critical medical situations, particularly cardiopulmonary arrest. Although mandatory in Türkiye since 2011, inappropriate activations still occur, often due to limited awareness among healthcare staff, including dental students. This pilot project aimed to assess dental students’ knowledge and awareness regarding Code Blue and to examine whether these outcomes differ according to the level of clinical training.

MATERIALS AND METHODS: A cross-sectional survey was conducted among 186 dental students at Akdeniz University, including 3rd-year (preclinical) and 5th-year (clinical) students. A structured 10-item multiple-choice questionnaire was used to evaluate participants’ knowledge of Code Blue indications, activation procedures, and response expectations. Descriptive and comparative statistical analyses were performed.

RESULTS: Of the 186 students analysed, 53.2% were female and 46.8% were male. The most recognised emergency code was Code White (82.26%), followed by Code Blue (70.43%). Code Blue awareness was significantly higher among fifth-year students (77.3%) than third-year students (62.9%) (p < 0.05). Fifth-year students also demonstrated greater knowledge of Code Blue indications and were less likely to choose “don’t know.” However, common misinterpretations were observed: 70.49% incorrectly identified vasovagal syncope as a Code Blue condition, and only 7.38% correctly rejected all non-indicated scenarios. Knowledge of basic life support (BLS) content did not significantly differ between groups (p = 0.8153).

CONCLUSIONS: Code Blue knowledge and awareness were higher among students with greater clinical exposure; however, overall awareness remained limited. These findings support earlier and more structured integration of institutional emergency code training, simulation-based reinforcement, and practical emergency preparedness training within the dental curriculum. Further multi-center studies are recommended to enhance generalizability and guide educational interventions.

PMID:41833538 | DOI:10.1111/eje.70133

Influenza Other Respir Viruses. 2026 Mar;20(3):e70238. doi: 10.1111/irv.70238.

ABSTRACT

BACKGROUND: Quantifying the burden of respiratory syncytial virus (RSV) in adults is challenging compared to influenza, and data among older adults remain scarce in Japan. Country-specific evidence is essential to support RSV vaccination policy.

METHODS: This prospective, multicenter study (APSG-J2) targeted hospitalized adults with community-acquired pneumonia (CAP) and other acute respiratory infections (ARI) in seven community hospitals across four catchment areas in Japan between September 2022 and August 2024. Respiratory samples were analyzed using a multiplex polymerase chain reaction (PCR) kit to detect RSV and influenza. Incidence rates of RSV- and influenza-associated hospitalizations were estimated using study data and national statistics, stratified by age and region.

RESULTS: Among 3047 hospitalized patients with CAP/ARI, 1499 (49.2%) underwent multiplex PCR testing. RSV and influenza were detected in 2.8% and 3.3% of tested patients, respectively. The incidences of RSV-associated CAP/ARI hospitalizations among adults aged ≥ 65 years were 29 and 36 per 100,000 person-years in the first and second years, respectively, with higher incidences among those aged ≥ 85 years (150 and 131 per 100,000 person-years). Influenza incidence increased markedly in the second year (from 11 to 71 per 100,000 person-years for adults age ≥ 65 years), possibly reflecting post-COVID-19 transmission changes.

CONCLUSIONS: In this multicenter study, we estimated the incidence of RSV- and influenza-associated hospitalizations among adults in Japan. The findings indicated that the incidence increased with age, and influenza-associated hospitalizations increased in the second year. Continued surveillance is essential to accurately assess RSV burden in the adult population.

PMID:41833535 | DOI:10.1111/irv.70238

Med Phys. 2026 Mar;53(3):e70385. doi: 10.1002/mp.70385.

ABSTRACT

BACKGROUND: The integration of artificial intelligence into image-guided intraoperative interventions holds considerable promise for deriving 3D geometric information from 2D imaging. 2D/3D registration establishes the spatial relationship between preoperative computed tomography (CT) and intraoperative X-rays. However, existing methods are often limited by the image domain gap and imprecise feature extraction, causing coarse registration to provide inadequate initial poses and subsequent fine registration to fall into local optima, thereby reducing accuracy.

PURPOSE: We aim to develop a robust single-view lumbar spine 2D/3D registration framework that balances high clinical accuracy with intraoperative efficiency requirements by aligning preoperative CT with intraoperative X-rays.

METHODS: We propose utilizing vertebral body edges in X-rays as novel semantic features to guide 2D/3D registration. For robust edge extraction, we develop ESegMamba, an efficient U-shaped Mamba network incorporating Group multi-axis Hadamard Product Attention (GHPA) and Group Aggregation Concatenation (GAC) modules. Experiments for semantic edge extraction were performed on a dataset of 710 images (comprising X-rays and Digitally Reconstructed Radiographs) derived from 10 patients. The dataset was partitioned using a 4:1 patient-specific split, resulting in 568 training and 142 test images. The training set was further utilized via 5-fold cross-validation for network fine-tuning. ESegMamba was benchmarked against SegMamba, SwinUNETR, and UNETR using Dice and mIoU metrics. For 2D/3D registration, experiments were conducted separately on 300 simulated samples and 90 real clinical samples, following the same patient-specific split. The proposed framework was compared with landmark-based, intensity-based, and learning-based methods using mean Target Registration Error (mTRE). Statistical significance was assessed using the Wilcoxon signed-rank test with a significance level of 0.05, applying Bonferroni correction for multiple comparisons.

RESULTS: ESegMamba outperforms representative networks with fewer parameters (99.18 M), achieving 90.36% Dice and 85.49% mIoU on the test set. Compared to the strong baseline SegMamba, ESegMamba demonstrated a large effect size in Dice improvement (Cohen’s $d=2.05$ , ). For 2D/3D registration, the proposed method demonstrated superior performance over representative benchmarks. Specifically, compared to Xreg and PSSS, our method achieved large practical improvements in mTRE ( $d=1.04$ and $d=2.12$ , respectively; ). On real clinical data, the method achieved a mean in-plane translation error of approximately 1.5 mm and an average registration time of approximately 10 s.

CONCLUSIONS: The proposed method, empowered by ESegMamba, yields statistically significant improvements over intensity-based benchmarks ( ). The achieved sub-2mm accuracy and 10 s processing time on clinical data confirm its efficacy for intraoperative spinal navigation. The code for the proposed method is available at github.com/shenao1995/lineReg.

PMID:41833531 | DOI:10.1002/mp.70385