Nevin Manimala

Arch Endocrinol Metab. 2026 Aug 1;70(4). doi: 10.20945/2359-4292-2026-0047.

ABSTRACT

OBJECTIVE: To assess the relationship between night work, metabolic syndrome (MS) prevalence, and dietary patterns in healthcare workers at a large hospital in southern Brazil.

SUBJECTS AND METHODS: A cross-sectional study was conducted with 156 healthcare workers (90 day-shift and 66 night-shift) from July 2023 to March 2024. Sociodemographic and occupational, sleep, dietary patterns, meal timing, anthropometric data, blood pressure, and lab test data were collected.

RESULTS: Night-shift workers had higher blood pressure, lower HDL cholesterol, and 135% greater likelihood of developing MS than those who worked during the day. They consumed more fats and less fiber. Chrononutrition analysis showed night workers had later last meals (p < 0.001), longer intervals between first and last meals (p < 0.001), and shorter night fasting (p < 0.001). Ultra-processed food consumption was similar across shifts. A shorter interval between the first and last meal in night workers was linked to a 7% lower risk of MS. Findings suggest an association between night work and higher MS prevalence, with hypertension, abdominal obesity, unfavorable lipid profile, and disrupted eating timing. Circadian rhythm disruption and misaligned eating patterns, particularly prolonged eating windows and reduced nocturnal fasting, may contribute to the increased metabolic risk.

CONCLUSION: Interventions targeting diet and chrononutrition are essential. Occupational health programs should address the specific challenges of night work.

PMID:42155078 | DOI:10.20945/2359-4292-2026-0047

J Strength Cond Res. 2026 May 20. doi: 10.1519/JSC.0000000000005468. Online ahead of print.

ABSTRACT

Aguila Camacho, A, Ochoa Ahmed, F, Rowlett, M, Ríos-Gallardo, PT, Cabarkapa, DV, Cabarkapa, D, and Montalvo, S. Longitudinal changes in countermovement jump and isometric mid-thigh pull metrics and their relationship with on-court basketball performance in elite female collegiate basketball players. J Strength Cond Res XX(X): 000-000, 2026-To quantify within-subject relationships among countermovement jump (CMJ) and isometric mid-thigh pull (IMTP) variables, describe their temporal behavior across a competitive season, and examine their association with game performance in female collegiate basketball. Eighteen athletes (21.6 ± 1.9 years; 69.9 ± 9.1 kg; 171.6 ± 8.2 cm) completed CMJ and IMTP testing for 33 weeks. Within-subject (demeaned) Spearman correlation matrices were used to identify functional clusters. Representative CMJ (jump height, peak power, contraction time, reactive strength index(mod) and IMTP (peak force, impulse 100 ms, rate of force development [RFD] 50 ms) variables were modeled longitudinally with linear mixed-effects models (random intercepts; autoregressive (1) for a week). Game outcomes from 24 contests were linked to the nearest prior test and evaluated with bivariate Spearman correlations and leave-one-out cross-validated (LOOCV) linear models. Countermovement jump variables clustered into (a) force-production measures (e.g., impulses/peak power; moderate-high positive associations), (b) performance outcomes (jump height with relative power), and (c) temporal measures (contraction/phase durations). Isometric mid-thigh pull variables formed tight early impulse and RFD clusters, with peak-force measures grouping separately. Cross-test associations were generally small (|ρ| ≤ ∼0.30), indicating complementary constructs. Mixed-model marginal means showed modest, nonuniform seasonal trends-modified reactive strength index (mRSI) tended to increase and contraction time to decrease late season, while IMTP peak force exhibited a mid-season rise-amid substantial within-player variability. For game performance, only mRSI showed a statistically significant positive correlation with point differential (ρ = 0.46, p = 0.024); other variables were small and nonsignificant. Single-variable LOOCV models explained little variance in point differential (R2_cv ≤ 0.04). Countermovement jump and IMTP capture largely independent neuromuscular qualities and exhibit modest, test-specific seasonal changes. Although mRSI relates positively to game point differential, single neuromuscular metrics showed limited standalone predictive value, supporting their use primarily for monitoring readiness in conjunction with contextual factors rather than for game-to-game prediction.

PMID:42155075 | DOI:10.1519/JSC.0000000000005468

JCO Oncol Pract. 2026 May 19:OP2501275. doi: 10.1200/OP-25-01275. Online ahead of print.

ABSTRACT

PURPOSE: Over 70% of cancer survivors also have chronic conditions requiring coordinated care throughout survivorship. Few intervention studies have focused on improving care coordination between oncology and primary care during active treatment, specifically among under- and uninsured survivors. This study evaluated the effectiveness of Project CONNECT, a system-level intervention using an EHR-based registry and an oncology nurse coordinator, in improving patient-reported care coordination among breast and colorectal cancer survivors with at least one chronic condition seen in a large, urban, safety-net health system.

METHODS: Using a pre-post quasi-experimental design, 294 patients diagnosed with stage I to III breast or colorectal cancer and ≥1 chronic condition were administered a telephone survey before intervention and 6 and 12 months after intervention to measure patient-reported care coordination. Summary statistics described patient characteristics, and generalized estimating equation assessed adjusted population-average changes in care coordination.

RESULTS: The mean age of eligible patients was 56 years (standard deviation = 9.54). The majority of the survivors were women (78.6%). Race/ethnicity distribution of the sample represented the patient population of the safety-net health system with 45% White, 34% Black, and 51% Hispanic. Nearly 80% had ≥1 chronic conditions. After the intervention, patient-reported care coordination scores demonstrated significant improvement (β = -.05, P = .016). Notably, the proportion of survivors reporting never or rarely receiving confusing or differing information about their health or treatments decreased by 11% after the intervention.

CONCLUSION: An EHR-based registry of cancer survivors with chronic conditions supported by an oncology nurse coordinator assisting survivors to establish or maintain primary care during active cancer treatment is a promising strategy to bridge the transition between oncology and primary care for cancer survivors receiving care in a safety-net heath system.

PMID:42155068 | DOI:10.1200/OP-25-01275

J Pediatr Hematol Oncol. 2026 May 18. doi: 10.1097/MPH.0000000000003211. Online ahead of print.

ABSTRACT

Pediatric hematology/oncology fellows at our institution lacked formal training in prescribing chemotherapy and supportive care. This pilot study aimed to assess the feasibility of implementing a structured curriculum in a fellowship program and to gain preliminary insights into its impact on fellows’ confidence and competence in placing chemotherapy and supportive care orders in the Epic Beacon system. We developed Beacon Bootcamp using Kern 6-Step Approach to Curriculum Development. General and targeted needs assessments informed the learning objectives. We held individual practice sessions, grounded in Kolb experiential learning theory, as one of our educational strategies and piloted a near-peer teaching model. The curriculum was implemented during the 2024 to 2025 academic year, and outcomes were compared with a baseline cohort from the prior academic year. Fellows who participated in Beacon Bootcamp reported higher levels of comfort with prescribing chemotherapy and supportive care compared with the previous cohort, which did not receive formal training. We observed a lower rate of order corrections required following the intervention (21% vs. 38%); however, the small sample size limited statistical analysis. Our findings suggest that Beacon Bootcamp improves fellows’ confidence and may reduce prescribing errors. Its impact could be greater if implemented during the first quarter of the fellowship. Further evaluation in a larger cohort is needed to more definitively assess its effectiveness.

PMID:42154508 | DOI:10.1097/MPH.0000000000003211

Quintessence Int. 2026 May 19;0(0):0. doi: 10.3290/j.qi.b7011446. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Peri-implant mucositis (PiM) is a reversible inflammatory condition that may progress to peri-implantitis if untreated. Professional mechanical plaque removal (PMPR) is the standard therapy, although complete resolution is not always achieved. This review aimed to evaluate the effectiveness of chemical and pharmacological adjunctive therapies to PMPR in PiM management.

MATERIALS AND METHODS: A literature search was conducted in PubMed and Scopus up to March 2025. Randomized controlled trials (RCTs) including adult patients with PiM, reporting bleeding on probing (BoP) changes, and with a minimum follow-up of 3 months were included. Nine RCTs (414 patients) were qualitatively analyzed.

RESULTS: PMPR alone resulted in significant reductions in BoP and probing depth (PD), but complete disease resolution was inconsistent. Adjunctive therapies, including chlorhexidine, local antibiotics, sodium hypochlorite, probiotics, and bioactive agents, showed intra-group improvements. However, additional benefits over PMPR alone were limited and often not statistically significant. Study heterogeneity in diagnostic criteria, outcome definitions, and treatment protocols limited comparability.

CONCLUSIONS: PMPR remains the gold standard for PiM treatment. Adjunctive therapies may provide additional clinical benefits in selected cases, but their routine use is not supported by consistent evidence. Standardized RCTs with long-term follow-up are needed.

PMID:42154501 | DOI:10.3290/j.qi.b7011446

Acta Otolaryngol. 2026 May 19:1-9. doi: 10.1080/00016489.2026.2667889. Online ahead of print.

ABSTRACT

BACKGROUND: Overlapping signal intensities in conventional MRI limit parotid tumor characterization, necessitating advanced techniques like arterial spin labeling (ASL) to assess physiological parameters such as vascularity.

OBJECTIVES: To evaluate the diagnostic performance of ASL in differentiating parotid gland tumors by quantifying tumor blood flow ASLm (mean) and ASLmax (maximum) and determining optimal cutoff values correlated with histopathological findings.

METHODS: Forty-seven patients (20 pleomorphic adenomas [PA], 20 Warthin tumors [WT], 7 malignant) underwent standardized 1.5 T MRI protocols and ASL prior to parotidectomy. Quantitative ASL values were obtained from lesions and contralateral tissue. Statistical comparisons and ROC analyses were performed to identify diagnostic cutoff values.

RESULTS: ASLm and ASLmax values were higher in WT compared to PA (p < 0.01). No significant side-to-side differences were found in PA and malignant groups. For PA differentiation, ASLm and ASLmax yielded AUCs of 0.766 (p = 0.002) and 0.742 (p = 0.005), respectively. For WT differentiation, both parameters showed excellent performance, yielding AUCs of 0.774 (p < 0.001) and 0.769 (p = 0.002).

CONLUSIONS: While ASL perfusion MRI effectively differentiates common benign parotid tumors, its limitations in malignancy evaluation necessitate its integration into a multiparametric MRI protocol for a more reliable preoperative diagnosis.

PMID:42154491 | DOI:10.1080/00016489.2026.2667889

Plast Reconstr Surg. 2026 May 19. doi: 10.1097/PRS.0000000000013206. Online ahead of print.

ABSTRACT

BACKGROUND: Hematoma remains a major complication following breast surgery. While tranexamic acid (TXA) efficacy is established in reduction mammaplasty, its utility across other breast procedures remains unclear.

METHODS: This retrospective cohort study included 5,202 consecutive procedures (2019-2025) performed by multiple surgeons at a single private hospital: primary augmentation (n=3,738), reduction mammaplasty (n=943), explantation with mastopexy (n=358), and explantation alone (n=163). TXA administration was at surgeon discretion. Inverse Probability of Treatment Weighting controlled for temporal adoption bias and confounders. Primary outcome was hematoma requiring surgical intervention within 30 days; isolated ecchymosis without palpable collection was not classified as hematoma.

RESULTS: TXA adoption increased from 7.0% (2019) to 93.0% (2025). After achieving covariate balance (all SMD <0.2), procedure-specific effects emerged. In reduction mammaplasty, TXA significantly reduced hematoma (2.2% vs 7.2%; adjusted OR 0.28, 95% CI 0.14-0.58, p<0.001; NNT=20). Explantation with mastopexy showed similar benefit (1.6% vs 6.0%; OR 0.42, 95% CI 0.20-0.88, p<0.001). Primary augmentation demonstrated no statistically detectable difference (1.2% vs 1.2%; OR 0.94, 95% CI 0.36-2.42, p=0.905), regardless of implant plane. No thromboembolic events occurred. Surgical site infection showed a nominally significant difference (OR 0.47, p=0.02) but should be considered exploratory given small event counts and absence of a plausible biological mechanism. Seroma and wound dehiscence showed no significant differences.

CONCLUSIONS: TXA efficacy is procedure-dependent. It provides significant protection in reduction mammaplasty and mastopexy involving extensive parenchymal dissection, but shows no statistically detectable benefit in primary augmentation. These findings support procedure-specific practice guidance rather than universal prophylaxis.

PMID:42154472 | DOI:10.1097/PRS.0000000000013206

JAMA Netw Open. 2026 May 1;9(5):e2613571. doi: 10.1001/jamanetworkopen.2026.13571.

NO ABSTRACT

PMID:42154470 | DOI:10.1001/jamanetworkopen.2026.13571

JAMA Netw Open. 2026 May 1;9(5):e2613292. doi: 10.1001/jamanetworkopen.2026.13292.

ABSTRACT

IMPORTANCE: Electronic cigarettes (EC) have been shown to expose users to fewer tobacco-related toxicants compared with combustible cigarettes. The current generation of ECs has rapidly shifted toward pod-based nicotine salt formulation ECs, and more research is needed to understand the impacts of using these EC products among those who smoke.

OBJECTIVE: To determine the short-term effects of switching from cigarettes to a pod-based 5% nicotine EC, compared with a 0% nicotine EC.

DESIGN, SETTING, AND PARTICIPANTS: This double-blind, parallel-arm, randomized, placebo-controlled trial with follow-up at 6 weeks (randomized phase) and 10 weeks (postrandomized phase) was conducted at a single-site academic medical center in Pennsylvania from April 22, 2022, to December 12, 2023. Participants included adults who smoked more than 4 cigarettes per day (CPD) and expressed interest in switching completely to an EC. Data were analyzed from August 23, 2024, to December 1, 2025.

INTERVENTIONS: Participants were allocated 1:1 to the standardized research EC (SREC) with 5% nicotine or 0% nicotine for 6 weeks.

MAIN OUTCOMES AND MEASURES: The primary outcome was concentration of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in urine corrected for creatinine level at 6 weeks. Secondary outcomes included exhaled carbon monoxide (CO), cotinine level, CPD, CO-verified cigarette abstinence, and levels of volatile organic compounds.

RESULTS: A total of 104 participants (52 per group) were randomized, of whom 68 (65.4%) were female, with a mean (SD) age of 50.9 (10.0) years. At 6 weeks, the 5% SREC group did not have significantly lower NNAL levels (mean difference [MD], -116.6 [95% CI, -245.4 to 12.2] pg/mg; P = .08). However, a greater proportion of participants in the 5% SREC group were abstinent from cigarettes (19 of 52 [36.5%] vs 6 of 52 [11.5%]; P = .005), compared with the 0% SREC group. The 5% SREC group had greater cotinine levels (MD, 2367.8 [95% CI, 407.5-4328.2] ng/mg; P = .02); however, there were no differences in CPD (MD, -0.9 [95% CI, -3.9 to 2.1] CPD; P = .55) or exhaled CO levels (MD, -5.1 [95% CI, -12.9 to 2.6] ppm; P = .19) between groups. Levels of cyanoethyl mercapturic acid (CYMA) (MD, -49.0 [95% CI, -90.4 to -7.6] ng/mg; P = .02) and 3-hydroxypropyl mercapturic acid (3HPMA) (MD, -290.8 [95% CI, -514.0 to -67.6] ng/mg; P = .01), biomarkers of acrylonitrile (a carcinogen) and acrolein (a cardiac toxicant) exposure (both of which are respiratory toxicants), were lower in the 5% SREC group compared with the 0% SREC group.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of adults who smoke, switching from cigarettes to a 5% SREC vs a 0% SREC resulted in reduced exposure to some toxicants delivered by cigarette smoking and an increased rate of smoking cessation. ECs that deliver nicotine like a cigarette may have an important role in reducing the harmful toxicant exposure caused by cigarette smoking.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03625986.

PMID:42154468 | DOI:10.1001/jamanetworkopen.2026.13292

JAMA Netw Open. 2026 May 1;9(5):e2613399. doi: 10.1001/jamanetworkopen.2026.13399.

ABSTRACT

IMPORTANCE: Previous evidence suggests a bidirectional association between physical activity and cognitive function. It remains unclear whether long-term cognitive trajectories are associated with later differences in how older adults allocate time during the day between physical activity, sedentary behavior, and sleep.

OBJECTIVE: To assess whether long-term cognitive trajectories are associated with the subsequent amount of daily time in physical activity, sedentary behavior, and sleep.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included community-dwelling adults aged 50 years or older at baseline and residing in England, using cognitive data from waves 1 (2002 to 2003) to 9 (2018 to 2019) and accelerometer data from wave 10 (2021 to 2023) of the English Longitudinal Study of Ageing.

EXPOSURES: Participant-specific annual rate of change in episodic memory (assessed via immediate and delayed recall) and verbal fluency (assessed via animal naming), estimated using linear mixed-effects models.

MAIN OUTCOMES AND MEASURES: The movement behavior composition, comprising mean daily minutes of moderate to vigorous physical activity, light physical activity, sedentary behavior, and sleep time. Differences were estimated in time spent in each behavior between a less favorable memory or fluency trajectory (corresponding to the 25th percentile for participant-specific memory or fluency change), median trajectory (50th percentile), and a more favorable trajectory (75th percentile).

RESULTS: The study included 2529 participants (1394 [55.1%] female, 1135 [44.9%] male) with a mean (SD) baseline age of 56.1 (5.4) years. Compared with the less favorable memory trajectory, the more favorable trajectory was associated with 14 (95% CI, 8 to 21) more minutes of light physical activity and 12 (95% CI, -20 to -5) fewer minutes of sedentary behavior per day, with larger differences among participants older than 70 years (eg, 20 [95% CI, 11 to 30] more minutes light physical activity). Memory-related differences in moderate to vigorous physical activity and sleep were comparatively minor. Fluency showed similar patterns to memory, but time-use differences between trajectories were smaller.

CONCLUSIONS AND RELEVANCE: In this cohort study of older adults, participants with less favorable long-term memory trajectories were subsequently less active and more sedentary, suggesting that later-life activity patterns may partly reflect cognitive change.

PMID:42154466 | DOI:10.1001/jamanetworkopen.2026.13399