Nevin Manimala

J Vet Intern Med. 2026 Jul 1;40(4):aalag156. doi: 10.1093/jvimsj/aalag156.

ABSTRACT

BACKGROUND: Necrotic laryngitis is an important cause of respiratory distress and economic loss in feedlot cattle.

HYPOTHESIS/OBJECTIVES: Describe the clinical presentation, pathologic lesions, and microbiologic findings associated with necrotic laryngitis in feedlot steers.

ANIMALS: Four 20-month-old feedlot steers diagnosed with necrotic laryngitis. Clinically affected steers exhibited inspiratory stridor, increased respiratory effort, and flared nares, indicative of upper airway obstruction.

METHODS: Samples from inflamed nasopharyngeal tissues were collected endoscopically using guarded cytology swabs and submitted for culture, with concurrent blood collection for CBC and plasma and serum biochemistry analyses.

RESULTS: Endoscopic examinations identified laryngeal chondritis, mucopurulent diphtheritic membranes, and necrotic inflammation of the vocal folds. Aerobic cultures were negative, but anaerobic cultures yielded Fusobacterium necrophorum subsp. necrophorum and or F. necrophorum subsp. funduliforme. Hematologic evaluation indicated leukocytosis and increased plasma fibrinogen concentration, whereas serum biochemistry disclosed marked hyperglycemia and mild increases in hepatic enzyme activities, consistent with stress-related metabolic alterations. Antimicrobial susceptibility testing showed that F. necrophorum isolates were susceptible to β-lactams, tetracyclines, florfenicol, tiamulin, and trimethoprim/sulfamethoxazole, and resistant to aminoglycosides, fluoroquinolones, and with respect to macrolides, 4 strains were susceptible and 1 strain was resistant to tylosin, tilmicosin, and tulathromycin.

CONCLUSIONS AND CLINICAL IMPORTANCE: These findings indicate involvement of either F. necrophorum subsp. necrophorum or subsp. funduliforme in necrotic laryngitis of feedlot cattle. Observed antimicrobial susceptibility patterns indicate ongoing susceptibility to β-lactams and tetracyclines, supporting their continued use as first-line therapeutic options.

PMID:42544489 | DOI:10.1093/jvimsj/aalag156

Age Ageing. 2026 Aug 3;55(8):afag227. doi: 10.1093/ageing/afag227.

ABSTRACT

BACKGROUND: Older adults presenting to the emergency department (ED) following a fall are at high risk for recurrent falls, injuries and increased healthcare utilisation. This systematic review and meta-analysis evaluated the effectiveness of interventions initiated upon ED presentation in reducing falls (primary outcome) and fall-related outcomes (secondary outcomes) among older adults.

METHODS: A comprehensive search was performed in Ovid Medline, Embase, CINAHL, PEDro, Web of Science, and Scopus up to June 2025, following PRISMA guidelines. This yielded 9624 references, of which 4811 records remained after deduplication and were screened for eligibility. Meta-analyses and descriptive methods, including vote counting, were applied where appropriate. Sensitivity and subgroup analyses were conducted.

RESULTS: Thirty articles were included. Interventions were associated with a significant reduction in fall incidence (rate ratio 0.69; 95% CI 0.54-0.88; I2 = 95%), supported by vote counting. While reductions were also observed in the proportion of fallers (odds ratio 0.87; 95% CI 0.71-1.07; I2 = 61%), fall-related and all-cause ED revisits, hospital admissions, recurrent falls and mortality, these trends did not reach statistical significance. Sensitivity analysis excluding studies with modified usual care showed a significant reduction in fall-related ED revisits and people sustaining an injurious fall. Secondary outcomes including quality of life, fear of falling and physical functioning generally showed trends favouring the intervention group. Considerable heterogeneity and variation in intervention characteristics were noted across studies.

CONCLUSION: Interventions for older adults presenting to the ED after a fall suggest a favourable effect on fall rate. Non-significant trends favouring the intervention group were observed for several other outcomes, but heterogeneity and methodological limitations preclude definitive conclusions.

PMID:42544467 | DOI:10.1093/ageing/afag227

J Sex Med. 2026 Jul 3;23(8):qdag108. doi: 10.1093/jsxmed/qdag108.

ABSTRACT

BACKGROUND: Lifelong premature ejaculation (LPE) is a prevalent male sexual dysfunction with unclear neurobiological mechanisms. Despite its high prevalence, the etiology of LPE remains debated, often attributed to psychological or biological factors. Recent neuroimaging studies have highlighted the role of central nervous system dysregulation in sexual behavior.

AIM: This study investigates abnormal brain functions and altered network connectivity in LPE patients after visual sexual stimuli (VSS) using functional magnetic resonance imaging.

METHODS: Twenty-five LPE patients and 31 healthy controls (HCs) underwent resting-state and task-state functional magnetic resonance imaging (fMRI). Clinical data, including sexual history, self-reported intravaginal ejaculatory latency time, International Index of Erectile Function-5, the Chinese Index of Premature Ejaculation, anxiety/depression scores, and serum testosterone levels, were collected. Neuroimaging preprocessing and analysis focused on amplitude of low-frequency fluctuation, fractional ALFF, and regional homogeneity. Task-state fMRI compared brain activation patterns after VSS. Statistical analyses included voxel-based comparisons and network connectivity assessments using SPM12 and DPABI v3.0.

OUTCOMES: LPE patients demonstrate distinct neurofunctional abnormalities after VSS, particularly hyperactivation in the precuneus.

RESULTS: ‌Clinical Data‌: LPE patients exhibited significantly lower International Index of Erectile Function-5 scores and higher depression rates compared to HCs, with no differences in age, BMI, or testosterone levels. Brain Activation‌: During VSS, LPE patients showed relative signal decrease in the middle cingulate cortex and left precentral gyrus compared to HCs. Regional homogeneity analysis revealed hyperactivation in the precuneus and fusiform gyrus post-stimulus. Network Connectivity‌: Altered connectivity in premature ejaculation patients involved the fusiform gyrus (linked to posterior cingulate, hippocampus, parahippocampus, and supplementary motor areas) and the superior parietal lobule (connected to the angular gyrus).

CLINICAL IMPLICATIONS: These findings suggest that aberrant central nervous system processing of sexual stimuli contributes to premature ejaculation pathophysiology, offering potential targets for neuromodulatory therapies.

STRENGTHS AND LIMITATIONS: The study focuses on the different activation patterns of patients with LPE from the perspective of sexual arousal. The methodological aspects of research, such as the use of images or videos in sexual stimulation, remain controversial. The findings of our network analysis only demonstrated a limited number of altered functional connections, and no established network metrics were provided to substantiate the claim of extensive network disruption. These factors collectively represent important limitations of the present study.

CONCLUSION: The hyperactivity in this brain region observed in patients could represent a unique response to VSS among those with LPE, ultimately leading to alterations in their ejaculatory behavior.‌‌‌.

PMID:42544459 | DOI:10.1093/jsxmed/qdag108

J Sports Med Phys Fitness. 2026 Aug 3. doi: 10.23736/S0022-4707.26.17762-7. Online ahead of print.

ABSTRACT

BACKGROUND: Sleep hygiene strategies (SHS) are practical, evidence-informed recommendations to enhance both the quantity and quality of sleep in athletes. However, little is known about how these strategies could be communicated and implemented in practice. The primary objective of this study is to investigate how different methods of delivering SHS (written vs. verbal) affect sleep hygiene and sleep parameters in athletes.

METHODS: The study was a three-arms randomized controlled trial (ClinicalTrials.gov Identifier: NCT07083544) involving track and field athletes competing at the regional or national level (N.=66). Athletes were randomized to either a control group (CON=22), a written SHS group (W-SHS=22), or a verbal SHS group (V-SHS=22). Sleep characteristics were assessed by actigraphy and sleep diary during a ten-day baseline period (T0) and a ten-day intervention period (T1). Six objective sleep parameters and the Sleep Regularity Index were assessed. Participants also completed a training diary and the Sleep Hygiene Index (SHI).

RESULTS: No statistical differences were found between and within groups in training and sleep parameters, but SHI scores improved significantly in the intervention groups between T0 and T1, with differences compared to the control group. A non-significant improvement in total sleep time was observed in the intervention groups, primarily due to earlier bedtimes.

CONCLUSIONS: While significant differences in objective sleep measures were not observed, the trends suggest that both written and verbal SHS interventions can modestly improve sleep-related behaviors, particularly by encouraging earlier bedtimes and slightly extending total sleep duration.

PMID:42544425 | DOI:10.23736/S0022-4707.26.17762-7

J Prim Care Community Health. 2026 Jan-Dec;17:21501319261475712. doi: 10.1177/21501319261475712. Epub 2026 Aug 3.

ABSTRACT

ObjectivesTo examine associations of a general cost-related barrier to medical care and BRFSS-defined poor mental health-day categories with cervical cancer screening adherence among U.S. female respondents.MethodsWe conducted a cross-sectional analysis of female BRFSS respondents. The primary outcome (_RFPAP37) identified Pap testing within the past 3 years among respondents aged 21-65 years with an intact cervix; the sensitivity outcome (_PAPHPV1) additionally incorporated HPV testing within the past 5 years for those aged 30-65 years. MEDCOST1 measured inability to see a doctor because of cost during the previous 12 months. _MENT14D classified respondents by 0, 1-13, or 14-30 poor mental health days. Survey-weighted adjusted logistic regression incorporated BRFSS weights, strata, and clustering.ResultsThe primary analytic sample included 101,580 female respondents; survey-weighted complete-case models included 84,705. Pap adherence was lower among respondents reporting a general cost-related barrier to medical care than among those without the barrier (54.5% vs 68.6%). In survey-weighted adjusted models, the barrier remained associated with lower Pap adherence (OR 0.79, 95% CI 0.65-0.95). Formal interaction terms were not statistically significant, and the ordinal poor mental health-day trend was attenuated (OR 1.02, 95% CI 0.97-1.07). Findings for Pap+HPV adherence were directionally similar but weaker.ConclusionsA general cost-related barrier to medical care was consistently associated with lower cervical cancer screening adherence. BRFSS-defined poor mental health days may indicate a co-occurring vulnerability, but adjusted interaction evidence was limited. Access-focused and mental health-informed strategies warrant evaluation in future intervention studies.

PMID:42544410 | DOI:10.1177/21501319261475712

J Pediatr Endocrinol Metab. 2026 Aug 4. doi: 10.1515/jpem-2026-0294. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to evaluate serum apelin levels in obese adolescents and to investigate their association with hepatic steatosis and metabolic risk parameters.

METHODS: This prospective case-control study included 75 obese adolescents and 68 age- and sex-matched healthy controls. Anthropometric measurements, biochemical parameters, and serum apelin levels were assessed. Hepatic steatosis was evaluated using ultrasonography. Multivariable logistic regression analysis including age, sex, waist circumference, and serum apelin levels was performed.

RESULTS: Serum apelin levels were significantly lower in obese adolescents compared with controls. Although apelin levels tended to be lower in participants with hepatic steatosis, the difference did not reach statistical significance. No significant correlations were observed between apelin levels and insulin resistance, lipid parameters, or liver enzymes. Multivariable analysis did not demonstrate an independent association between apelin levels and hepatic steatosis.

CONCLUSIONS: Serum apelin levels were significantly lower in obese adolescents than in healthy controls. Although apelin levels tended to be lower in participants with hepatic steatosis, no independent association was demonstrated in this cohort. Larger prospective studies are needed to clarify the potential relationship between apelin and hepatic steatosis in pediatric obesity.

PMID:42544397 | DOI:10.1515/jpem-2026-0294

J Public Health (Oxf). 2026 Aug 3:fdag058. doi: 10.1093/pubmed/fdag058. Online ahead of print.

ABSTRACT

BACKGROUND: Harmful alcohol use is a major modifiable risk factor for self-harm. We aimed to examine associations between minimum unit pricing for alcohol, introduced in Scotland in 2018, and rates of hospital-admitted self-harm.

METHODS: Data were obtained from Public Health Scotland and English Hospital Episode Statistics. Interrupted time series (ITS) analysis compared pre- and post-intervention self-harm admission rates per 100 000 population, including controlled comparisons with England.

RESULTS: The before-after slope reduction in Scotland corresponded to -5.6 (95% CI -7.5 to -3.7) admissions per quarter, per 100 000 population, over the intervention period. Using controlled ITS, a greater slope reduction was observed in Scotland relative to England: -3.5, CI -6.4 to -0.6. No differences in slope change were observed when examining only pre-pandemic study quarters. Findings were consistent with a possible postintervention rate reduction in the two most deprived population quintiles, while no between-nation slope difference was observed in the three least deprived quintiles.

CONCLUSIONS: Findings were consistent with possible postintervention reductions in hospital-admitted self-harm in Scotland compared to England, with reductions concentrated in more deprived populations. Population-level alcohol pricing policies may contribute to reducing self-harm frequency, although causal interpretation is limited by the observational, quasi-experimental study design and differing between-nation pre-intervention trajectories.

PMID:42544395 | DOI:10.1093/pubmed/fdag058

Front Genet. 2026 Jul 20;17:1776578. doi: 10.3389/fgene.2026.1776578. eCollection 2026.

ABSTRACT

BACKGROUND: Small-cell lung cancer (SCLC) is an aggressive malignancy with poor survival outcomes. Biomarkers that reliably capture tumor mutational burden (TMB), tumor immunogenicity, and prognosis could substantially improve clinical stratification. Prior studies have suggested that mutational signatures, including single-base substitution (SBS) 4 and 13, may be associated with TMB and survival in SCLC. We therefore evaluated these relationships using complementary analytical approaches.

METHODS: We evaluated associations among mutational signatures, TMB, and overall survival in a dataset examined in a prior study and an independent external cohort. To improve reproducibility and interpretability, we performed reference-based mutational signature assignment and analyzed signature activity, primarily as a continuous variable, while also evaluating binary stratifications using fixed thresholds. Signature-TMB relationships were assessed using continuous regression models, and associations with overall survival were evaluated pooling all clinically annotated samples using Kaplan-Meier analysis and Cox-proportional-hazards modeling.

RESULTS: Across both cohorts, SBS4 activity was positively associated with TMB, whereas SBS13 showed no consistent relationship with TMB. Neither SBS4 nor SBS13 was a statistically significant predictor of overall survival.

CONCLUSION: Our study clarifies the prognostic and immunogenomic relevance of SBS4 and SBS13 in SCLC and shows that analytical choices materially influence inference. Reference-based signature assignment provided a comprehensive, computationally efficient, and stable framework, while continuous measures of signature activity yielded more reliable inferences than arbitrary thresholds. These findings support more rigorous evaluation of mutational signatures and TMB as biomarkers in SCLC.

PMID:42544366 | PMC:PMC13429233 | DOI:10.3389/fgene.2026.1776578

Infect Dis Clin Microbiol. 2026 Jul 28;8(4):339-350. doi: 10.36519/idcm.2026.1044. eCollection 2026 Jul.

ABSTRACT

OBJECTIVE: Granulomatous mastitis (GM) is a chronic inflammatory breast disease with a heterogeneous clinical presentation and uncertain optimal management. Increasing evidence suggests a role for Corynebacterium species, particularly Corynebacterium kroppenstedtii, in its pathogenesis. This study aimed to evaluate the clinical characteristics, treatment strategies, and outcomes of granulomatous mastitis, with particular emphasis on cases associated with Corynebacterium species and the impact of antibiotic therapy.

MATERIALS AND METHODS: This retrospective cohort study included female patients with GM treated at a university hospital between January 2018 and January 2023. Patients were grouped according to Corynebacterium isolation. Clinical characteristics, microbiological findings, and treatment modalities-oral steroids, combined antibiotic-steroid therapy, antibiotics with intralesional steroids, and segmental mastectomy-were evaluated. The impact of lipophilic antibiotics (tetracyclines, linezolid, rifampin) combined with steroids was assessed. Recurrence rates and associated factors, including symptom duration, were -analyzed.

RESULTS: A total of 165 patients were included in the study, of whom 25 tested positive and 140 negative. Corynebacterium spp. were detected in 15.15% of cases, with C. kroppenstedtii identified in 8.48%. Patients with Corynebacterium-associated GM had more extensive abscess formation and required more interventional procedures. Multimodal treatment strategies combining steroids, antibiotics, and surgery resulted in favorable outcomes. Lipophilic antibiotics combined with steroids showed a positive but statistically non-significant effect. Recurrence occurred in 16.4% of patients and was associated with longer symptom duration.

CONCLUSION: Accurate microbiological identification is essential in GM, particularly in C. kroppenstedtii infections, to guide targeted antibiotic therapy and reduce recurrence. Tailored management strategies, including lipophilic antibiotics, may improve outcomes. Further studies are needed to define optimal treatment duration and the role of surgery in refractory GM.

GRAPHICAL ABSTRACT: Graphical Abstract.

PMID:42544365 | PMC:PMC13429223 | DOI:10.36519/idcm.2026.1044

Dela J Public Health. 2026 Jul 31;12(3):101-107. doi: 10.32481/djph.2026.07.17. eCollection 2026 Jul.

ABSTRACT

OBJECTIVE: To determine whether fecal incontinence is associated with cardiovascular, pulmonary, and kidney disease, individually and in combination, and with all-cause mortality among community-dwelling US adults.

METHODS: Nationally representative cohort study using the National Health and Nutrition Examination Survey (NHANES) 2005-2010 with linkage to the National Death Index through December 31, 2019. The analytic cohort comprised 14,731 adults aged 20 years or older, with 14,718 eligible for mortality analysis. Fecal incontinence, defined as accidental leakage of mucus, liquid stool, or solid stool during the prior 30 days. A composite cardiopulmonary-kidney (CPK) burden was calculated as the count of three affected systems: cardiovascular disease (self-report), pulmonary disease (current asthma, emphysema, or chronic bronchitis), and kidney disease markers (estimated glomerular filtration rate <60 mL/min/1.73 m², urine albumin-creatinine ratio ≥30 mg/g, or self-reported kidney disease). Multisystem CPK burden was defined as ≥2 affected systems.

Survey-weighted prevalence ratios (PRs) for each cardiopulmonary-kidney outcome from modified Poisson regression and hazard ratios (HRs) for all-cause mortality from Cox proportional hazards models, with sequential adjustment for sociodemographic, cardiometabolic, and shared functional/mood/urinary factors.

RESULTS: Among 14,731 adults (weighted mean age 46.8 years; 51.2% women), the weighted prevalence of fecal incontinence was 8.4% (95% CI, 7.8%-9.0%). Adults with fecal incontinence were nearly a decade older than those without (mean age 55.6 vs 46.0 years) and had higher prevalences of urinary incontinence (62.0% vs 32.6%), depressive symptoms (17.4% vs 6.2%), and functional limitation (30.3% vs 13.8%) (all P<.001). After full adjustment, fecal incontinence remained associated with kidney disease markers (PR, 1.16; 95% CI, 1.02-1.32) and with simultaneous involvement of all three CPK systems (PR, 2.38; 95% CI, 1.47-3.86). During follow-up, 2,395 deaths occurred. Crude mortality was 80.8 per 1,000 person-years among adults with both fecal incontinence and multisystem CPK burden, versus 10.6 in adults with neither. After adjustment, multisystem CPK burden alone (HR, 1.80; 95% CI, 1.58-2.04) and combined fecal incontinence plus burden (HR, 2.14; 95% CI, 1.66-2.77) predicted mortality. Fecal incontinence alone did not (HR, 1.06; 95% CI, 0.87-1.28). With multisystem CPK burden as the reference, the combined group did not demonstrate a statistically significant mortality increment (HR, 1.19; 95% CI, 0.92-1.54; P=.18).

CONCLUSIONS AND RELEVANCE: Fecal incontinence in US adults is associated with disproportionate cardiopulmonary-kidney disease, functional impairment, and mortality, but the association with mortality was related to multisystem disease rather than to bowel symptoms themselves. Disclosure of fecal incontinence is a low-cost clinical signal that warrants integrated systemic assessment, including routine kidney function testing, rather than purely anorectal evaluation.

PMID:42544354 | PMC:PMC13429248 | DOI:10.32481/djph.2026.07.17