Nevin Manimala

Actas Esp Psiquiatr. 2026 Apr 15;54(2):443-454. doi: 10.62641/aep.v54i2.2115.

ABSTRACT

BACKGROUND: Psychometric screening tools for persons in penitentiary centers (PPC) are key to assessing their mental health needs, given the shortage of both time and mental health personnel. Depression and anxiety are among the most prevalent mental health problems in PPC. Inadequate diagnosis can lead to increased symptom severity and even suicide. Therefore, validating instruments to assess depression and anxiety in PPC populations is essential to reduce the risk of misdiagnosis and its consequences.

METHODS: A cross-sectional study was conducted to evaluate the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) in 272 men (>18 years old) deprived of liberty in a penitentiary center in Mexico. Both exploratory and confirmatory factor analyses were performed. Concurrent and discriminant validity were assessed using the depression and anxiety scales of the International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11) Primary Health Care (PHC). Receiver Operating Characteristic curves were plotted to determine the best cut-off points in both instruments.

RESULTS: Both the PHQ-9 and GAD-7 showed items that were representative of their underlying constructs and supported the original one-factor structure, with satisfactory goodness-of-fit indices in both exploratory and confirmatory analyses. Both instruments exhibited good internal consistency in the sample of Mexican men incarcerated in penitentiary centers (α = 0.87 and α = 0.89, respectively). Furthermore, both scales showed strong correlations with the ICD-11 PHC depression and anxiety scales, along with adequate sensitivity, specificity, false positive, and false negative rates, resulting in a low misclassification rate.

CONCLUSIONS: The PHQ-9 and GAD-7 can be used to briefly and reliably assess depression and anxiety among male PPC in Mexico City and in populations with similar institutional and sociodemographic conditions Given the specific characteristics of PPC populations across different countries, it remains necessary to continue testing these instruments in underrepresented populations to ensure the development of reliable and valid tools that help identify potentially confusing items and minimize diagnostic errors.

PMID:42023458 | DOI:10.62641/aep.v54i2.2115

Actas Esp Psiquiatr. 2026 Apr 15;54(2):362-368. doi: 10.62641/aep.v54i2.2161.

ABSTRACT

OBJECTIVE: This study aims to identify predictive factors for significant cognitive improvement following transcranial direct current stimulation (tDCS) in patients with post-stroke cognitive impairment (PSCI), thereby providing evidence for individualized clinical intervention.

METHODS: A total of 123 patients with PSCI who received tDCS treatment were retrospectively enrolled. Based on changes in Mini-Mental State Examination (MMSE) scores, patients were classified into a cognitive improvement group (n = 61) and a non-improvement group (n = 62). Baseline clinical characteristics were collected, and activities of daily living were using the Modified Barthel Index (MBI). Univariate analyses were performed to compare differences between the two groups, and variables with statistical significance in univariate analysis were further entered into a multivariate logistic regression model to identify independent predictors of significant cognitive improvement following tDCS treatment.

RESULTS: The proportion of patients with a university education or above was significantly in the cognitive improvement group higher than in the non-improvement group (p < 0.001); whereas the proportion of patients with a history of stroke in the non-improvement group was significantly higher (p < 0.05). Patients in the cognitive improvement group had a significantly shorter disease duration compared to those in the non-improvement group (p < 0.05); meanwhile, a higher proportion of patients with Fazekas grade 0-1 was observed in the improvement group (p < 0.05). Results of the multivariate Logistic regression analysis indicated that educational level and disease duration were independent predictive factorsforsignificant cognitive improvement after tDCS treatment (p < 0.05).

CONCLUSION: PSCI patients with higher educational level and shorter disease duration have a better cognitive improvement effect following tDCS treatment.

PMID:42023448 | DOI:10.62641/aep.v54i2.2161

Actas Esp Psiquiatr. 2026 Apr 15;54(2):398-408. doi: 10.62641/aep.v54i2.2174.

ABSTRACT

BACKGROUND: This research aimed to examine the effects of multi-role collaborative palliative care on anxiety, cancer-related fatigue (CRF), psychological status, and quality of life in patients with advanced lung cancer, and to explore potential mechanisms using correlation analysis and structural equation modelling.

METHODS: We conducted a retrospective study of the medical records of 200 patients with advanced lung cancer. Based on the care they received, patients were divided into two groups: a control group (n = 100) that received standard nursing care, and a combined nursing group (n = 100) that received multi-role collaborative palliative care. Anxiety, CRF, psychological status, and overall quality of life were compared between the two groups based on the record documented before and after nursing care. Adverse events recorded during the nursing period were also reviewed and analysed. Path analysis of variables was conducted using the AMOS module of SPSS.

RESULTS: Following nursing care, the combined group showed significantly lower CRF and anxiety scores, and significantly higher psychological state and quality of life scores compared with both pre-nursing scores and the control group (all p < 0.05). There was no statistically significant difference in the rate of adverse event between the two groups (36.00% vs. 28.00%, p > 0.05). Path analysis indicates that multi-role collaborative palliative care is associated with lower levels of anxiety. This association has a direct relationship and indirect relationships through its connection with the reduction of CRF and the improvement of psychological condition. Path analysis shows that multirole collaborative palliative care not only directly alleviates patients’ inner anxiety, but also may indirectly reduce inner anxiety by lowering CRF and improving psychological conditions.

CONCLUSIONS: Implementing multi-role collaborative palliative care for patients with advanced lung cancer can help alleviate CRF, relieve anxiety, improve psychological state and enhance quality of life. Exploratory path analysis suggests that this nursing model has a significant direct statistical association with lower anxiety. This association may also involve indirect interrelations with lower CRF and a better psychological state.

PMID:42023445 | DOI:10.62641/aep.v54i2.2174

Acad Emerg Med. 2026 Apr;33(4):e70285. doi: 10.1111/acem.70285.

ABSTRACT

BACKGROUND: Adult epiglottitis is an uncommon but potentially life-threatening condition requiring rapid recognition and airway-focused management, yet evidence regarding early medical therapy is limited. We evaluated temporal trends in adult epiglottitis and examined associations between early corticosteroid or antibiotic therapy and clinically important outcomes.

METHODS: We conducted a retrospective cohort study of adults (≥ 18 years) presenting to U.S. emergency departments with acute epiglottitis between 2014 and 2024 using the TriNetX Research Network. Cases were identified using the ICD-10 code J05.1; patients with preexisting tracheostomy were excluded. Early therapy was defined as systemic corticosteroid or parenteral antibiotic administration within 24 h of presentation. The primary outcome was endotracheal intubation; secondary outcomes included ICU admission, 30-day ED recidivism, and 30-day mortality. Propensity score matching (1:1) and multivariable Cox proportional hazards models were used to estimate risk ratios (RRs) and hazard ratios (HRs).

RESULTS: The annual incidence proportion of adult epiglottitis increased from 0.002% in 2014 to 0.005% in 2024 (RR per year 1.09; 95% CI 1.08-1.10), with the steepest rise among adults aged 60-74 years. In matched cohorts, early corticosteroid therapy was associated with lower risks of intubation (RR 0.48; 95% CI 0.26-0.88) and ICU admission (RR 0.71; 95% CI 0.55-0.92). Early antibiotic therapy demonstrated similar associations for intubation (RR 0.54; 95% CI 0.34-0.85) and ICU admission (RR 0.72; 95% CI 0.60-0.86). In adjusted Cox models, early steroids (HR 0.33; 95% CI 0.25-0.44) and early antibiotics (HR 0.50; 95% CI 0.34-0.75) were independently associated with lower hazards of intubation. Older age, comorbidities, and hypoxia were strong predictors of airway compromise.

CONCLUSIONS: Adult epiglottitis incidence has increased over the past decade, particularly among older adults. Early corticosteroid and antibiotic therapy were independently associated with lower risks of intubation and ICU admission, supporting current clinical practice favoring timely medical therapy in adults with suspected epiglottitis.

PMID:42023439 | DOI:10.1111/acem.70285

Disaster Med Public Health Prep. 2026 Apr 23;20:e92. doi: 10.1017/dmp.2026.10352.

ABSTRACT

Few reports detail the operation of Japan’s unique disaster countermeasures, mobile pharmacy vehicles (MPVs). This case report draws on the authors’ direct operational experience and anonymized, retrospective open-access data to describe the current system and actual operations of MPVs and examine the feasibility of their international implementation. During the Noto Peninsula Earthquake in January 2024, 13 MPVs were deployed to the affected areas following dispatch requests, and 1,834 disaster prescriptions were issued. In accordance with the local medical care delivery system, the deployment of MPVs was coordinated by the disaster pharmacy coordinator, contributing to the rapid and flexible provision of medical services. These results demonstrate the potential international applicability of the MPV system. Further development of information management and operational systems, along with their adaptation for other uses, may enhance the utility of the MPV model as a component of disaster medical support in other countries.

PMID:42023420 | DOI:10.1017/dmp.2026.10352

Biomater Investig Dent. 2026 Apr 16;13:45703. doi: 10.2340/biid.v13.45703. eCollection 2026.

ABSTRACT

BACKGROUND: Rebonding of orthodontic brackets requires effective surface conditioning to restore adequate adhesive retention.

OBJECTIVE: To compare the shear bond strength (SBS) of rebonded metal brackets using four light-curing resins.

MATERIAL AND METHODS: Eighty premolars were allocated to two conditioning protocols (n = 40 per group): G1 – enamel etching with 37% phosphoric acid; G2 – sandblasting of bracket bases followed by enamel etching. Each group was subdivided according to the resin used (n = 10 per subgroup): Orthocem (FGM), Bracespace (3M), Transbond XT (3M), and Z250 (3M). Brackets were bonded, debonded, reconditioned, and rebonded. SBS was tested using a universal testing machine (0.5 mm/min). Data were analyzed using Kruskal-Wallis and Dunn’s post-hoc tests (α = 0.05).

RESULTS: In the acid-etched group, there was no statistically significant difference in SBS among the four resins (Kruskal-Wallis, p = 0.097). In the sandblasting group, a significant intergroup difference was observed (p = 0.044). Dunn’s post-hoc test identified higher SBS for Bracespace (3M) and Transbond XT (3M) compared with Orthocem (FGM) and Z250 (3M). When comparing conditioning methods within each resin, sandblasting of the bracket bases resulted in significantly higher SBS only for Bracespace and Transbond XT, whereas Orthocem and Z250 showed no significant change.

CONCLUSIONS: Rebonding of metal brackets showed comparable SBS among resins after acid etching. However, when the bracket bases were sandblasted, Bracespace and Transbond exhibited significantly higher bond strengths. Surface preparation of the bracket base is therefore a key factor influencing SBS in rebonding procedures.

PMID:42023411 | PMC:PMC13097089 | DOI:10.2340/biid.v13.45703

Front Parasitol. 2026 Apr 7;5:1749169. doi: 10.3389/fpara.2026.1749169. eCollection 2026.

ABSTRACT

Malaria remains a major public health concern in Cameroon, with Plasmodium falciparum responsible for most morbidity and mortality, particularly among children under five. In response to rising cases, Cameroon began implementing the RTS,S/AS01 malaria vaccine in early 2024. Given the vaccine’s strain-specific efficacy, understanding haplotypic diversity is critical for evaluating long-term impact. We analyzed 100 P. falciparum-positive dried blood spots collected in Mapoussere, Kaele Health District (2022-2023). Using the 4CAST amplicon sequencing assay, we targeted four genes: csp (circumsporozoite protein), ama1 (apical membrane antigen 1), sera2 (serine repeat antigen 2), and trap (thrombospondin-related anonymous protein). Haplotypes were identified using SeekDeep, and diversity metrics including heterozygosity (He), nucleotide diversity (π), and selection statistics (Tajima’s D, Fu and Li’s D*, F*) were computed. We successfully genotyped csp in 35% of samples, identifying 22 haplotypes (He = 0.908; π = 0.021). The vaccine-matched haplotype was present in 20% of genotyped infections. The T cell TH2 and TH3 epitopes of csp showed signs consistent with balancing selection. Both ama1 and sera2 exhibited higher genotyping success and diversity, with ama showing significant Tajima’s D values. Within-participant haplotype counts were highest for ama1 (mean = 2.8), followed by sera2 (2.1), csp (1.3), and trap (1.2). This study provides a baseline of P. falciparum haplotype diversity in a vaccine-targeted region. The presence of vaccine-matched strains and high diversity in TH2/TH3 epitopes in csp may influence vaccine efficacy. Continued molecular surveillance is essential to monitor antigenic shifts and guide future strategies.

PMID:42023409 | PMC:PMC13097004 | DOI:10.3389/fpara.2026.1749169

Clin Ophthalmol. 2026 Apr 17;20:576990. doi: 10.2147/OPTH.S576990. eCollection 2026.

ABSTRACT

PURPOSE: To understand the efficiency, safety, and patient acceptability of using an artificial intelligence-based conversational agent Dora R2 (Ufonia Limited, UK) in the cataract pathway.

PATIENTS AND METHODS: This mixed methods cohort-based service evaluation included both prospective and retrospective data collection from two UK public hospitals: Oxford University Hospitals National Health Service (NHS) Foundation Trust and Buckinghamshire Healthcare NHS Trust. Patients undergoing cataract surgery of mixed complexity were included. All patients who had postoperative calls with Dora R2 between October 2022 and April 2023 were included. Dora R2 calls patients three weeks after routine cataract surgery to assess symptoms and answer patient queries. Patient demographics and clinical outcomes were reviewed, and statistical analyses were performed to identify any differences based on age, gender and ethnicity.

RESULTS: Of 1580 eligible patients, 1269 (78%) completed the Dora R2 call. About 767 (63%) had “no clinical concerns” identified by Dora. The median patient age was 77 years, with 84% identifying as white. There were no significant differences in call outcomes based on demographic factors (at 5% significance level). The Net Promoter Score for patient acceptability was 47, indicating high satisfaction. Regarding safety, only 0.3% of patients required unplanned management changes within two weeks of a Dora call with a “no concerns identified” outcome.

CONCLUSION: Dora R2 effectively supports postoperative follow-up for cataract surgery, demonstrating high efficiency, safety, and patient acceptability. The technology successfully supports clinicians in identifying uncomplicated cases, reduces the need for clinician-led consultations, and does not exacerbate digital inequalities, showing promise for broader implementation.

PMID:42023401 | PMC:PMC13098554 | DOI:10.2147/OPTH.S576990

Res Pract Thromb Haemost. 2026 Mar 24;10(3):103418. doi: 10.1016/j.rpth.2026.103418. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: Hemophilia carriers (HCs) and women with von Willebrand disease (VWD) receive specialized obstetric care because of a higher chance for postpartum bleeding and potential bleeding in the neonates. It is unknown what their postpartum quality of life (QoL), childbirth satisfaction, and experience are and how this differs from the general population.

OBJECTIVES: This study assessed QoL, childbirth satisfaction and experience in HCs and women with VWD at week 1 and 6 postpartum. These outcomes are compared with those from retrospective studies of the general population.

METHODS: Participants completed 3 patient-reported outcome measures postpartum: the Short Form-36 at week 1 and 6 measuring QoL, the Mackey Childbirth Satisfaction Rate Scale at week 1 for childbirth satisfaction, and the Labor and Delivery Index at week 6 for childbirth experience. Descriptive statistics were used.

RESULTS: In total, 85 HCs and 81 women with VWD completed ≥1 questionnaire. Pain and physical functioning improved over time (both moderate to fairly well; P < .001). Six weeks postpartum, QoL was lower in both groups than those in the general population. Over 88% of both cohorts reported “at least satisfied” on the Mackey Childbirth Satisfaction Rate Scale, significantly higher than the general population (>61%; P < .001). Mean Labor and Delivery Index scores (1.3-1.9 points) indicated an adequate childbirth experience. HCs reported more child-related worries than the general population (37.3% vs 72.2%; P < .001).

CONCLUSION: HCs and women with VWD recover less between week 1 and 6 postpartum than the general population. HCs report more worries about their child during childbirth than women with VWD and the general population.

PMID:42023400 | PMC:PMC13098571 | DOI:10.1016/j.rpth.2026.103418

Res Pract Thromb Haemost. 2026 Mar 26;10(3):103433. doi: 10.1016/j.rpth.2026.103433. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: Intracranial hemorrhage (ICH) is a fatal complication of leukemia; however, mechanisms underlying its development, particularly central nervous system (CNS) involvement and vascular injury, remain unclear.

OBJECTIVES: We aimed to investigate the histopathologic features of cerebral vessels in leukemia and the expression of hemostasis-related factors in leukemia cells.

METHODS: We conducted an autopsy-based study including 37 leukemia cases and 20 matched controls. Histopathologic analysis of CNS tissues was performed to evaluate ICH, leukemia cell localization, and vascular injury. Immunohistochemistry was performed to assess expression of vascular endothelial growth factor (VEGF), cathepsin G, tissue-type plasminogen activator, urokinase-type plasminogen activator, urokinase-type plasminogen activator receptor, and tissue factor in leukemia cells. Vascular integrity was evaluated using stains for smooth muscle actin, collagen, fibrin, and von Willebrand factor.

RESULTS: ICH was identified in 68% of leukemia cases and was associated with fatal brain herniation in 40%. CNS involvement was observed in 54% of cases, often without a clinical diagnosis. The leukemia cell infiltration of meninges and vascular walls was frequently associated with changes in smooth muscle cells and adventitial collagen. CNS vascular injury was frequently associated with ICH in the presence of leukemia cell infiltration. VEGF and urokinase-type plasminogen activator were highly expressed in leukemia cells. VEGF was associated with meningeal invasion, while cathepsin G was predominantly expressed in myeloid leukemia and linked to vascular damage.

CONCLUSION: VEGF and cathepsin G may serve as markers of meningeal invasion and cerebral vascular damage in leukemia, respectively.

PMID:42023399 | PMC:PMC13098595 | DOI:10.1016/j.rpth.2026.103433