Nevin Manimala

Acta Psychiatr Scand. 2026 Jun 3. doi: 10.1111/acps.70114. Online ahead of print.

ABSTRACT

INTRODUCTION: Individuals with mental illness have a markedly reduced life expectancy, partly due to a significantly increased risk of developing type 2 diabetes, driven by lifestyle factors and the adverse metabolic effects of psychotropic medications. This study examined whether abnormal laboratory values indicating incident diabetes, when ordered within psychiatric services, were followed by documented interventions.

METHODS: We used electronic health record data from the Psychiatric Services of the Central Denmark Region and drew a random sample of patients with incident diabetes detected between 2019 and 2024. Incident diabetes was defined by the first laboratory value ordered by the psychiatric services indicating diabetes: glycated haemoglobin ≥ 48 mmol/mol, fasting plasma glucose ≥ 7.0 mmol/L, plasma glucose ≥ 11.1 mmol/L during a 2-h oral glucose tolerance test or random plasma glucose. Patients with pre-existing diabetes, identified through ICD-10 codes or antidiabetic medication history, were excluded. Manual chart review assessed whether incident diabetes was followed, within 3 months, by documented clinical intervention (such as referral, repeat testing, or medication initiation), or was merely acknowledged without further action. Descriptive statistics and adjusted logistic regression analysis were used to characterise the cohort and examine characteristics associated with lack of intervention.

RESULTS: Among 416 patients with incident diabetes (57% male, median age 48 years [IQR: 35-59], 33% with schizophrenia or other psychotic disorders), only 37% received a clinical intervention. The most frequent intervention was referral to a general practitioner (27%), while antidiabetic medication was initiated in only 6% of those who received an intervention. The only characteristic associated with lack of clinical intervention was body mass index < 25 kg/m² (adjusted odds ratio 3.82, 95% CI: 1.92-8.20).

CONCLUSION: This study suggests that appropriate clinical intervention following detection of incident diabetes is lacking. This may inform future strategies to reduce metabolic and cardiovascular risks among individuals with mental illness.

PMID:42233222 | DOI:10.1111/acps.70114

Br J Nutr. 2026 Jun 3:1-34. doi: 10.1017/S0007114526107624. Online ahead of print.

ABSTRACT

Skinfold prediction equations (SF-PE) are used to estimate percent body fat (%BF), but it’s unclear which SF-PE are most accurate among different age/sex groups. The purpose was to assess accuracy of estimating %BF from SF-PE in young, middle-age, and older male and female adults, and compare %BF from SF-PE to Inbody770 (IB770), a selected bioelectrical-impedance criterion reference. Two hundred two healthy males (n=96) and females (n=106) had %BF assessed from 12 SF-PE for females, 13 SF-PE for males, and IB770. Repeated measures 1-way ANOVAs (p < 0.01) were employed for three age groups for both males and females, and Bland-Altman plots were employed to evaluate the agreement between IB770 and SF-PE. Based both on statistical assessment and the Bland-Altman plots, similarity, agreement, and accuracy observed in %BF between IB770 and SF-PE were determined. From these assessments and plots, the following SF-PE are recommended to estimate %BF in young males (YM), middle-age males (MM), older males (OM), young females (YF), middle-age females (MF), and older females (OF) (%BF between IB770 and SF-PE shown): 1) YM: IB770 = 16.2%; Durnin 1974 (DW) = 16.3%; Williams 1992 (W) = 16.2%; Lean 1996 (L) = 16.6% ; 2) MM: IB770 = 19.7%; W = 19.7%; DW = 22.3%; 3) OM: IB770 = 24.4%; DW = 25.3%; W = 22.4%; 4) YF: IB770 = 24.9%; Jackson 1985 (JP3b) = 23.8%; 5) MF: IB770 = 25.2%; Jackson 1980 = 25.0%; JP3b = 26.1%; and 6) OF: IB770 = 36.6%; Peterson 2003 = 36.2%. Given that SF-PE either underestimated, overestimated, or accurately estimated %BF compared to IB770, this emphasizes the importance of using SF-PE that are appropriate for different age/sex groups and provide as accurate as possible estimates of %BF. Assessing %BF accurately is important given excessive %BF increases cardiometabolic disease risk.

PMID:42233218 | DOI:10.1017/S0007114526107624

Am J Public Health. 2026 Jun 3:e1-e10. doi: 10.2105/AJPH.2026.308500. Online ahead of print.

ABSTRACT

Objectives. To identify nutritional characteristics associated with the perceived addictive potential of commonly consumed foods in the US food supply, the majority of which are ultraprocessed foods (UPFs). Methods. In a demographically diverse sample of US adults (n = 1664; 55.2% female), participants rated the perceived addictiveness of 297 commonly consumed foods (74.4% UPFs). Data were collected through Prolific in June 2024. Machine-learning models identified nutritional predictors of addictiveness using both the 15 variables required on US Nutrition Facts labels and an expanded set of 166 nutrient characteristics from the Nutrition Data System for Research. Results. Models performed comparably and revealed consistent nonlinear associations between nutrient content and perceived addictiveness. Foods higher in carbohydrates, glycemic load, energy density, and fat were rated as more addictive. These nutrient profiles were rare in minimally processed foods but common in UPFs, which frequently exceeded multiple addictive nutrient thresholds simultaneously. Conclusions. This study identifies a nutritional signature linked to perceived addictive potential. Findings provide a data-driven framework for identifying foods most likely to promote compulsive intake and inform policies aimed at creating a healthier, less addictive food environment. (Am J Public Health. Published online ahead of print June 3, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308500).

PMID:42233199 | DOI:10.2105/AJPH.2026.308500

Ther Clin Risk Manag. 2026 May 27;22:597422. doi: 10.2147/TCRM.S597422. eCollection 2026.

ABSTRACT

PURPOSE: This retrospective multicenter cohort study evaluated the real-world effectiveness of propofol alone versus a propofol-plus-dexmedetomidine combination on clinical outcomes in mechanically ventilated ICU patients.

METHODS: Adult mechanically ventilated ICU patients receiving long-term continuous infusion sedation (≥48 h) with either propofol alone or propofol plus dexmedetomidine were identified from the MIMIC-IV and eICU databases. An external validation cohort from Nanjing Drum Tower Hospital (2013-2022) was assembled using the same eligibility criteria. Patients were categorized into a propofol monotherapy group (Pro) and a propofol plus dexmedetomidine group (Pro+Dex). Outcomes included 28-day all-cause mortality, incident delirium, ICU length of stay, duration of mechanical ventilation, and longitudinal changes in mean arterial pressure, heart rate, and oxygen saturation.

RESULTS: Among 5495 patients (Pro: n=4730; Pro+Dex: n=765), the Pro+Dex regimen was associated with lower 28-day mortality (adjusted HR: 0.45, 95% CI: 0.36-0.56; P < 0.001) and a markedly reduced incidence of delirium (adjusted OR: 0.28, 95% CI: 0.21-0.37; P < 0.001), but with a modestly longer ICU stay (13.07 vs 10.60 days; adjusted ratio: 1.23, 95% CI: 1.18-1.29). Mechanical ventilation duration did not differ significantly between groups (154.79 vs 157.64 hours; adjusted ratio: 0.98, 95% CI: 0.92-1.05). Longitudinal mixed-effects models suggested a more stable MAP trajectory and lower HR with Pro+Dex, while SpO₂ was slightly lower on average but remained stable over time. Subgroup analyses were broadly consistent with the overall cohort. In the external validation cohort, Pro+Dex was also associated with significantly lower 28-day mortality, whereas the reduction in delirium incidence did not reach statistical significance.

CONCLUSION: In this large real-world multicenter study, combination sedation with propofol and dexmedetomidine was associated with lower 28-day mortality and a lower risk of delirium, without a significant difference in mechanical ventilation duration, although ICU length of stay was modestly longer.

PMID:42233162 | PMC:PMC13222770 | DOI:10.2147/TCRM.S597422

Front Cell Infect Microbiol. 2026 May 18;16:1816857. doi: 10.3389/fcimb.2026.1816857. eCollection 2026.

ABSTRACT

OBJECTIVE: To establish a rapid multiplex PCR capillary electrophoresis (MPCE) method for the simultaneous detection of seven sexually transmitted infection pathogens, and to evaluate its clinical utility.

METHODS: We designed specific primers and optimized multiplex PCR conditions. Capillary electrophoresis enabled fragment analysis. We assessed diagnostic performance, including sensitivity, specificity, anti-interference capacity, and repeatability. Using commercially available reagents as references, we evaluated the agreement of MPCE with 205 clinical samples. Kappa consistency test and McNemar test were used to evaluate the consistency and difference between this method and the reference methods.

RESULTS: The detection system was successfully constructed, with a detection time of three hours. It enabled simultaneous detection of seven common genital tract pathogens, including Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), Mycoplasma genitalium (MG), Neisseria gonorrhoeae (NG), Mycoplasma hominis (MH), Herpes simplex virus type 2 (HSV-2), and Ureaplasma parvum (UP). The method demonstrated good specificity and anti-interference capacity, with a limit of detection (LOD) ranging from 325 to 900 copies/mL across all targets. Repeatability results showed minimal fragment length fluctuations (0.13-0.20 nt), and the coefficient of variation (CV) for log peak area ranged from 0.78% to 5.56%. Agreement between the developed method and commercial reference assays was good for all seven pathogens: CT, 94.93% (Kappa = 0.84); MG, 95.12% (Kappa = 0.88); NG, 96.59% (Kappa = 0.91); UP, 95.61% (Kappa = 0.88); MH, 97.07% (Kappa = 0.82); HSV-2, 100% (Kappa = 1.00); and UU, 91.71% (Kappa = 0.69). The positivity rates of MG and NG detected by this method were higher than those by the reference methods (P = 0.008 and P = 0.011, respectively), and there was no statistical difference for the other pathogens (P>0.05).

CONCLUSION: This study successfully established a MPCE-based assay for the simultaneous detection of seven common genital tract pathogens (CT, UU, MG, NG, MH, HSV-2, and UP) in a single reaction. The method demonstrated high sensitivity, excellent repeatability and strong agreement with commercial reference assays. With its high throughput and rapid turnaround time, this method is well-suited for clinical screening and large-scale epidemiological surveillance of genital tract infections.

PMID:42233157 | PMC:PMC13223153 | DOI:10.3389/fcimb.2026.1816857

Mitochondrial DNA B Resour. 2026 May 30;11(7):807-811. doi: 10.1080/23802359.2026.2679244. eCollection 2026.

ABSTRACT

The complete chloroplast (cp) genome of Hydrocleys nymphoides, an aquatic ornamental plant, was sequenced and assembled in this study. The circular genome was 187,253 bp in length and exhibited a typical quadripartite structure of the large single-copy (LSC, 94,246 bp) and small single-copy (SSC, 483 bp) regions, separated by a pair of inverted repeats (IRs, 46,262 bp). The cp genome contains 116 unique genes, including 80 protein-coding genes, 32 tRNA, and four rRNA genes. The phylogenetic analysis based on whole cp genome demonstrated a close relationship between Hydrocleys and Alisma under current sampling. Our study will offer valuable genetic resources for phylogenetic and evolutionary research.

PMID:42233151 | PMC:PMC13224693 | DOI:10.1080/23802359.2026.2679244

Indian J Palliat Care. 2026 Apr-Jun;32(2):207-211. doi: 10.25259/IJPC_440_2025. Epub 2026 May 12.

ABSTRACT

OBJECTIVES: Cancer-related fatigue (CRF) is a debilitating symptom that significantly affects the quality of life of patients with cancer. Effective management requires accurate documentation and timely implementation of non-pharmacological interventions (NPIs), which are considered first-line strategies. This study aimed to assess the documentation of CRF and NPIs in palliative care and evaluate the impact of a standardized operating procedure (SOP) on documentation compliance. The aim of the study is to assess the documentation of CRF and NPIs in palliative care and evaluate the impact of implementing a standardised operating procedure (SOP) on documentation compliance.

MATERIALS AND METHODS: A retrospective audit was conducted in two phases: pre-multidisciplinary team (MDT) induction and post-MDT induction, followed by a re-audit after six months. Documentation rates for CRF and NPIs were statistically analysed, and associated symptom clusters were identified using Epi Info software (Version 7.6.2).

RESULTS: CRF documentation improved from 67% in 2021 to 84% in 2022, and further to 98.5% (February 2023) and 89.3% (March 2023) and 96.7% (September 2023). NPI documentation increased from 0% in 2021 to 36% in 2022, and subsequently to 86.5%, 89.9%, and 86.5% in re-audits. Significant symptom clusters associated with CRF included loss of appetite (p < 0.01), loss of well-being (p < 0.001), and breathlessness (p < 0.01).

CONCLUSION: Implementation of an SOP significantly improved CRF and NPI documentation. Identification of key symptom clusters provides important insights for targeted interventions and future research in palliative care.

PMID:42233144 | PMC:PMC13224299 | DOI:10.25259/IJPC_440_2025

Indian J Palliat Care. 2026 Apr-Jun;32(2):212-221. doi: 10.25259/IJPC_409_2025. Epub 2026 May 12.

ABSTRACT

OBJECTIVES: Cancer-related pain and fatigue are prevalent and debilitating symptoms experienced by most cancer patients. Chronic fatigue in cancer patients leads to sleep disturbances and reduces performance status, especially during treatment. This study aims to explore characteristics of pain and factors associated with fatigue among patients with solid malignancies diagnosed for the 1^st time.

MATERIALS AND METHODS: This cross-sectional, prospective survey purposively included 141 patients with solid malignancies presenting for the 1^st time at a tertiary care hospital. Information was collected using a structured pre-tested socio-demographic and clinical profile, the McGill pain questionnaire and the multi-dimensional fatigue inventory-20. Relevant descriptive and inferential statistics were used to generate the results.

RESULTS: In this study, 141 patients (male 66, female 75, mean age 49.87 [standard deviation = 10.45]) were included. The most frequent pain descriptor terms were ‘pricking’ (n = 49, 34.8%), ‘sharp’ (n = 39, 27.7%), ‘shooting’ (n = 33, 23.4%), ‘stabbing’ (n = 29, 20.6%), ‘pulling’ (n = 27, 19.1%) and ‘suffocating’ (n = 25, 17.7%). Severe clinical insomnia was presented in 14.9% of patients. Findings reported that advanced age, informal education, distant metastasis, no pain medications, sleep disturbances and poor performance status were associated with higher fatigue in patients.

CONCLUSION: Patients with cancer reported a multifaceted nature of pain. Cancer stage, tumour extension, performance status and sleep disturbances are among the factors associated with higher fatigue among patients. The use of evidence-based pain and fatigue management protocols, along with targeting sleep quality and performance status, may help improve the care and well-being of cancer patients.

PMID:42233140 | PMC:PMC13224310 | DOI:10.25259/IJPC_409_2025

Indian J Palliat Care. 2026 Apr-Jun;32(2):190-197. doi: 10.25259/IJPC_245_2025. Epub 2026 May 12.

ABSTRACT

OBJECTIVES: Head-and-neck cancer (HNC) survivors undergoing concurrent chemoradiotherapy frequently experience treatment-related impairments such as trismus, cervical and shoulder dysfunction, and masticatory muscle weakness. This study aimed to develop and evaluate the feasibility of the CALORIE CARE programme, a tailored exercise intervention for HNC survivors undergoing concurrent chemoradiotherapy (CCRT). The secondary objective was to assess changes in mouth opening measured by maximal interincisal opening (MIO).

MATERIALS AND METHODS: A feasibility study was conducted at a tertiary care hospital in Karnataka, India, from January 2024 to January 2025. Eligible participants were HNC survivors with TNM (Tumor, Node, and Metastasis) stages III-IVb and MIO <35 mm undergoing concurrent chemoradiotherapy. The CALORIE CARE programme was developed using the Template for Intervention Description and Replication (TIDeR) checklist. The 8-week intervention included mobility, stretching, strengthening, swallowing exercises, and aerobic activity. Feasibility outcomes included recruitment rate, adherence rate, and withdrawal rate. Exercise adherence was assessed using the Exercise Adherence Rating Scale-Kannada (EARS-Kn). MIO was measured at baseline, week 4, and week 8.

RESULTS: Among 53 eligible patients, 37 consented to participate (recruitment rate 69.81%), and 35 completed the programme (withdrawal rate 5.4%). The adherence rate was 73.94%. The mean EARS score was 17.8, indicating good adherence. A statistically significant change in MIO was observed between baseline and week 4 (p < 0.001), whereas no significant difference was observed between week 4 and week 8 (p = 0.075).

CONCLUSION: The CALORIE CARE programme appears feasible, well tolerated, and demonstrates good adherence among HNC survivors undergoing chemoradiotherapy. Early implementation of multidomain rehabilitation may help delay functional deterioration during treatment; however, its efficacy for improving clinically meaningful outcomes requires confirmation in controlled trials.

PMID:42233138 | PMC:PMC13224306 | DOI:10.25259/IJPC_245_2025

Indian J Palliat Care. 2026 Apr-Jun;32(2):167-174. doi: 10.25259/IJPC_277_2025. Epub 2026 Mar 6.

ABSTRACT

OBJECTIVES: The most prevalent malignancy among women worldwide is breast cancer (BC). While evaluating the effectiveness of treatment, the quality of life (QoL) of BC patients is crucial. The purpose of this study was to assess patients’ QoL after receiving therapy for BC.

MATERIALS AND METHODS: This was a prospective study examining the QoL in BC patients following treatment completion, which included surgery, chemotherapy and radiation therapy. The study measured the QoL of 100 patients using the European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ-C30) and its BC supplementary measure (EORTC QLQ-BR23) at three different points in time: 3 months, 1 year and 2 years after completing treatment. The patients were selected for the study using a purposive sampling technique. The socio-demographic and clinical data collected included age, education, marital status, disease stage and initial treatment. Descriptive analysis was made using frequency and percentages. For inferential statistics, a non-parametric test (Friedman test) was used for non-continuous data.

RESULTS: The average age of the patients was 46.9 ± 10.1 years, and the majority (82%) underwent mastectomy, chemotherapy and radiotherapy. The results indicated significant differences in patient functioning and overall QoL at three different points in time (p < 0.001). While there were declines in patients’ scores for body image and sexual enjoyment, there were notable improvements in breast symptoms and systemic therapy side effects (p < 0.05). Across the functioning scale, physical, cognitive, emotional, social and role functioning all showed improvement. However, on the symptom scale, fatigue was the most common issue experienced by patients, even 2 years after treatment, followed by financial difficulties and arm symptoms.

CONCLUSION: There was a significant improvement in the QoL after receiving BC treatment. However, fatigue and arm symptoms need supportive treatment on follow-up.

PMID:42233137 | PMC:PMC13224243 | DOI:10.25259/IJPC_277_2025