Nevin Manimala

Hypertension. 2026 Mar 25. doi: 10.1161/HYPERTENSIONAHA.125.26213. Online ahead of print.

ABSTRACT

BACKGROUND: Sex differences influence cardiovascular risk assessment and management; however, their role in aldosterone-mediated cardiac remodeling in primary aldosteronism remains incompletely understood.

METHODS: We conducted a retrospective study of 547 patients with primary aldosteronism, including 249 men and 298 women. Clinical and echocardiographic data were collected at baseline and 1 year following aldosterone-targeted therapies.

RESULTS: The mean age was 53.8 years in men and 54.6 years in women. At baseline, men had a higher left ventricular mass index (LVMI), whereas women had a higher prevalence of left ventricular (LV) hypertrophy and worse diastolic function, as indicated by a higher ratio of early diastolic transmitral to mitral annular velocity (E/e’) and left atrial volume index. In multivariable analyses, plasma aldosterone concentration was associated with baseline LVMI in both sexes. Associations between plasma aldosterone concentration and baseline diastolic indices, including E/e’ and left atrial volume index, were observed in men but not in women in sex-stratified models. However, formal interaction testing did not demonstrate significant sex-by- plasma aldosterone concentration interactions for left atrial volume index, E/e’, or LAVI. After 1 year of treatment, LVMI reduction was comparable between sexes. Improvement in E/e’ was significantly less pronounced in women. LAVI decreased significantly in men but not in women, although between-sex differences in change were not statistically significant.

CONCLUSIONS: Sex-specific differences in cardiac remodeling and diastolic function were observed in patients with primary aldosteronism. Despite lower baseline LVMI, women exhibited a more adverse cardiac phenotype, with a higher prevalence of left ventricular hypertrophy and worse diastolic function. Following aldosterone-targeted therapies, structural regression was similar between sexes, whereas diastolic function improved to a lesser extent in women.

PMID:41878808 | DOI:10.1161/HYPERTENSIONAHA.125.26213

Public Health Nutr. 2026 Mar 25:1-36. doi: 10.1017/S1368980026102195. Online ahead of print.

ABSTRACT

OBJECTIVE: Child hunger is a significant global health concern prioritised by multiple global public health organisations. In 2006, the United States Committee on National Statistics (CNSTAT) highlighted the need for clarity and consistency in the operationalisation and measurement of child hunger. This review examines whether these recommendations have been implemented in child nutrition programming over the past two decades. In addition, we explore how child hunger is currently conceptualised and measured across different contexts.

DESIGN: We conducted a pre-registered rapid review of studies that define or measure ‘child hunger’. Six electronic databases (Web of Science, MEDLINE, Embase, PsycINFO, Social Science Database, and ERIC) and websites of 20 public health organisations were searched for reports that mentioned the term “child hunger” or “child” near “hunger” published after 2006.

SETTING: There were no restrictions on study settings.

PARTICIPANTS: Studies focusing on children under the age of 18 years were included.

RESULTS: Sixty-seven articles measured child hunger and were therefore eligible for inclusion. Of these, only 23 provided a definition of child hunger. Definitions commonly described child hunger as a consequence of, or as a subcategory of household ‘food insecurity’. Most scales used in the included studies examined the quantity or amount of food intake by children, while few measures also assessed the quality of food consumed. The physiological dimension of hunger was not measured by any of the questionnaires.

CONCLUSIONS: The findings underscore the need for more comprehensive and standardised approaches that account for the multidimensional nature of child hunger.

PMID:41878797 | DOI:10.1017/S1368980026102195

Int Health. 2026 Mar 25:ihaf161. doi: 10.1093/inthealth/ihaf161. Online ahead of print.

ABSTRACT

This study estimated the pooled prevalence of visual acuity (VA) outcomes and potentially blinding cataract surgery complications in Nigeria. Ethical clearance was waived by the Ethical Review Board of the Kano State Ministry of Health. We searched PubMed, African journals online, Embase, MEDLINE and Google Scholar to identify relevant studies from January 1990 to February 2025. Data on presenting and best-corrected visual acuities at ≥6 weeks after cataract surgery, intraoperative posterior capsular rupture with vitreous loss and postoperative endophthalmitis were extracted from included studies. I2 statistics were used to assess heterogeneity across studies. Articles were systematically reviewed and a random effects meta-analysis model was applied to estimate the pooled effect size across studies. All statistical analyses were performed using Stata version 17.0 software. Sixteen studies, with a total of 3631 cataract-operated eyes, were included in the review. A total of 80.0% of all operated eyes had a preoperative VA of <3/60. At ≥4 weeks the percentage with good presenting VA ranged from 8% to 86%, with evidence of improved outcomes over time (95% confidence interval [CI] 45.0 to 67.0, I2=96.7%). With the best correction, 75% (95% CI 66.0 to 83.0, I2=98%) had a good outcome at ≥6 weeks postoperatively. The pooled prevalence of posterior capsular ruptures with vitreous loss was 4.0%, while 1.0% had postoperative endophthalmitis. In this review, the VA outcome after cataract surgery in Nigeria is well below the World Health Organization-recommended benchmark of >90% for a good result, with a higher rate of potentially blinding complications. The findings of this review suggest the need for improvement in modern surgical techniques, quality biometry and stocking of intraocular lenses of different powers and types to improve visual outcome and reduce complication rates.

PMID:41878785 | DOI:10.1093/inthealth/ihaf161

Public Health Nutr. 2026 Mar 25:1-28. doi: 10.1017/S1368980026102262. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the Indigenous Nourishment Scales (INS), a set of community-developed strengths-based measures of nourishment, for psychometric validity and reliability through community-based research with two urban American Indian/Alaska Native (AI/AN) communities.

DESIGN: Cross-sectional survey of health measures and INS. Descriptive statistics, exploratory factor analysis (EFA), correlation analysis, and regression were used to determine the psychometric properties of the INS and their relationship with Physical (Fruit and Vegetable Intake), Spiritual (Spiritual Wellbeing), Emotional (Emotional Wellbeing), and Relational (Social Wellbeing) health outcomes.

SETTING: Two urban cities in the U.S.

PARTICIPANTS: 249 urban AI/AN adults.

RESULTS: EFA revealed two unidimensional scales (Connectedness to Food; Indigenous Food Identity), and one two-factor scale (Access to and Participation in Indigenous Foodways). The INS demonstrated strong internal consistency reliability and convergent construct validity as evidenced by their association with fruit and vegetable intake and other related concepts. Regression models showed that Access to Indigenous Foodways and Participation in Indigenous Foodways were significantly and positively associated with all four domains of wellbeing. Food Connectedness was positively and significantly associated with spiritual, emotional, and relational wellbeing, while Indigenous Food Identity was positively and significantly associated with spiritual and emotional wellbeing.

CONCLUSIONS: Positive associations between scale scores and multiple domains of wellbeing indicate the potential relevance of Indigenous nourishment as a meaningful determinant of health. By establishing the psychometric validity of community-developed measures, this study offers a pathway for Indigenizing assessments of nutrition and wellbeing among AI/AN peoples.

PMID:41878784 | DOI:10.1017/S1368980026102262

Front Microbiol. 2026 Mar 9;17:1782552. doi: 10.3389/fmicb.2026.1782552. eCollection 2026.

ABSTRACT

Current subtyping methods are often restricted by labor intensity and high costs. To address this, this study integrated matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) with whole-genome sequencing (WGS) to characterize Salmonella isolates and investigate the correlation between spectral features and genomic data. Between 2023 and 2024, 96 Salmonella isolates from Yixing, Jiangsu Province, China, underwent serotyping, WGS, and MALDI-TOF MS profiling. Serotyping and Multilocus Sequence Typing (MLST) analysis resolved 25 serovars and 21 sequence types. Machine learning models based on spectral features achieved area under the curve (AUC) values exceeding 0.90 for Salmonella typhimurium, ST11, ST155, ST19, and ST34. Specific discriminatory mass peaks were identified, and their correlations with genomic annotations were investigated through peak-gene co-occurrence analysis. The findings indicate that discriminatory MALDI-TOF MS peaks can serve as statistical indicators for specific genomic features, reflecting underlying genomic differences. This study proposes a machine learning-based classification strategy that enables rapid analysis of MALDI-TOF MS spectra in routine diagnostics, thereby extending the application of mass spectrometry in Salmonella subtyping. This strategy functions as a high-throughput pre-filter to concentrate WGS efforts on high-risk clones for accelerated outbreak investigation.

PMID:41878745 | PMC:PMC13006217 | DOI:10.3389/fmicb.2026.1782552

Front Microbiol. 2026 Mar 9;17:1791871. doi: 10.3389/fmicb.2026.1791871. eCollection 2026.

ABSTRACT

Environmental microorganism recognition from microscopic images is crucial for environmental monitoring and ecological analysis. In practical scenarios, microorganism categories often evolve over time, and newly emerging classes usually have only a few labeled samples due to high annotation costs. This combination naturally gives rise to the few-shot class-incremental learning (FSCIL) problem. FSCIL requires models to incrementally learn new classes under severe data scarcity while effectively retaining knowledge of previously learned ones. In this work, we propose a unified FSCIL framework for environmental microorganism recognition. The proposed method is composed of three complementary components. First, a contrastive-inspired fine-grained representation learning strategy is introduced in the base session. This strategy enhances intra-class compactness by mining prediction-consistent augmented samples, without introducing explicit contrastive losses. Second, a prototype rectification mechanism is designed to stabilize the representations of incremental classes by leveraging semantic structures learned from base classes. Third, a dual-graph knowledge distillation framework is proposed to preserve both instance-level and class-level relational knowledge during incremental learning. This process is guided by a teacher model updated via exponential moving average. Experiments conducted on the EMDS-7 dataset demonstrate the effectiveness of the proposed approach. Compared with state-of-the-art FSCIL methods, our method achieves the highest average accuracy of 78.19% and maintains the best final-session accuracy of 65.36%. Meanwhile, strong base-session performance is consistently preserved. These results indicate that the proposed framework effectively mitigates catastrophic forgetting and enables robust adaptation to new microorganism categories in real-world incremental recognition scenarios.

PMID:41878735 | PMC:PMC13006286 | DOI:10.3389/fmicb.2026.1791871

Front Physiol. 2026 Mar 9;17:1779008. doi: 10.3389/fphys.2026.1779008. eCollection 2026.

ABSTRACT

Acute Mountain Sickness (AMS) is a frequent condition triggered by exposure to hypobaric hypoxia at high altitude. Its pathophysiology involves endothelial dysfunction and oxidative stress, with elevated oxidative molecules identified as key contributors to its development. Antioxidant therapies such as vitamins C/E, α-lipoic acid, and Ginkgo biloba have been proposed, though results across studies remain inconsistent.

OBJECTIVE: This study aims to evaluate the effects of antioxidant treatments in subjects with AMS induced by high-altitude exposure, examining their impact on clinical outcomes and oxidative stress markers.

METHODS: A systematic review and meta-analysis were performed according to PRISMA2020 guidelines. Searches were conducted in PubMed, Scopus, and Web of Science through November 2025, supplemented by snowball methods, focusing on studies investigating antioxidant treatments in humans exposed to hypobaric or high-altitude hypoxia. Inclusion criteria were original research in English with full-text availability, human exposure to hypobaric hypoxia, AMS assessment using the Lake Louise Score (LLS), and explicit antioxidant interventions compared with placebo or control. A random-effects meta-analysis using the REML estimator was applied to calculate relative risk (RR), including continuity corrections for zero-event studies. Data extraction was performed in duplicate, and risk of bias was evaluated using the Cochrane tool.

RESULTS: The search yielded 727 records; nineteen studies were included in the qualitative synthesis, and four trials provided comparable dichotomous data for quantitative analysis. Pooled estimates showed a non-significant trend toward reduced AMS incidence with antioxidant treatment (RR ≈ 0.73; 95% CI: 0.47-1.11; p = 0.14). Moderate heterogeneity was detected (I² = 52%, Q p = 0.048). Although not statistically significant, all studies showed a direction of effect favoring antioxidants. Nevertheless, interpretation is limited using pre-2018 LLS diagnostic criteria, absence of studies under chronic intermittent hypobaric hypoxia, and methodological variability.

CONCLUSION: Current evidence does not demonstrate a statistically significant protective effect of antioxidant therapy against AMS; however, findings remain inconclusive due to few available trials, small sample sizes, pharmacokinetics and pharmacodynamics analysis, and methodological heterogeneity. Larger, well-designed trials with standardized ascent profiles and redox biomarkers are required to determine clinical efficacy.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261331390, identifier CRD420261331390.

PMID:41878732 | PMC:PMC13006292 | DOI:10.3389/fphys.2026.1779008

Ann Appl Stat. 2026 Mar;20(1):604-622. doi: 10.1214/25-aoas2133. Epub 2026 Mar 20.

ABSTRACT

In recent years longitudinal, multi-site imaging studies have emerged as key tools for investigating brain function. These studies follow a large number of participants for an extended period, offering exciting opportunities to uncover brain functional network changes over time as a function of clinical and demographic covariates. However, these studies also introduce many statistical challenges such as site-effects and accounting for the heterogeneous nature of network differences between subjects. Robust statistical methods are highly needed to address these issues, but to date there has been little methods development addressing these problems in the context of data-driven brain network estimation. This work addresses this gap in the literature, introducing a general Bayesian framework, REMBRAiNDT, incorporating site- and subject-effects into the network decomposition, while also enabling covariate effect estimation and efficient information pooling across brain locations. We use our procedure to conduct a novel analysis of neurodevelopment among adolescents in the longitudinal, multi-site ABCD study. We find extensive evidence of increasing functional integration with age in networks associated with higher order cognitive processes. Our study is one of the first to examine neurodevelopment using blind source separation in the longitudinal ABCD study data, and the findings enrich earlier cross-sectional results on neurodevelopment.

PMID:41878728 | PMC:PMC13008291 | DOI:10.1214/25-aoas2133

Int J Womens Health. 2026 Mar 19;18:582171. doi: 10.2147/IJWH.S582171. eCollection 2026.

ABSTRACT

OBJECTIVE: Overactive bladder (OAB) is a common condition in older women, characterized by urinary urgency, frequency, and nocturia. This study compared the efficacy and safety of thread-embedding acupuncture (TEA) and sham TEA in postmenopausal women with OAB.

METHODS: In this multicenter, randomized, controlled trial, 68 postmenopausal women with OAB were allocated in a 1:1 ratio to receive TEA or sham TEA (manual acupuncture without thread embedding) once weekly for 8 weeks, followed by an 8-week follow up. The primary outcome was the mean daily voiding frequency over 3 days. Secondary outcomes included other bladder diary parameters, the Overactive Bladder Symptom Score (OABSS), and the King’s Health Questionnaire score.

RESULTS: At week 8, both groups showed reductions in 24-hour micturition frequency; however, after adjustment for baseline values using ANCOVA, no significant between-group difference was observed in the primary outcome. Repeated measures analysis demonstrated no significant group-by-time interactions for secondary outcomes, although significant improvements over time were observed in both groups. At follow-up, nighttime voiding remained significantly reduced from baseline in the TEA group, whereas this reduction was not statistically significant in the sham group; however, the between-group difference did not reach statistical significance. No serious adverse events were reported.

CONCLUSION: TEA and manual acupuncture were effective and safe in reducing OAB symptoms in postmenopausal women, with no significant differences between interventions. Larger, long-term studies are needed to clarify specific benefits of TEA.

PMID:41878717 | PMC:PMC13007670 | DOI:10.2147/IJWH.S582171

Int J Womens Health. 2026 Jan 27;18:560668. doi: 10.2147/IJWH.S560668. eCollection 2026.

ABSTRACT

BACKGROUND: High maternal mortality in sub-Saharan Africa has been linked to inadequate medical care for pregnant women due to limited health facility delivery utilization. In Somalia, many births still take place at home, most often without a skilled birth attendant. This study aimed to identify the prevalence and determinants of facility delivery among pregnant women in Somalia using data from the 2020 Somalia Demographic and Health Survey (SDHS).

METHODS: This cross-sectional study analyzed SDHS 2020 data for 18,561 women aged 15-49 years. Descriptive statistics summarized participant characteristics and delivery location. Binary logistic regression was used to identify determinants of facility delivery. Variables with p < 0.05 were considered statistically significant, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported.

RESULTS: The prevalence of facility delivery was 20.8%, indicating high utilization of home delivery. Several factors were significantly associated with increased odds of facility delivery. Women in the highest wealth had over five times higher odds of delivering at a health facility (AOR = 5.63; 95% CI: 4.56-6.97). Women who attended ANC had four times higher odds of facility delivery (AOR = 4.42; 95% CI: 3.99-4.89). Women who perceived the distance between their home and the nearest health facility as a barrier had 75% lower odds of facility delivery (AOR = 0.25; 95% CI: 0.23-0.27). Additionally, nomadic residence, high parity (≥5 children), and early marriage were significantly associated with lower likelihood of facility-based delivery.

CONCLUSION: Facility delivery remains low in Somalia. Wealth status, ANC attendance, and perceived distance to health facilities were key determinants of facility delivery, alongside residence type, parity, and early marriage. Improving ANC coverage, enhancing birth preparedness education, and increasing access to skilled birth attendants are vital steps to reduce home delivery.

PMID:41878707 | PMC:PMC13006375 | DOI:10.2147/IJWH.S560668