Nevin Manimala

Clin Child Fam Psychol Rev. 2026 Jun 2. doi: 10.1007/s10567-026-00573-7. Online ahead of print.

ABSTRACT

The arrival of a baby and the early years of a child’s life represent a critical period for parents, often marked by increased parental stress that can impact both their well-being and the child’s development. Although parental stress has been widely studied, no systematic review has yet focused specifically on early childhood. To address this gap, we conducted a systematic review synthesizing evidence on factors examined as antecedents of parental stress during the first three years postpartum. Following PRISMA guidelines, we included 108 quantitative studies published in the past 12 years that investigated variables statistically modeled as predictors of parental stress. Key determinants of parental stress were identified at three levels: (1) at the personal level, internalizing symptoms, adverse childhood experiences, and perinatal negative experiences were related to higher stress; (2) at the relational level, marital satisfaction and coparenting quality were associated with lower stress; and (3) at the contextual level, social support from friends and family served as a protective factor of parental stress, while children’s developmental problems served as risk factors. Despite the increasing number of longitudinal studies and the growing inclusion of fathers in research, few studies have focused on participants from social minority groups or from non-Western contexts. These findings may contribute to the development of effective strategies to support families during the early years of parenthood.

PMID:42228327 | DOI:10.1007/s10567-026-00573-7

J Cancer Educ. 2026 Jun 2. doi: 10.1007/s13187-026-02918-w. Online ahead of print.

ABSTRACT

Breast Cancer necessitates effective patient education. Large language models (LLMs) facilitate patient health consultation, yet their generated medical content may contain misleading and unsafe information. Systematic evaluations of mainstream LLMs for breast cancer health guidance are currently lacking. This study evaluated six LLMs’ (ChatGPT-5.4-thinking, Claude-4.6-sonnet, Gemini-3.1-Pro, DeepSeek-V3.2, Doubao-2.2-thinking, and ERNIE 4.5 Turbo) performance in breast cancer consultation via a structured checklist. A set of 61 standardized questions regarding breast cancer was developed based on Google Trends, clinical guidelines, practical experiences, and expert reviews. Responses from each LLM were independently evaluated by three breast cancer experts focusing on quality, accuracy, comprehensiveness, and safety. Besides, four patients independently evaluated the satisfaction and understandability of their selected three questions of interest. This study utilized Bernard’s Global Quality Score (GQS) tool to assess quality. Readability was assessed using the Chinese Resource Platform (CRP). Other indicators were evaluated using self-designed questionnaires. Statistical analyses were performed using RStudio. In expert evaluations, ERNIE 4.5 Turbo had the highest descriptive quality score and was among the top-performing models in safety (Bonferroni-adjusted P < 0.05), while several models performed comparably in comprehensiveness. There was no significant difference in accuracy among the models. ChatGPT-5.4-thinking scored significantly lower in safety, and Doubao-2.2-thinking had significantly lower reading difficulty, required age, and Chinese character count (adjusted P < 0.05). In patient evaluations, ERNIE 4.5 Turbo showed the highest descriptive satisfaction and understandability ratings. Six large language models performed strongly in breast cancer question-answering, with ERNIE 4.5 Turbo ranking highest. However, issues like poor readability and unsafe recommendations remain in answers. Future research should prioritize enhancing patient readability to facilitate AI’s application in precision cancer health education.

PMID:42228312 | DOI:10.1007/s13187-026-02918-w

Ann Biomed Eng. 2026 Jun 2. doi: 10.1007/s10439-026-04187-6. Online ahead of print.

ABSTRACT

BACKGROUND: Aortic regurgitation (AR) alters normal blood flow patterns in the left ventricle (LV), affecting diastolic filling dynamics, and is commonly quantified by the regurgitant fraction (RF). However, conventional diagnostic methods have notable limitations, prompting growing interest in four-dimensional flow magnetic resonance imaging (4D-flow MRI) as a tool for quantitatively assessing AR severity. In parallel, viscous energy dissipation (VED), which captures the energy loss caused by viscous forces within blood flow, provides additional important insight into the hemodynamic burden imposed on the LV by valvular dysfunction.

OBJECTIVE: This study aims to investigate the potential correlation between RF and VED in patients with AR, hypothesizing that higher RF values are associated with increased VED, thereby reflecting greater hemodynamic compromise.

METHODS: This pilot study included 10 patients with diagnosed AR and 9 healthy controls, all of whom underwent standardized cardiac MRI, including 4D-flow MRI. Volumetric blood flow and VED were assessed using validated post-processing techniques. Statistical analyses were conducted to evaluate group differences and explore the correlation between RF and VED.

RESULTS: In healthy controls, LV flow exhibited a typical pattern during diastole and systole, forming a vortex during filling. Severe AR patients displayed disrupted LV flow, with regurgitant jets altering the flow dynamics. Quantitatively, integrated kinetic energy (iKE), vorticity (iVRT), and VED (iVED) were significantly elevated in AR patients compared to controls: iKE (0.003 ± 0.002 J vs. 0.001 ± 0.0004 J, p = 0.019), iVRT (0.304 ± 0.0738 s^-1 vs 0.251 ± 0.0466 s^-1, p = 0.077), and iVED (0.434 ± 0.307 mW vs. 0.166 ± 0.055 mW, p = 0.020). An increase was observed in patients with severe AR compared to controls, iKE rose to (0.005 J vs. 0.001 J), iVRT (0.335 s^-1 vs. 0.233 s^-1), and iVED (0.792 mW vs. 0.174 mW). All three parameters positively correlated with RF: iVRT (R² = 0.175, p = 0.1263; Spearman R = 0.486), iVED (R² = 0.628, p = 0.0038; Spearman R = 0.597), and iKE (R² = 0.601, p = 0.0051; Spearman R = 0.616), indicating that increasing regurgitation severity is associated with greater intraventricular energy and flow disruption.

CONCLUSION: This study quantifies the impact of AR on LV flow dynamics and demonstrates elevated VED in patients with AR. The observed correlation underscores the potential of VED as a complementary metric to RF in evaluating the hemodynamic impact of valvular regurgitation. Further studies with larger cohorts are needed to validate these findings and explore their clinical implications.

PMID:42228301 | DOI:10.1007/s10439-026-04187-6

Health Econ Rev. 2026 Jun 2. doi: 10.1186/s13561-026-00801-4. Online ahead of print.

ABSTRACT

Spain leads the world in organ donation, and the 40th anniversary of its first liver transplant was recently commemorated. Our aim was to evaluate the evolution of the Liver Transplantation (LT) program in Spain over its four decades (1984-2024), examining clinical outcomes and societal economic benefits within a mature transplantation framework. Standardized national data from the Organización Nacional de Trasplantes and the Sociedad Española de Trasplante Hepático were used to reconstruct recipient cohorts by age group. Patient survival was estimated using Kaplan-Meier analysis. An economic evaluation from a societal perspective integrated surgical costs, long-term immunosuppressive therapy, and productivity gains associated with recipients’ participation in the labour market. LT activity increased steadily during the initial expansion of the program and has stabilised at approximately 1,200 procedures per year over the past two decades. Both donor and recipient populations have aged; there are currently more patients over 60 years of age than two decades ago. Survival improved throughout the study period, extending life expectancy despite variations related to underlying disease. From an economic perspective, annual surgical costs remained below €60 million, increasing to €70-90 million when long-term immunosuppressive therapy was included. The economic contribution of surviving recipients to the labour market increased steadily, exceeding €75 million in 2024 and resulting in a positive balance since the early 2010s. Adult recipients generated net economic benefits, whereas paediatric recipients showed delayed but progressively increasing contributions as they entered the workforce. LT in Spain has produced sustained improvements in expected survival while generating substantial societal value, demonstrating that LT is both an effective clinical intervention and a valuable public health investment. The Spanish liver transplantation system may serve as a benchmark for evaluating the sustainability and societal impact of liver transplant programs in other healthcare systems.

PMID:42228276 | DOI:10.1186/s13561-026-00801-4

Mol Cell Biochem. 2026 Jun 2. doi: 10.1007/s11010-026-05588-w. Online ahead of print.

ABSTRACT

Spatial organisation of immune cells reflects a balance between tissue anchoring and migratory compatibility, yet how this balance is structured within inflammatory skin disease remains poorly understood. Spatial transcriptomic analyses defined transit-retention immune organisation across lesional and non-lesional skin in atopic dermatitis (AD) and psoriasis (PsO). A unified transit-retention axis captured contextual immune organisation within leukocyte-rich tissue microenvironments. Non-lesional skin in both diseases exhibited retention-dominant organisation. In contrast, psoriatic lesions showed disruption of retention dominance, accompanied by coordinated alignment of antigen presentation, T cell activation, Th17, and B cell programmes with transit-compatible organisation, a pattern not observed in AD. An independent spatial transcriptomic dataset of psoriatic skin enabled assessment of compartmental specificity and clinical relevance. These analyses identified the epidermis as the primary site of transit-skewed reorganisation, with epidermal transit alignment scaling with disease severity. Extension of the same transcriptional framework to circulating adaptive immune cells using CITE-seq revealed lineage-specific transit-associated features in psoriatic disease. Circulating CD4 T cells and B cells showed stronger transcriptional and protein-level alignment with transit-associated states in PsO and psoriatic arthritis. Together, these analyses reveal transit-skewed adaptive immune organisation as a unifying feature of psoriatic disease.

PMID:42228270 | DOI:10.1007/s11010-026-05588-w

Eur J Epidemiol. 2026 Jun 2. doi: 10.1007/s10654-026-01417-y. Online ahead of print.

ABSTRACT

Type 1 Diabetes (T1D) is a common chronic autoimmune disorder in children and adolescents worldwide. We described the development of T1D incidence from 2012 to 2021 and compared the incidence of the pre-pandemic period (2012-2019) with the pandemic period (2020-2021) in Bavaria, Germany. Routinely collected health claims from the Bavarian Association of Statutory Health Insurance Physicians (KVB), covering a population of 2 million children and adolescents (aged ≤ 19 years), were used. All cases of newly diagnosed T1D (ICD-10-GM E10) were included. Sex-specific annual and quarterly crude incidence rates (CIR) and age-standardized incidence rates (ASIR) were calculated. Sex-specific CIRs were calculated by 5-year age groups. Interrupted time series analysis was used to analyze trend changes in the pandemic versus the pre-pandemic period. From 2012 to 2021, 5,762 incident cases were identified in Bavaria. Overall, an increasing incidence was observed with an average annual increase of 3.7% in females (from 23.5 in 2012 to 32.5 per 100,000 person-years (py) in 2021) and 5.0% in males (from 25.2 to 38.9 per 100,000 py). The increase was highest in age groups 0-4 (12.4%) in males and 15-19 (8.5%) in females. Regression analysis showed no clear level or slope change in T1D incidence for both sexes during the pandemic period. When accounting for non-linear trends, a statistically significant level change was observed for females during the pandemic period (ß=7.66, 95% CI 0.23, 15.09), suggesting a potential association for females. The increasing T1D incidence in Bavarian youth from 2012 to 2021 highlights the importance of incidence surveillance.

PMID:42228226 | DOI:10.1007/s10654-026-01417-y

Plant Foods Hum Nutr. 2026 Jun 2;81(2):72. doi: 10.1007/s11130-026-01515-y.

ABSTRACT

Nonalcoholic fatty liver disease is a prevalent metabolic disorder linked to lifestyle factors. This study aimed to evaluate the effects of Pilates exercise and broccoli sprout supplementation, individually and combined, on liver enzyme levels in women with nonalcoholic fatty liver disease. In this double-blind, randomized controlled trial, 32 women aged 30-45 years from Mashhad were allocated into four groups: Pilates plus broccoli sprout supplement(SP), Pilates plus placebo(PP), supplement only(S), and placebo control(P). The Pilates training was performed three times per week for 8weeks at intensities progressing from 54 to 75% of maximum heart rate. Participants in supplementation groups received two 500 mg tablets daily (total 1,000 mg/day) of standardized broccoli sprout extract produced under good manufacturing practice guidelines. Serum liver enzyme levels, including aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase, were measured before and after the intervention. Data normality was assessed using the Kolmogorov-Smirnov test. Paired t-tests were applied for between-group comparisons, while one-way analysis of variance and analysis of covariance adjusted for baseline values were used for between-group comparisons. Tukey’s post-hoc test was employed for pairwise analyses with p < 0.05 considered statistically significant. After 8 weeks, no statistically significant differences were observed in enzyme levels among the groups. Pilates exercise and broccoli sprout supplementation, alone or in combination, did not significantly alter hepatic enzyme levels in this population The modest exercise intensity and supplement dosage may have been insufficient to elicit measurable hepatic effects. Future studies should consider higher exercise intensities, longer intervention periods, and more diverse participant characteristics to better clarify potential synergistic effects in nonalcoholic fatty liver disease management.

PMID:42228225 | DOI:10.1007/s11130-026-01515-y

Eur J Health Econ. 2026 Jun 2. doi: 10.1007/s10198-026-01931-6. Online ahead of print.

ABSTRACT

OBJECTIVES: The EQ Health and Wellbeing Short Version (EQ-HWB-9) is a 9-item instrument capturing multidimensional health or well-being. This study aimed to evaluate its psychometric properties in Chinese college students-a high-risk group for mental health problems.

METHODS: A nationwide online cross-sectional survey was conducted across eastern, central, and western China between January and February 2025. Ceiling and floor effects of the EQ-HWB-9 were evaluated based on the response distributions of its items. Convergent validity of EQ-HWB-9 items, as well as its level sum score (LSS) and utility score was assessed according to their correlations with EQ-VAS score using Spearman correlations. Known-group validity of LSS and utility score was evaluated by comparing the mean difference and effect sizes of six pairs of college students with different status. Sensitivity of the two scores was further tested by comparing its efficiency to detect the differences with EQ-VAS score using relative efficiency (RE).

RESULTS: A total of 3,589 college students participated in the survey, with females being 53.4% and mean age of 20.7 years. Two EQ-HWB-9 items-daily activities (75.8%) and mobility exhibited (74.6%) ceiling effects. All EQ-HWB-9 items demonstrated statistically significant correlations with the EQ-VAS score ranging from – 0.421 to -0.312, and both the EQ-HWB-9 LSS and utility score showed moderate correlations (LSS: -0.522; Utility: 0.522). Differences in mean values of LSS and utility score were statistically significant in five out of six known-groups (except for gender). The two scores generally demonstrated larger RE values compared to EQ-VAS score (LSS range: 1.049-51.590; Utility range: 0.715-61.143).

CONCLUSIONS: Despite the high ceiling effect in physical-related dimensions, it appears that the EQ-HWB-9 is a valid instrument in assessing health and well-being among Chinese college student.

PMID:42228220 | DOI:10.1007/s10198-026-01931-6

Eur J Health Econ. 2026 Jun 2. doi: 10.1007/s10198-026-01943-2. Online ahead of print.

ABSTRACT

Longevity and death rates are closely linked to socioeconomic conditions. However, the relationship between income and specific causes of death (CoD) remains insufficiently explored. This study examines socioeconomic inequalities in cause-specific mortality in Spain, simultaneously accounting for CoD, age, sex, and income. To the best of our knowledge, no previous study has jointly combined all these variables. Using data for the entire population residing in Spain from 2010 to 2019, we compute death rates by CoD, age, sex, and income decile by linking individual demographic records with census tract-level disposable income. The analysis covers 4 million deaths and over 466 million person-years at risk. Robust income-based relative risks and gradients by CoD are calculated for five-year age groups, stratified by sex, while Relative Index of Inequality (RII) values are derived for single years of age. Results show strong and consistent income-related inequalities in mortality across age, CoD, and sex, especially among younger and middle-aged groups. Particularly steep and significant gradients are found for circulatory, respiratory, digestive, infectious, endocrine, and genitourinary diseases, as well as for symptoms and abnormal findings, and other conditions, with lower-income individuals facing markedly higher risks. For neoplasms, nervous, mental and behavioural disorders, and external causes, patterns are more heterogeneous and gender-specific. Notably, neoplasms exhibit RIIs < 1 among women aged 55 and older. Overall, the results highlight widespread income-related inequalities in mortality in Spain and underscore the need to prioritise lower-income groups in public health efforts, particularly regarding chronic and behavioural health conditions.

PMID:42228219 | DOI:10.1007/s10198-026-01943-2

Hernia. 2026 Jun 2;30(1):237. doi: 10.1007/s10029-026-03736-1.

ABSTRACT

PURPOSE: Ventral hernias are common abdominal wall defects associated with substantial healthcare burden and impaired quality of life. Minimally invasive extraperitoneal techniques have evolved to optimize midline reconstruction while avoiding intraperitoneal mesh placement, especially in the setting of diastasis recti. Preperitoneal Extended Totally Extraperitoneal (PeTEP) repair is a recently introduced approach, but evidence regarding its safety and effectiveness remains limited. Therefore, we performed a systematic review and meta-analysis to synthesize the available evidence.

METHODS: A systematic search of PubMed, Embase, and the Cochrane Library was conducted to identify studies evaluating PeTEP repair for ventral hernia with or without rectus diastasis. Meta-analytical pooling of outcomes was performed using a random-effects model. All statistical analyses were conducted using R software (version 4.4.1).

RESULTS: Four studies were included, comprising 99 patients, with a mean age of 51.53 years and a mean body mass index of 29.55 kg/m². The pooled mean operative time was 129.48 min (95% CI 74.96 to 184.00). Hematoma occurred in 10.61% of patients (95% CI 5.14 to 20.62), and overall postoperative complications in 21.21% (95% CI 12.98 to 32.69), with no intervention required in either case. Bulging was observed in 4.88% of cases (95% CI 1.22 to 17.52). No recurrences were reported across studies, with follow-up ranging from 1 to 12 months.

CONCLUSION: Current evidence suggests that PeTEP may be a feasible minimally invasive extraperitoneal approach for ventral hernia repair. However, further comparative studies with longer follow-up are needed.

PMID:42228218 | DOI:10.1007/s10029-026-03736-1