Nevin Manimala

Nutr Diet. 2026 Jan 28. doi: 10.1111/1747-0080.70067. Online ahead of print.

ABSTRACT

AIMS: Transition to employment is considered a vulnerable period for health professional graduates. This study aimed to follow the transition to employment for graduates from a single dietetics program, at several timepoints over 24 months to assess dietetic employment outcomes.

METHODS: Griffith University dietetics graduates from 2017 to 2019 were invited to participate in the longitudinal Griffith Dietetics Graduate Outcomes Study comprising four online surveys on employment preferences and outcomes: Survey 1 (graduation), Survey 2 (6-months), Survey 3 (12-months), and Survey 4 (24-months). Quantitative data were analysed using descriptive statistics, for cross-sectional findings (Surveys 3 and 4) and longitudinal analyses (Surveys 1-4).

RESULTS: Of the 150 eligible graduates, 91.3%, 73.3%, 59.3% and 51.3% responded to Surveys 1-4 respectively. At Survey 3, 84.3% of respondents were employed as a dietitian, 60.0% working more than 32 h/week and 25.3% in permanent positions. At Survey 4, 85.7% worked as a dietitian, 69.7% more than 32 h/week, predominantly in hospitals (45.5%) and private practice (37.9%). Longitudinal analyses showed that of 44/62 (70.1%) respondents who preferred a hospital role at graduation, 25 (56.8%) worked in a hospital at 24 months. All but one of the 16/62 (25.8%) who preferred private practice at graduation worked there at 6 months (93.8%), 12 of whom remained in private practice at 24 months (75%).

CONCLUSION: Universities need to prepare graduates for the challenging transition to full-time employment within their preferred sector. For dietitians within this study, the most vulnerable period was the 12 months post-graduation. National, longitudinal studies to at least 24 months are needed to investigate graduate employment outcomes for all dietetics programs.

PMID:41603125 | DOI:10.1111/1747-0080.70067

Adv Sci (Weinh). 2026 Jan 28:e11406. doi: 10.1002/advs.202511406. Online ahead of print.

ABSTRACT

Colorectal cancer remains a major global health challenge, particularly in advanced stages where current therapies show limited efficacy. Natural products, specifically those derived from herbal medicines, provide a valuable resource for discovering novel anticancer agents. In this study, a bioactive homoisoflavanone was successfully isolated and structurally characterized from Polygonatum kingianum, a widely used medicinal herb. In vitro, homoisoflavanone exhibited potent antiproliferative and pro-apoptotic effects in colorectal cancer cells. Mechanistically, homoisoflavanon induced DNA damage mediated mitochondrial apoptosis and parthanatos-like cell death, accompanied by ATM/ATR-Chk1 pathway and PARP activation, loss of mitochondrial membrane potential, elevated ROS levels, and ATP depletion. In vivo, homoisoflavanone significantly suppressed tumor growth in a colorectal cancer xenograft model without inducing systemic toxicity. Immunohistochemical analysis further confirmed decreased proliferation, increased apoptosis, and parthanatos-like cell death in tumor tissues. Collectively, these findings establish homoisoflavanone as a promising plant-derived therapeutic candidate that targets DNA integrity and mitochondrial homeostasis to inhibit colorectal cancer progression, highlighting the potential of herbal medicine-based compounds in anticancer drug development.

PMID:41603109 | DOI:10.1002/advs.202511406

Biom J. 2026 Feb;68(1):e70107. doi: 10.1002/bimj.70107.

ABSTRACT

Clinical trials often compare a treatment to a control group concerning multiple possible combined time-to-event endpoints like hospital-free survival. Thereby, the first endpoint may occur more than once (“recurrent”), whereas the second endpoint is absorbing. Inclusion of all observed events in the analysis can increase the power and provide a more complete picture of the disease but it needs more sophisticated methodology. We give a stepwise guidance on how to extend the simple time-to-first event model to complex multistate methodology, where multiple events are incorporated. We thereby consider non- and semiparametric methods and show how they are related. Special attention is given to the prerequisites of the models, for example, the Markov property, and their interpretation. Due to novel results in non-Markov models, the summary measurements: state occupation probability, mean number of hospitalizations, and average length of stay allow an easy interpretation of a treatment effect in non-Markov models if the censoring is random. Partly conditional transition rates can be estimated instead of hazards. We investigate the difference between partly conditional transition rates and hazards and the impact of the random censoring condition in a simulation study. Furthermore, the simulation study considers the sensitivity of a Markov test. Different estimators are introduced, and their use is explained based on data from the randomized controlled Interdisciplinary Network Heart Failure trial, which investigated the effects of a nurse-coordinated disease management program. The aim is to give an overview of existing methods, present the assumptions, and elaborate on the differences in interpretation.

PMID:41603102 | DOI:10.1002/bimj.70107

Biom J. 2026 Feb;68(1):e70111. doi: 10.1002/bimj.70111.

ABSTRACT

This paper is concerned with estimation and testing for treatment effects with multivariate outcomes. It primarily focuses on the situation where imperfect diagnostic tools are used to classify subjects into different groups. Oftentimes, there are more expensive and/or invasive diagnostic tools to accurately determine the subjects’ status or conditions, yielding partially validated data on a smaller number of subjects. We propose moment-based approaches for estimating and testing treatment effects. We compare our methods with maximum likelihood approach using the EM algorithm, which requires strong assumptions and bears computational burden, and with traditional methods, which ignore the diagnostic tool’s imperfection. The proposed methods show advantages in terms of coverage probability, computations efficiency, and robustness. The application of the methods is illustrated with gene-expression data from the Genes-environments & Admixture in Latino Americans (GALA) II study of asthma in Hispanic/Latino children.

PMID:41603081 | DOI:10.1002/bimj.70111

CNS Neurosci Ther. 2026 Feb;32(2):e70733. doi: 10.1002/cns.70733.

ABSTRACT

PURPOSE: The heterogeneous and homogeneous clinical manifestations of peripheral facial palsy (FP), hemifacial spasm (HFS), and Meige’s syndrome (MS) complicate the differentiation of diagnoses for these facial motor diseases. To comprehensively investigate the white matter microstructural characteristics in patients with facial dyskinesias and palsy using geometric and integrity metrics in DTI.

MATERIAL AND METHODS: In this prospective study conducted from September 2020 to January 2022, patients with FP, HFS, and MS, as well as sex-matched healthy control subjects, underwent 3.0 T MRI. Geometric metrics (i.e., splay, bend, twist, and total distortion) based on “Director Field Analysis” and fractional anisotropy (FA) and mean diffusivity (MD) were calculated from DTI data. Cross-sectional tract-based spatial statistics were performed among FP, HFS, MS patients, and healthy controls. The correlation between disease severity and DTI metrics was evaluated. Additionally, the geometric microstructural properties combining FA and MD were used to classify FP, HFS, and MS patients using machine learning methods.

RESULTS: Geometric metrics and FA/MD were widely altered across white matter in FP and HFS patients compared with healthy controls. However, in MS patients only DFA metrics were significantly altered. FA and DFA values strongly correlated with the severity of facial movement disorder in FP patients. Combing conventional FA/MD value with DFA metrics enabled the diagnostic differentiation of FP and HFS from MS.

CONCLUSION: Our findings demonstrated that the geometric microstructural information of white matter fibers could provide novel insight into the underlying pathological changes in facial dyskinesias and palsy.

PMID:41603069 | DOI:10.1002/cns.70733

Acta Anaesthesiol Scand. 2026 Mar;70(3):e70191. doi: 10.1111/aas.70191.

ABSTRACT

BACKGROUND: Vasopressors are often introduced in severe burn patients who respond poorly to fluid resuscitation to maintain adequate blood pressure and avoid fluid creep. This study aims to characterise these patients and explore potential correlations between vasopressor use and patient outcomes.

METHODS: Medical records from 2010 to 2023 for patients aged ≥ 18 years with burns ≥ 20% of the total body surface area (TBSA) were extracted from the TriNetX Research Network, a global federated health research platform aggregating de-identified electronic health records. The patients were divided into two groups: those who received vasopressors within the first 2 days of hospitalisation and those who did not. Statistical analysis included Cramér-von Mises and χ² test, with significance set at p < 0.05. Propensity score matching (PSM) in a 1:1 ratio was applied for the variables age, sex, pre-existing comorbidities (hypertension, diabetes, chronic heart disease, chronic lung disease, chronic kidney disease, and alcohol or opioid addiction), presence of inhalation injury, %TBSA burned, and burn injury year. Odds ratios (OR) for outcomes were calculated, with p-values adjusted for multiple testing using the Benjamini-Hochberg correction.

RESULTS: Of 6872 included patients, 17.7% received vasopressors within the first two days of hospitalisation. These patients were older, had more comorbidities and sustained more severe burns. After PSM we included 1206 patients in both cohorts (VP+ and VP-). Acute kidney injury occurred within 3 days in 51.0% of the VP+ group and 28.4% in VP- (OR 2.62, 95% CI: 2.20-3.11). VP+ patients also had higher rates of sepsis (30.8% vs. 22.9%, OR 1.50, 95% CI: 1.25-1.81) and higher mortality (45.1% vs. 32.7%, OR 1.69, 95% CI: 1.43-2.01) within 30 days following hospitalisation.

CONCLUSION: While vasopressors are frequently administered as part of burn resuscitation, their use was associated with higher rates of early acute kidney injury and an increased 30-day mortality rate.

EDITORIAL COMMENT: Potent vasopressor use to support the circulation is commonly combined with fluid resuscitation in modern intensive care, and this is a prominent aspect of care in major burn cases. In this retrospective analysis of a commercial, de-identified health care dataset (primarily from US hospitals or health systems), matched cases over 14 recent years were analysed by early vasopressor use (or not) and then for important outcomes including mortality. Vasopressor use was associated with some complications and negative outcomes, though there are likely many factors which may contribute to negative outcomes which were not included in this analysis.

PMID:41603062 | DOI:10.1111/aas.70191

Front Neurol. 2026 Jan 12;16:1760868. doi: 10.3389/fneur.2025.1760868. eCollection 2025.

ABSTRACT

OBJECTIVE: To investigate the efficacy and safety of low-dose urokinase combined with papaverin administered via superselective ophthalmic artery thrombolysis in patients with non-arteritic central retinal artery occlusion (CRAO).

METHODS: A retrospective analysis was conducted on the clinical data of 20 CRAO patients who underwent ophthalmic artery thrombolysis at our hospital between December 2023 and July 2025. All procedures were performed under local anesthesia via femoral artery puncture and catheterization. A sequential injection of 400,000 IU urokinase followed by 30 mg papaverine was administered into the ophthalmic artery. Best-corrected visual acuity (BCVA, expressed in logMAR) was assessed pre- and post-operatively, and adverse events were recorded.

RESULTS: The median time from symptom onset to treatment was 7.25 h (IQR: 2.00-20.50). The mean preoperative BCVA in the affected eye was 2.38 ± 0.93 logMAR, which significantly improved to 0.33 ± 0.26 logMAR postoperatively (p < 0.001). The median improvement in BCVA was 2.54 logMAR units (IQR: 0.84-2.78). Although a statistically significant difference persisted between the postoperative visual acuity of the affected eye and that of the contralateral healthy eye (0.28 ± 0.26 logMAR) (p = 0.002), the median difference was only 0.075 logMAR, suggesting limited clinical significance. No serious adverse events, such as hemorrhage or cerebral infarction, occurred in any patient.

CONCLUSION: Low-dose urokinase combined with papaverine via ophthalmic artery thrombolysis significantly improved visual acuity with a favorable safety profile in carefully selected CRAO patients, demonstrating potential for clinical application.

PMID:41603002 | PMC:PMC12832333 | DOI:10.3389/fneur.2025.1760868

Front Neurol. 2026 Jan 12;16:1753257. doi: 10.3389/fneur.2025.1753257. eCollection 2025.

ABSTRACT

BACKGROUND: This study sought to characterize sex-specific treatment effects by comparing clinical outcomes between men and women undergoing EVT.

METHODS: Analyses were based on the DEVT, RESCUE BT, and MARVEL databases. Men and women were matched using propensity score matching (PSM). The primary outcome was defined as the 90-day ordinal modified Rankin Scale score (mRS) distribution. Secondary outcomes included the favorite outcome (mRS 0 to 3), functional independence (mRS 0 to 2), and excellent outcome (mRS 0 to 1). Safety outcomes were symptomatic intracranial hemorrhage (sICH) and mortality.

RESULTS: Of 2,862 patients, 1,221 (42.7%) were women and 1,641 (57.3%) were men. After adjusting for covariates, there were no sex differences in 90-day ordinal mRS distribution (median [interquartile range], 3 [1-6] versus 3 [1-5], common odds ratio [OR], 1.02 [0.89-1.18], p = 0.741). The secondary outcomes demonstrated consistency with the primary findings, and the safety outcomes remained stable across men and women. After 1:1 PSM, the results remained consistent with the adjusted outcomes described above.

CONCLUSION: This pooled analysis demonstrated that no statistically significant differences were observed between men and women in clinical or safety outcomes following EVT for anterior circulation LVO. Furthermore, there was no evidence of interaction between sex and predefined subgroups in terms of treatment effect modification for EVT outcomes.

PMID:41602998 | PMC:PMC12832441 | DOI:10.3389/fneur.2025.1753257

Front Neurol. 2026 Jan 12;16:1769992. doi: 10.3389/fneur.2025.1769992. eCollection 2025.

ABSTRACT

[This corrects the article DOI: 10.3389/fneur.2025.1634369.].

PMID:41602994 | PMC:PMC12832513 | DOI:10.3389/fneur.2025.1769992

Front Neurol. 2026 Jan 12;16:1673716. doi: 10.3389/fneur.2025.1673716. eCollection 2025.

ABSTRACT

OBJECTIVE: This research aimed to assess the effectiveness of electroacupuncture in treating post-stroke dysphagia (PSD) and to investigate the optimal stimulation parameters.

METHODS: We conducted a comprehensive review of eight databases: PubMed, Web of Science, Cochrane Library, Embase, CBM, CNKI, Wan Fang, and VIP. Randomized controlled trials (RCTs) on electroacupuncture for the treatment of PSD published between the inception of these databases and March 19, 2025, were integrated. The treatment’s effectiveness was evaluated using several outcome indicators, including the Video Fluoroscopic Swallow Study (VFSS) and the Water Swallowing Test (WST), which collectively assess swallowing function. Two independent reviewers performed risk of bias (ROB 2) evaluations, frequency of use for electroacupuncture parameter combinations through the R language (version 4.5.1), and data analysis using Review Manager (RevMan) version 5.4 and Stata SE 18.

RESULTS: This analysis encompassed a total of 30 RCTs that involved 2,290 patients. The research demonstrated an overall efficiency of (RR = 1.29, 95% CI: 1.23-1.34, p < 0.0001; I² = 13%, fixed-effects model). The mean differences for the various scales were as follows: VFSS (MD = 1.67, 95% CI: 1.26-2.09, p < 0.01; I² = 57%, random effects model). WST (MD = -0.75, 95% CI: -0.93 to -0.57, p < 0.01; I² = 54%, random effects model). Aspiration pneumonia (RR = 0.41, 95% CI: 0.25 to 0.68, p = 0.0005; I² = 8%, fixed effect model). Subgroup analysis revealed significant disparities between the various waveforms (Dense-sparse wave (Ds-W): RR = 1.58, p = 0.003 < 0.01) and the distinctions among the top three combinations of electroacupuncture parameter usage frequency (≥ 30 min + Ds-W, ≥ 30 min + Continuous Wave (C-W), and ≥ 30 min + Intermittent Wave (I-W) groups) were statistically significant (≥ 30 min + Ds-W: RR = 1.55, p = 0.03 < 0.05). In addition, there were no statistically significant differences between the other electroacupuncture parameter subgroups, which included the stimulation frequency and single treatment time (p > 0.05).

CONCLUSION: Electroacupuncture, in conjunction with dysphagia training, is more effective than a solitary treatment in patients with PSD. Furthermore, applying waveforms with Ds-W might enhance the effectiveness of electroacupuncture for PSD. However, the higher risk of bias (ROB) in the included trials indicates that the quality of evidence for the outcomes of these assessments may be jeopardized. Thus, further high-quality clinical trials are urgently required to evaluate the efficacy and effectiveness of electroacupuncture parameters (waveforms) in the treatment of PSD, ultimately increasing the total level of evidence (PROSPERO registration number: CRD420251014881, https://www.crd.york.ac.uk/prospero/).

PMID:41602993 | PMC:PMC12832666 | DOI:10.3389/fneur.2025.1673716