Nevin Manimala

J Antimicrob Chemother. 2026 Aug 4;81(9):dkag228. doi: 10.1093/jac/dkag228.

ABSTRACT

BACKGROUND: Antimicrobial resistance is driven by antibiotic exposure. People living with HIV (PLWH) and PrEP users face high STI rates, but the magnitude of cumulative antibiotic exposure in these populations compared with the general population has not been well characterized.

METHODS: This retrospective study (Madrid, 2024-2025) linked pharmacy and microbiology records of 562 325 adults. Participants were categorized into: (A) PLWH or PrEP users with documented rectal STI episodes in the context of active sexual health follow-up; (B) PrEP/PLWH without STIs; and (C) general population controls. Consumption was measured in Defined Daily Doses per 1000 persons-day (DHD) using propensity score overlap weights.

RESULTS: Antibiotic use was significantly higher in Group A (95.3%) compared to Group B (35.4%) and Group C (27.3%) (P < 0.001). After weighting, individuals with documented rectal STI episodes (Group A) exhibited a markedly higher overall antibiotic exposure compared with general population controls (Group C) (adjusted rate ratio [RR]-DHD 4.67, 95% CI 4.41-4.94), driven by tetracyclines (RR-DHD 23.7), corresponding to a population rate equivalent to ∼1.1 seven-day doxycycline courses per person-year (a population-level metric, not an individual estimate). Group B consumption was 33% higher than controls (P = 0.004). Direct comparison confirmed that Group A’s tetracycline use was 5.6-fold higher than Group B’s (P < 0.001).

CONCLUSIONS: PLWH and PrEP users with documented rectal STI episodes experience markedly higher antibiotic exposure than the general population, driven primarily by tetracycline use. This disproportionate exposure in a small, identifiable subgroup supports targeted antimicrobial stewardship strategies in sexual health and HIV care settings, including systematic consumption monitoring, individualized doxy-PEP counselling, and integration of STI-focused populations into national AMR surveillance frameworks.

PMID:42610960 | DOI:10.1093/jac/dkag228

J Int Med Res. 2026 Aug;54(8):3000605261476584. doi: 10.1177/03000605261476584. Epub 2026 Aug 18.

ABSTRACT

ObjectiveTo investigate short-term diffusion tensor imaging-derived changes in the knee physis after whole-body vibration and to assess postural stability in healthy adolescents.MethodsThis prospective, single-arm, within-subject exploratory study included 48 healthy adolescents (24 males and 24 females; mean age, 11.94 ± 2.31 years) who underwent a 1-week whole-body vibration protocol (15 Hz, 5 mm amplitude). Fractional anisotropy and apparent diffusion coefficient values of the distal femoral and proximal tibial physes were measured before and after whole-body vibration using knee diffusion tensor imaging. Postural stability was evaluated using force plate center-of-pressure parameters. Paired comparisons were performed for the overall cohort and sex-stratified subgroups, and age- and bone age-related trends were explored using quadratic regression models.ResultsIn the overall cohort, fractional anisotropy increased in both the distal femoral physis (0.472 ± 0.074 to 0.515 ± 0.070; mean change, 0.043; Cohen’s dz = 0.737; p < 0.001) and the proximal tibial physis (0.486 ± 0.063 to 0.527 ± 0.067; mean change, 0.041; Cohen’s dz = 0.897; p < 0.001). Apparent diffusion coefficient decreased in the distal femoral physis (1.171 ± 0.230 to 1.081 ± 0.160 × 10^-3 mm²/s; mean change, -0.090; Cohen’s dz = -0.483; p = 0.002) and the proximal tibial physis (1.171 ± 0.211 to 1.100 ± 0.168 × 10^-3 mm²/s; mean change, -0.071; Cohen’s dz = -0.584; p < 0.001). Sex-stratified analyses showed generally larger standardized changes in males, whereas apparent diffusion coefficient changes in females did not reach statistical significance. Exploratory scatter plots and quadratic regression models suggested that the magnitude of diffusion tensor imaging-derived changes varied with chronological age and bone age, with a trend toward larger changes within a bone age range of 12-14 years. Postural stability parameters increased transiently but remained within the “no-impact” safety threshold.ConclusionsA 1-week whole-body vibration protocol was associated with measurable diffusion tensor imaging-derived changes in the adolescent knee physis and transient changes in postural stability. These findings should be interpreted as preliminary, hypothesis-generating biophysical observations rather than direct evidence of improved physeal function, growth promotion, or beneficial structural effects. Larger sham-controlled longitudinal studies incorporating growth outcomes and complementary diffusion tensor imaging metrics are warranted.

PMID:42610955 | DOI:10.1177/03000605261476584

J Int Med Res. 2026 Aug;54(8):3000605261476138. doi: 10.1177/03000605261476138. Epub 2026 Aug 18.

ABSTRACT

ObjectiveGastroesophageal reflux disease comprises heterogeneous phenotypes, and symptom severity does not always correlate with endoscopic findings. This retrospective observational study aimed to characterize serum proteomic alterations in gastroesophageal reflux disease and to explore whether nonerosive reflux disease and reflux esophagitis exhibit distinct circulating protein signatures.MethodsSeventy individuals were included, comprising 26 controls, 14 patients with nonerosive reflux disease, and 30 with reflux esophagitis. For exploratory group-level proteomic discovery, pooled serum samples from each group were analyzed using liquid chromatography-tandem mass spectrometry. Clinical characteristics, upper gastrointestinal endoscopy, high-resolution manometry, and 24-h pH-impedance monitoring were assessed as appropriate. Differentially expressed proteins were identified using a fold change threshold of 1.3 together with nominal statistical significance, followed by functional annotation and enrichment analyses.ResultsAge and sex were comparable among the groups. Nonerosive reflux disease and reflux esophagitis showed no significant differences in gastroesophageal reflux disease questionnaire score, disease duration, body mass index, or most reflux-monitoring parameters. However, patients with reflux esophagitis had more gas reflux episodes, lower distal contractile integral values, and a higher frequency of esophageal motility disorders, suggesting impaired motor function. Proteomic profiling identified 872 proteins, including 666 quantified proteins. Differential expression analysis identified 48 proteins in nonerosive reflux disease versus controls, 43 in reflux esophagitis versus controls, and 7 in nonerosive reflux disease versus reflux esophagitis. The exploratory nonerosive reflux disease-associated protein profile was mainly characterized by cytoskeletal remodeling, adhesion-related regulation, redox adaptation, and selective immune rearrangement, whereas the exploratory reflux esophagitis-associated profile showed features related to actin remodeling, injury-defense responses, and alterations in lipid homeostasis.ConclusionsNonerosive reflux disease and reflux esophagitis exhibited distinct but partially overlapping serum proteomic profiles in this exploratory pooled serum analysis. These preliminary findings suggest phenotype-related biological differences beyond reflux burden alone; however, they should be interpreted as hypothesis-generating and require validation in independent, individual-level cohorts.

PMID:42610948 | DOI:10.1177/03000605261476138

ACS Macro Lett. 2026 Aug 18;15(8):1191-1198. doi: 10.1021/acsmacrolett.6c00385.

ABSTRACT

The synthesis of sequence-controlled block copolyesters from mixtures of both cyclic ester monomers remains challenging, as insufficient chemoselectivity leads to gradient or statistical copolymers rather than well-defined block structures. Herein we exploit CH-π interactions between a zirconium alkoxide initiator and the aryl side group of a lactone monomer to selectively enhance the coordination of asymmetric 3-phenyl-1,4-dioxane-2,5-diketone (PDD) over that of ε-caprolactone (CL) in a self-switchable ring-opening polymerization (ROP). This monomer side-group recognition promoted preferential binding makes the ROP of PDD kinetically favored over that of CL, thereby endowing the system with high chemoselectivity. As a result, PDD is consumed rapidly and nearly completely (98% conversion) before the polymerization autonomously switches to the ROP of CL, affording well-defined (AB)nCm-type diblock copolyesters. By supplying additional monomer mixtures sequentially during the polymerization, this approach can be further extended to sequence-controlled ((AB)nCm)z-type multiblock copolyesters. The thermal and mechanical analyses reveal that both block length ratios and chain architecture govern material performance. Remarkably, the diblock PPDD-b-PCL exhibited a tensile strength of 47.2 ± 2.5 MPa and an elongation at break of 942.0 ± 45.0%, making it a strong and ductile material comparable to commercial isotactic polypropylene. This work establishes a side-group recognition approach for self-switchable polymerization, establishing a powerful platform for the precision synthesis of sustainable plastics.

PMID:42610941 | DOI:10.1021/acsmacrolett.6c00385

Work. 2026 Aug 18:10519815261477340. doi: 10.1177/10519815261477340. Online ahead of print.

ABSTRACT

BackgroundDespite its economic benefits, the tobacco processing industry poses health risks to workers due to occupational hazards. Body mapping can help gather evidence about the work effects on the body.ObjectiveTo assess the occupational health of tobacco processing workers by body mapping.MethodsBody mapping data were collected from one hundred private industry tobacco processing workers in November, 2024. The other data were collected by health professional workers (body temperature, heart rate, blood pressure, random blood glucose, height, and weight).ResultsA survey of one hundred employees revealed that many workers reported experiencing pain in the areas of the left (35%) and right shoulder (36%) and the waist (26%). Additionally, wound complaints were predominantly noted in the left (9%) and right finger (8%) areas, while bruising was less prevalent among the sample. Complaints of itching or redness were most frequently reported in the left (7%) and right forearm (10%) areas. The other general health of the workers mostly showed a normal result. Statistical analysis on 4 major pain locations showed significant results in body mass index (BMI) for each left and right shoulder, in duration and type of work for the back, but none for the buttocks.ConclusionsBased on this study, we can divide three groups of possible causes of workers’ complaints, i.e., ergonomic problems, contact dermatitis, and injury by sharp objects. Several risk factors were the BMI, the type and duration of work. Further investigation is required to ascertain other causes and to determine appropriate countermeasures.

PMID:42610874 | DOI:10.1177/10519815261477340

Work. 2026 Aug 18:10519815261477098. doi: 10.1177/10519815261477098. Online ahead of print.

ABSTRACT

Background Organizations increasingly invest in Green Human Capital (GHC) to develop sustainability-oriented capabilities, yet evidence on how it enhances employee Work Engagement (WE) remains limited. Psychological Ownership (PO) rooted in motivation and responsibility research, may explain this relationship, but its mediating role in sustainability contexts remains underexplored.ObjectiveThis study examines the direct relationship between GHC and WE and the mediating role of PO, while also analyzing these relationships across four WE dimensions: Vigor, Dedication, Absorption, and Sustainable Engagement.MethodsA cross-sectional survey of 400 employees from small to large-sized Indian organizations engaged in sustainability initiatives was conducted between January and June 2025 using validated questionnaires. Covariance-Based Structural Equation Modeling (CB-SEM) with AMOS was used to test the measurement model, direct effects, and mediation.ResultsGHC significantly and positively predicted overall WE (β = 0.405, p < .001) and had a particularly strong effect on Sustainable Engagement (β = 0.775, p < .001), while its effect on Absorption was not statistically significant. GHC also strongly predicted PO (β = 0.752, p < .001). Although PO exhibited a weak direct association with WE, mediation analysis revealed a statistically significant but modest partial mediating effect, with no significant mediation observed across individual engagement dimensions.ConclusionsThe findings indicate that GHC enhances employee WE primarily through direct capability-based mechanisms, especially sustainability-related engagement, while PO plays a limited yet complementary mediating role.Originality/ValueThis study pioneers a sustainability-driven engagement framework by revealing how GHC directly and psychologically drives employee WE through PO.

PMID:42610836 | DOI:10.1177/10519815261477098

Cancer. 2026 Aug 15;132(16):e70566. doi: 10.1002/cncr.70566.

ABSTRACT

BACKGROUND: Blinatumomab, a bispecific CD19 × CD3 antibody is effective for the treatment of B-cell acute lymphoblastic leukemia (ALL). Because of its immune toxicities, namely cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), the US Food and Drug Administration (FDA) recommends preemptive hospitalization for the initiation of cycle 1 (C1) and cycle 2 (C2). The necessity of this approach is unclear.

METHODS: The authors conducted a retrospective cohort study among all patients treated with blinatumomab between 2012 and 2025 at two academic cancer centers: Memorial Sloan Kettering Cancer Center (MSK) and Dana-Farber Cancer Institute (DFCI).

RESULTS: For C1, only nine of 308 (3%) patients initiated outpatient (OP) treatment. A total of 184 of 308 (60%) initiated C2: At DFCI, 10 of 83 (12%) initiated C2 OP and at MSK, and 74 of 101 (88%) initiated C2 OP. Demographic and clinical characteristics were similar between patients initiating C2 inpatient versus OP. No patients who initiated C2 (0 of 184) had Gr3+ CRS (across all cycles) and only two (1%) had Gr3+ ICANS; both were inpatient for C2. Of 84 patients treated without preemptive hospitalization for C2, 16 of 84 (19%) required hospitalization at some point during the cycle, largely for infections (50%).

CONCLUSIONS: OP administration of C2 of blinatumomab can be administered safely with no unexpected, severe, or life-threatening toxicities. The ability to safely manage treatment without preemptive hospitalization may support the patient experience and limit costs of care.

PMID:42610826 | DOI:10.1002/cncr.70566

Rep Prog Phys. 2026 Aug 18. doi: 10.1088/1361-6633/ae9afb. Online ahead of print.

ABSTRACT

Single-file transport means no overtaking: particles move in a narrow channel while preserving their longitudinal order. This simple constraint has profound dynamical consequences, most notably tracer subdiffusion, and has made single-file transport a paradigmatic form of confined many-body motion, observed from molecular transport in zeolites to single-file diffusion of colloids in narrow channels. The standard view is that, once overtaking is suppressed, collective transport reduces to that of a strictly one-dimensional file. Here we show that this reduction fails in experimentally relevant finite-width channels: even when exchange is forbidden, the transverse equilibrium structure controls the transport laws and can qualitatively reshape them. Starting from the Brownian dynamics in the full confined geometry, we derive an exact large-scale one-dimensional fluctuating hydrodynamics for the longitudinal density, whose coefficients are fixed by the confined equilibrium equation of state. In the minimal hard-core setting, this yields a collective diffusivity that can become non-monotonic in density. This geometric anomaly propagates to exact large-scale predictions for integrated-current fluctuations, tracer displacement fluctuations and the associated density profiles. The effect is robust to the interaction potential, channel geometry, initial preparation and microscopic dynamics. Quasi one-dimensional single-file transport therefore defines a distinct regime in which forbidding overtaking does not erase geometry from collective transport.

PMID:42610824 | DOI:10.1088/1361-6633/ae9afb

Chaos. 2026 Aug 1;36(8):083133. doi: 10.1063/5.0349658.

ABSTRACT

Voluntary vaccination is often challenged by the vaccination dilemma, wherein individual costs conflict with the collective benefits of herd immunity. Motivated by the considerable influence of online “Big Vs,” we introduce a coupled vaccination-epidemic coevolution model on scale-free networks. We incorporate a fraction ρ of committed influencers who consistently advocate for vaccination, incorporating a trust-weighting parameter α to quantify their social influence. Multi-agent simulations and heterogeneous mean-field theory demonstrate that strategic placement of influencers is vital: positioning committed influencers at high-degree nodes results in nearly comprehensive vaccination coverage and substantially suppresses outbreaks across a wide range of vaccination costs. Conversely, random placement proves less effective, and assigning influencers to low-degree nodes necessitates a significantly higher ρ to manage epidemic outbreaks. These results underscore how influence filtered through trust and network heterogeneity can be exploited to develop resilient, resource-efficient vaccination strategies.

PMID:42610823 | DOI:10.1063/5.0349658

Radiology. 2026 Aug;320(2):e243548. doi: 10.1148/radiol.243548.

ABSTRACT

Background Artificial intelligence (AI) models for fracture detection have shown promise in improving diagnostic efficiency and accuracy in radiology workflows. However, despite potential differences in imaging protocols and clinical workflows in different health care systems and settings, the performance across countries of these models and their effects on reader performance remain underexplored. Purpose To evaluate the performance of a pretrained fracture detection tool across three European hospitals and assess its impact on clinician performance. Materials and Methods In this retrospective, multireader, multicase crossover study, the radiographs of patients aged 21 years or older with suspected appendicular fractures acquired from April 2018 to July 2022, across three European hospitals, were analyzed. Reference standards were established by expert local radiologists. AI tool performance was evaluated with the area under the receiver operator characteristic curve, sensitivity, and specificity. Sensitivity and specificity were statistically compared across hospitals and per-anatomy subgroup with the χ² test and across readers with generalized estimating equations. Results A total of 1500 patients (mean age, 43.3 years ± 19.5 [SD]; 820 men) were included. The hospital-level sensitivities of the AI tool ranged from 400 of 500 (80%; 95% CI: 76, 84) to 430 of 500 (86%; 95% CI: 83, 90) and specificities ranged from 465 of 500 (93%; 95% CI: 91, 95) to 480 of 500 (96%; 95% CI: 95, 98). Anatomy-based subgroup analysis revealed lower sensitivity of 105 of 140 (75%) for wrist/hand and finger examinations in one hospital versus 125 of 138 (91%) and 150 of 160 (94%) (P = .004), but no differences in overall sensitivity or specificity were observed across all hospitals (P = .23 and P = .10, respectively). Use of the AI tool improved overall reader sensitivity (11 percentage points [95% CI: 6.8, 14.4; P < .001]) while maintaining specificity (0.6 percentage points [95% CI: -0.6, 1.7; P = .34]). Conclusion No differences in AI performance were observed across centers, and AI assistance was associated with higher reader sensitivity. © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license. Supplemental material is available for this article See also the editorial by Maas and Beekman in this issue.

PMID:42610815 | DOI:10.1148/radiol.243548