Nevin Manimala

Pharmacoeconomics. 2026 Jun 11. doi: 10.1007/s40273-026-01629-w. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to derive a Korean value set for the SF-6Dv2.

METHODS: Following an adapted international protocol, an online discrete choice experiment with duration (DCE_TTO) was conducted among 3800 Korean adults representative of the general population. The experimental design included three components: choice sets from a Core Module, choice sets pairing commonly occurring health states (Common Module), and triplet choice sets with death options (Triplet Module). Preferences were analyzed using conditional and mixed logit models.

RESULTS: Model 9 (based on the Core Module) was selected as the preferred model for its superior logical consistency, including monotonicity of coefficients and avoidance of counterintuitive results. The pain dimension had the largest utility decrement at its worst level (- 0.496), followed by physical functioning (- 0.480), mental health (- 0.391), social functioning (- 0.329), vitality (- 0.178), and role limitations (- 0.138). The utility for the worst possible health state (556555) was estimated at – 1.012, with 31.7% of all states valued as worse than dead. Significant preference heterogeneity was observed across dimensions, indicating substantial individual-level variation in health state valuations. While including death comparisons (Triplet Module) produced less-negative worst-state utilities, it was not recommended as the primary value set due to its non-efficient experimental design and logical monotonicity issues necessitating greater level collapsing.

CONCLUSION: We derived the first Korean SF-6Dv2 value set. This enables quality-adjusted life-year calculations from both SF-36v2 and SF-6Dv2 data, supporting economic evaluations in Korea.

PMID:42274976 | DOI:10.1007/s40273-026-01629-w

Discov Nano. 2026 Jun 11;21(1):257. doi: 10.1186/s11671-026-04713-4.

ABSTRACT

The findings of this study have significant implications for a wide range of engineering applications that include cooling of rotating disk surfaces, the optimization of chemical reactors, and the design of filtration systems, where the synergistic use of variable porous media and hybrid nanofluids offers a pathway to enhanced performance. Keeping these substantial applications in perspective, the present study examines the optimization of thermal transport in an unsteady Casson hybrid nanofluid flowing through a variable porous medium between two rotating disks. The flow is influenced by inertial effects, Joule heating, viscous dissipation, and time-dependent heat generation and absorption effects. The modeled equations are solved through the Homotopy Analysis Method (HAM) in dimensionless form. It is deduced in this investigation that axial velocity [Formula: see text] augments with growth in stretching parameter of the lower disk [Formula: see text], Reynolds number [Formula: see text] and suction factor [Formula: see text] while declines with augmentation in stretching parameter of the upper disk [Formula: see text]. Radial velocity [Formula: see text] augments on the interval [Formula: see text] and it declines on the range [Formula: see text] with growth in the stretching parameter of the lower disk [Formula: see text]. Tangential velocity [Formula: see text] augments with growth in suction parameter [Formula: see text] and angular velocity at the lower disk [Formula: see text], while it declines with growth in Reynolds numbe r[Formula: see text]. Thermal profiles [Formula: see text] augment with growth in Eckert number [Formula: see text], heat source parameter [Formula: see text], suction parameter r[Formula: see text] and stretching parameter of lower and upper disks [Formula: see text]. A close agreement is observed between the HAM solutions and the numerical Runge-Kutta shooting results, confirming the accuracy, reliability, and validity of the HAM-based solutions. For variations in Reynolds number in the range [Formula: see text] the percentage error in [Formula: see text] between HAM and Runge-Kutta shooting results are 0.0%, 2.4 × 10^{– 5}%, 2.2 × 10^{– 5}% and 1.5 × 10^{– 5}%. Moreover, for the same range of [Formula: see text] the percentage error in [Formula: see text] between these results are 0.05 × 10^{– 5}%, 1.3 × 10^{– 5}%, 1.5 × 10^{– 5}% and 1.7 × 10^{– 5}%.

PMID:42274958 | DOI:10.1186/s11671-026-04713-4

J Racial Ethn Health Disparities. 2026 Jun 11. doi: 10.1007/s40615-026-03031-w. Online ahead of print.

ABSTRACT

BACKGROUND: Few large cohort studies of dementia have successfully recruited cohorts that reflect the diversity of the aging population. We aim to describe the complex racial/ethnic, immigration, linguistic histories of a United States (US)-based cohort to describe the complexity of operationalizing identity and describing health disparities.

METHODS: The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study enrolled 1,892 participants ages 65 and older. Participants self-reported race/ethnicity (Asian, Black, Latino, White, Native American), immigration status (US-born/non-US-born), and languages spoken (monolingual, bilingual, and unascertained) via questionnaire. Participants were screened using NIH Toolbox and those suspected of impairment underwent a neurological exam. Descriptive statistics included means, standard deviations, counts, and percentages of cohort demographics across race/ethnicity, immigration status, and language as well as by cognitive status.

RESULTS: Participants had a mean age of 76 (SD ± 7) and 60% were women. Approximately equal proportions of Asian (24%), Black (26%), Latino (22%), Native American (0.1%), and White (29%) participants were enrolled. 46% of participants were monolingual, 31% bilingual, and 23% unascertained. Of the 25% of participants who reported being non-US-born, most identified as Asian or Latino. Bilingualism was most common among non-US-born men and those reporting multiple racial/ethnic identities. Alcohol consumption, cigarette use, and self-rated health varied across language, race/ethnicity, and immigration status. Cognitive impairment was most prevalent among U.S.-born Black and non-U.S.-born Latino participants.

CONCLUSION: Highlighting the diversity of older Americans illustrates the need for recruitment of populations that reflect the cultural and linguistic diversity of older adults in the US at risk of dementia.

PMID:42274946 | DOI:10.1007/s40615-026-03031-w

Res Health Serv Reg. 2026 Jun 11;5(1):9. doi: 10.1007/s43999-026-00093-5.

ABSTRACT

INTRODUCTION: Infertility remains a significant reproductive health challenge globally. In vitro fertilization (IVF), the most widely used form of assisted reproductive technology (ART), presents an opportunity for overcoming childlessness. Knowledge, perception and attitudes toward IVF remain underexplored, especially in rural settings in Nigeria. This study assessed these aspects among women of childbearing age, especially at the primary healthcare level.

METHODS: This study employed a descriptive cross-sectional survey conducted among 222 women of childbearing age, selected from health centers in Ado Ekiti, Ekiti State, via simple random sampling. Data collected through questionnaires were analyzed using SPSS version 26, applying both descriptive and inferential statistics. The significance level was set at p < 0.05.

RESULTS: Most respondents (63.1%) were aged 20-29 years, with 55.9% employed and 60.8% identifying as Yoruba. Their knowledge of IVF was high, with an average score of 3.06. Overall perception of IVF was favorable (mean = 2.89), and attitudes towards IVF were positive (mean = 3.08). Moderate, statistically significant positive correlation were observed between knowledge and perception (r = 0.520, p < 0.05) and between knowledge and attitude (r = 0.606, p < 0.05).

CONCLUSION: Women of childbearing age in Ado Ekiti exhibited high awareness, positive perceptions, and favorable attitudes toward in vitro fertilization. However, cost, accessibility, and emotional concerns remain major obstacles. It was recommended to advocate to government and stakeholders for affordable, accessible in vitro fertilization services to increase uptake and acceptance.

PMID:42274942 | DOI:10.1007/s43999-026-00093-5

J Ophthalmic Inflamm Infect. 2026 Jun 11. doi: 10.1186/s12348-026-00608-8. Online ahead of print.

ABSTRACT

PURPOSE: To describe the contemporary management and outcomes of patients with acute retinal necrosis (ARN) at a tertiary Canadian hospital over a 5-year period.

METHODS: This was a retrospective cohort study of patients who presented to The Ottawa Hospital (Ottawa, Canada) and were newly diagnosed with ARN between January 2019 and July 2024. Data regarding demographics, clinical presentation, investigations, treatment, and outcomes were collected. The primary outcome was retinal detachment. Secondary outcomes were severe vision loss and other complications associated with ARN. Statistical analyses were performed to identify factors associated with develop of the primary and secondary outcomes.

RESULTS: A total of 16 eyes amongst 14 patients met inclusion criteria. The mean age at presentation was 56 years old, with 57% male. 5 patients (36%) had a known history of previous systemic herpetic infection. The most common exam findings on presentation were anterior chamber cell (94%), keratitic precipitates (88%), vitritis (94%), and arteritis (75%). Aqueous humor serology was positive for 96% of eyes (56% for VZV and 40% for HSV). Eyes received an average of 5.8 injections (range 1 to 17) of intravitreal antiviral therapy. Corticosteroids were administered in 13 patients (81%). Prophylactic laser retinopexy was used in 1 eye (6%) and pars plana vitrectomy was done for vitreous opacities in 1 eye (6%). During a mean follow-up of 424 days, 44% of eyes developed retinal detachment. The average time from symptom onset to diagnosis of retinal detachment was 105 days (range 14 to 180). Half of eyes had a final visual acuity worse than 20/200. The most common complications were cataract (38%) and recurrent anterior uveitis (31%). Initial BCVA of worse than 20/400 was significantly associated with an outcome of severe vision loss. No associations were found for development of retinal detachment.

CONCLUSION: Our cohort demonstrates the range of presentations and outcomes in the management of ARN. While early recognition and systemic antivirals remain essential, our centre uses a larger number of intravitreal antiviral injections with less prophylactic laser or vitrectomy to achieve similar outcomes as other cohorts. This study highlights the value of standardized protocols for recognition and treatment of ARN.

PMID:42274937 | DOI:10.1186/s12348-026-00608-8

Int Ophthalmol. 2026 Jun 11;46(1):261. doi: 10.1007/s10792-026-04133-4.

ABSTRACT

BACKGROUND: Fabry disease is an X-linked lysosomal storage disorder characterized by systemic glycosphingolipid accumulation that may disrupt endothelial and neuronal integrity, leading to autonomic and ocular involvement. Non-invasive ocular imaging may offer early diagnostic biomarkers reflecting systemic disease activity. This study aimed to evaluate autonomic, ocular surface, and corneal morphological parameters in patients with Fabry disease (FD) and explore their correlations with plasma Lyso-Gb3 concentrations.

METHODS: In this prospective cross-sectional study, 25 eyes of genetically confirmed FD patients and 25 age-and sex-matched healthy controls were examined. All participants underwent dynamic pupillometry, non-contact tear break-up time, Schirmer I testing, meibography, and anterior-segment optical coherence tomography (AS-OCT) to quantify corneal epithelial thickness. Plasma Lyso-Gb3 levels were available for 14 patients. Group comparisons were performed using Mann-Whitney U and t-tests, and correlations were assessed via Spearman analysis.

RESULTS: Static pupil diameters were wider in Fabry patients under all light conditions, though not significantly (p > 0.05). Maximal Redilation Velocity (MRV) was significantly reduced in patients with FD (p = 0.015), possibly indicating sympathetic dysfunction. Peripheral (5-7 mm) corneal epithelial thickness was significantly thinner in patients with FD (p = 0.031). Lyso-Gb3 concentrations exhibited moderate, statistically significant negative correlations with epithelial thickness across all zones (central r = – 0.659, paracentral r = – 0.638, peripheral r = – 0.607; all p < 0.05). No significant associations were found between Lyso-Gb3 and pupillometric or ocular-surface parameters (p > 0.05).

CONCLUSION: Fabry disease involves subclinical ocular autonomic and structural alterations, reflected by reduced MRV and peripheral epithelial thinning correlated with biochemical disease load. Dynamic pupillometry and AS-OCT-based epithelial mapping may serve as complementary, non-invasive biomarkers for early diagnosis and monitoring of Fabry-related ocular involvement.

PMID:42274905 | DOI:10.1007/s10792-026-04133-4

Drug Saf. 2026 Jun 11. doi: 10.1007/s40264-026-01686-2. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Concerns about modafinil and armodafinil use in pregnancy emerged from animal reproductive toxicity and limited human data, including a US registry suggesting increased risk of major congenital malformations (MCMs). Subsequent studies have reported conflicting findings. This study aimed to evaluate the risk of MCMs and other adverse pregnancy outcomes following prenatal modafinil exposure in the French population.

METHODS: This retrospective cohort study identified pregnancies during 2012-2019 using the French national health database (SNDS). Pregnancies exposed and unexposed to modafinil were identified and propensity score matched (1:4 ratio). Outcomes assessed included MCMs, spontaneous abortion, stillbirth, elective termination, preterm birth, low birth weight, and growth restriction. Prevalence and prevalence ratios (PRs) were calculated and adjusted risk ratios (RR) were estimated using Poisson regression models.

RESULTS: A total of 786 modafinil-exposed pregnancies were matched to 3144 unexposed pregnancies. The prevalence of MCMs among first-trimester modafinil-exposed pregnancies was 4.2%, compared with 3.3% in unexposed pregnancies (PR 1.26; 95% CI 0.77-2.04). After adjustment for potential confounding factors, no statistically significant increase in MCM risk was observed (RR 1.32, 95% CI 0.81-2.15). Most other pregnancy and birth outcomes showed no significant differences. However, elective terminations were 32% more frequent in the exposed group (PR 1.32; 95% CI 1.14-1.51).

DISCUSSION: This large, population-based study found no increased risk of MCMs or most adverse pregnancy outcomes following modafinil exposure. The elevated rate of elective terminations may reflect clinical decisions influenced by underlying maternal conditions such as narcolepsy. While these findings do not indicate an increased risk of MCM, caution remains warranted regarding modafinil use during pregnancy.

PMID:42274903 | DOI:10.1007/s40264-026-01686-2

Head Neck Pathol. 2026 Jun 11;20(1):65. doi: 10.1007/s12105-026-01929-9.

ABSTRACT

PURPOSE: To benchmark the diagnostic accuracy and inter-model agreement of contemporary large language models (LLMs) on text-only histopathologic narrative descriptions in oral and maxillofacial pathology (OMFP), and to assess how performance varies by diagnostic dependency and diagnostic category.

METHODS: In this retrospective diagnostic accuracy study, 171 de-identified OMFP cases were screened, and 155 cases were included after predefined selection. Each case comprised an edited histopathologic narrative and a single expert-verified reference diagnosis. Three general-purpose LLMs (ChatGPT-5.0, Gemini-2.5-Pro, Claude-Opus-4.1) were queried once per case using an identical zero-shot prompt requesting a single definitive diagnosis. Primary outcome was case-level accuracy; paired comparisons used McNemar’s test, and inter-model agreement was assessed with Cohen’s κ. Performance was stratified by histology-sufficient (HS) versus correlation-dependent (CD) lesions and by OMFP diagnostic category.

RESULTS: Overall accuracies were 83.2% (ChatGPT-5.0), 77.4% (Gemini-2.5-Pro), and 72.3% (Claude-Opus-4.1). ChatGPT-5.0 significantly outperformed Claude-Opus-4.1, whereas the differences between ChatGPT-5.0 and Gemini-2.5-Pro and between Gemini-2.5-Pro and Claude-Opus-4.1 were not statistically significant. Agreement was highest between Gemini-2.5-Pro and Claude-Opus-4.1 (κ = 0.73). All models showed higher accuracy for HS than CD lesions, with best performance in malignant, hematolymphoid, and immune-mediated categories.

CONCLUSION: Contemporary LLMs can interpret OMFP histopathologic narratives with moderate overall diagnostic accuracy, particularly for lesions with distinctive microscopic features. Performance declined for CD entities, indicating persistent reliance on clinicoradiologic context. Although not suitable as stand-alone diagnosticians, these findings provide a controlled benchmark of text-based diagnostic performance and suggest potential supportive value in OMFP education and exploratory pathology informatics applications under expert supervision.

PMID:42274902 | DOI:10.1007/s12105-026-01929-9

Ir J Med Sci. 2026 Jun 11. doi: 10.1007/s11845-026-04439-3. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effects of psychosocial interventions on sexual function, quality of life, and stress levels in women with gynecologic cancer.

METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 guidelines. PubMed, Web of Science, EBSCOhost, Google Scholar, and the YÖK Thesis Center were searched between June and July 2024 without year restriction. Randomized controlled and quasi-experimental studies evaluating psychosocial interventions were included. Data were synthesized using meta-analysis and narrative synthesis. Outcomes were synthesized separately for sexual function, quality of life, and stress.

RESULTS: Seven studies were included in the analysis. Psychosocial interventions significantly improved sexual function (SMD: 0.868; 95% CI: 0.021 to 1.715; Z = 2.008; p = 0.045; I² = 89.97%) and quality of life (SMD: 0.709; 95% CI: 0.060 to 1.358; Z = 2.142; p = 0.032; I² = 88.61%) in women with gynecologic cancer. However, psychosocial interventions did not demonstrate a significant effect on stress levels (SMD: – 1.126; 95% CI: – 2.649 to 0.397; Z = – 1.449; p = 0.147; I² = 95.65%).

CONCLUSION: This systematic review and meta-analysis indicates that psychosocial interventions are associated with improvements in sexual function and quality of life among women with gynecologic cancer, whereas no statistically significant reduction in stress was observed. Although substantial between-study heterogeneity was present, the overall evidence supports the integration of psychosocial approaches into supportive oncology nursing care.

PMID:42274896 | DOI:10.1007/s11845-026-04439-3

Cerebellum. 2026 Jun 11;25(4):92. doi: 10.1007/s12311-026-02033-y.

ABSTRACT

Upper limb postural tremor is common in both Spinocerebellar Ataxia type 12 (SCA12) and Essential Tremor (ET). In the early stages, their clinical presentation can be similar, leading to potential misdiagnosis. This study aimed to develop and evaluate a low-cost device and methods to quantify 2D reaching kinematics objectively, with the goal of improving differentiation between ET and SCA12 using machine learning (ML) models. We recruited 48 participants, including 16 SCA12 patients, 16 ET patients, and 16 healthy controls (HC). Clinical severity was scored using TETRAS and SARA scales. A Raspberry Pi-based device was used to record upper limb reaching during a button-press task. The videos were processed with DeepLabCut and six 2D kinematic parameters were extracted via MATLAB scripts. We expanded the dataset using Generative Adversarial Networks (GAN). Classification was performed using multiple ML algorithms, with and without GAN-based data augmentation. Both patient cohorts showed significant alterations in kinematic features compared to HC, with SCA12 demonstrating more pronounced abnormality. Kinematic parameters including maximum reaching speed, endpoint precision, and time fraction to peak speed emerged as potential markers for differentiating ET and SCA12. The ML models demonstrated high classification performance in distinguishing HC from patients (CA 88.9%) and SCA12 from ET (CA 83.3%) using original data. The device-guided reaching kinematics provide objective markers of motor impairment. Combined with ML, this approach could enhance diagnostic accuracy; it also has potential for remote monitoring and as an outcome measure in clinical trials.

PMID:42274882 | DOI:10.1007/s12311-026-02033-y