Nevin Manimala

Am J Addict. 2026 May 10. doi: 10.1111/ajad.70172. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: To describe provider preparedness and experiences engaging families after a patient overdose death.

METHODS: We used descriptive statistics to summarize responses to a national survey of interdisciplinary providers.

RESULTS: Participants (n = 524; 47,937 invited) agreed that providers should communicate with a patient’s family after an overdose death (78.2% agreed), yet few felt very well prepared to do so (22.6%).

DISCUSSION AND CONCLUSIONS: Providers inconsistently contacted families despite believing these interactions are opportunities to improve family and provider coping.

SCIENTIFIC SIGNIFICANCE: There is a potential need for interventions addressing this discrepancy between providers’ desired behaviors and practice contacting families following a patient death.

PMID:42106972 | DOI:10.1111/ajad.70172

Am J Ind Med. 2026 May 10. doi: 10.1002/ajim.70088. Online ahead of print.

ABSTRACT

BACKGROUND: We used national-level data to compare worker demographic and socioeconomic characteristics, work arrangements, psychosocial working conditions, safety and health, job security, wages and benefits, and worker health and well-being before the COVID-19 pandemic, in 2018, and in the late stage of the pandemic, in 2022. Understanding these changes helps inform some of the potential ways these factors may shape the future of work.

METHODS: We analyzed self-reported and publicly available data from the 2018 and 2022 waves of the General Social Survey (GSS)-Quality of Worklife (QWL) module, focusing on adults working part-time or full-time. We describe differences in the broad categories of interest mentioned above, as well as subcategories within each. For example, we assessed changes in psychosocial working conditions by focusing on subcategories that included job demands, job control, role conflict, resource adequacy, job support, work flexibility, and work and family interface, that is, the boundaries between work and family life. We used Mann-Whitney tests to assess statistically significant changes, using weighted, nationally representative worker samples (N = 1473 in 2018; N = 2112 in 2022).

RESULTS: Between 2018 and 2022, we observed two changes in work arrangements; the share of independent contractors increased (from 12.4% to 14.4%) while the share of those working full-time decreased (from 81.3% to 78.5%). Psychosocial conditions exhibited mixed trends; job demands and control showed marginal improvement, while role conflict, resource adequacy, and job support worsened. The share of workers who mainly worked at home increased (6.6%-17.2%), alongside those experiencing family-work conflict (from 26% to 32%). Health and well-being also worsened, with more workers reporting lower job satisfaction and very often feeling used up (from 13.1% to 16.0%). In addition, workers reported more days in poor mental health (from 3.6 to 4.4 days) and days with activity limitations (from 1.6 to 2.2) in the past 30 days.

CONCLUSIONS: The quality of worklife in 2022 differed meaningfully from 2018, though not uniformly for better or worse. For example, increases in working at home and the share of independent contractor arrangements suggest different potential long-term consequences for worker well-being. Continued monitoring and more nuanced analyses are essential to understanding the evolving future of work.

PMID:42106970 | DOI:10.1002/ajim.70088

Knee Surg Sports Traumatol Arthrosc. 2026 May 10. doi: 10.1002/ksa.70420. Online ahead of print.

ABSTRACT

PURPOSE: To compare the career longevity of professional soccer players after achilles tendon rupture (ATR) with that of an uninjured matched control cohort.

METHODS: A retrospective analysis of ATR cases in professional male athletes from the English Premier League and English Championship was performed. Each athlete with ATR was matched to three control athletes who had not sustained ATR. The analysis included all identified ATR cases, including those who failed to return to professional competition. Statistics were compiled for each year until retirement or study end.

RESULTS: A total of 36 players with ATR were matched to 108 controls. The return-to-professional play rate following ATR was 91.7%. The mean career length after ATR was 4.9 ± 3.3 years, while that of the matched control athletes was 3.4 ± 3.5 years (p = 0.045). After ATR, an athlete had a 33% lower risk of retirement compared with the matched control athlete, which approached statistical significance (hazard ratio [HR] = 0.67; 95% confidence interval [CI], 0.45-1.00; p = 0.051). Significant subsequent non-ATR injuries were documented in 24.1% of control athletes during the follow-up period. At 5 years after ATR, 58.3% of athletes had retired from professional soccer, while 70.4% of the matched cohort were retired (p = 0.259). By 10 years, 83.3% of the ATR cohort had retired compared with 91.7% of the matched cohort (p = 0.270). Within the ATR cohort, re-rupture occurred in seven players (19.4%) but did not significantly affect career length (HR = 0.80; p = 0.622). Age at ATR remained the strongest predictor of retirement (HR = 1.27 per year; p < 0.001).

CONCLUSION: Professional male soccer players who sustained ATR demonstrated comparable career longevity to a matched player cohort, with a trend toward longer survival in those who successfully return to play. ATR did not significantly shorten professional careers in this elite population. This likely reflects the efficacy of modern rehabilitation, a potential selection effect, and the high non-ATR injury burden observed in the control group.

LEVEL OF EVIDENCE: Level III.

PMID:42106965 | DOI:10.1002/ksa.70420

Psychiatr Pol. 2026 Feb 28;60(1):91-104. doi: 10.12740/PP/199519. Epub 2026 Feb 28.

ABSTRACT

OBJECTIVES: The aim of the study was to search for the relationship between insomnia, stress, and occupational burnout and to identify factors influencing their severity among health care workers.

METHODS: This survey-based study was conducted among 216 health care workers. It was performed using the author questionnaire, the Perceived Stress Scale (PSS-10), the Athens Insomnia Scale (AIS), and the Maslach Burnout Inventory (MBI).

RESULTS: Analysis of the effects of stress (PSS-10) and insomnia (AIS) on occupational burnout showed that stress correlated significantly (p ˂ 0.05) and positively (r ˃ 0) with all MBI subscales; that is, the more severe the stress, the higher the levels of emotional exhaustion, depersonalization, but also personal accomplishment. Insomnia correlated significantly (p ˂ 0.05) and positively (r ˃ 0) with all MBI subscales – the more severe the insomnia, the higher the levels of emotional exhaustion, depersonalization, but also personal accomplishment.

CONCLUSIONS: (1) Age and work experience were the sociodemographic variables that determined the occurrence of insomnia among the surveyed participants. (2) The form of employment may be an important factor that determines the level of stress, insomnia, and job burnout. Those employed under permanent contracts had lower levels of stress and job burnout, more often suffered from insomnia, and had higher levels of personal accomplishment. (3) In the study group, stress and insomnia influenced all aspects of job burnout. As stress and insomnia increased, so did levels of depersonalization, emotional exhaustion, but also personal accomplishment.

PMID:42106944 | DOI:10.12740/PP/199519

West J Nurs Res. 2026 May 10:1939459261443177. doi: 10.1177/01939459261443177. Online ahead of print.

ABSTRACT

BACKGROUND: Bedside whiteboards serve as communication tools that contribute to improved patient outcomes by supporting information sharing, improving patient participation, and facilitating communication between patients and health care teams.

OBJECTIVE: This quasi-experimental study aimed to compare pain and anxiety levels between surgical patients who used bedside whiteboards and those who received standard care.

METHODS: The study was conducted in the general surgery department of a university hospital between August 2022 and December 2024. The intervention group consisted of 52 patients, and the control group included 54 patients. The data collection tools used included a patient demographic form, the Visual Analog Pain Scale (VAS), the Anxiety Specific to Surgery Questionnaire (ASSQ), and the State-Trait Anxiety Inventory (STAI-I and II).

RESULTS: The mean VAS score in the intervention group was 5.3 ± 2.9, the mean ASSQ score was 16.5 ± 6.0, and the mean STAI-I score was 34.4 ± 13.8. In contrast, the control group reported a mean VAS score of 6.6 ± 2.9, a mean ASSQ score of 21.9 ± 5.7, and a mean STAI-I score of 39.2 ± 8.2. Comparative analysis revealed statistically significant differences between the intervention and control groups in terms of VAS, ASSQ, and STAI-I scores.

CONCLUSION: The results indicate that patients in the intervention group who were exposed to bedside whiteboards had lower pain and anxiety scores than those in the control group. The use of bedside whiteboards may support patient education and enhance the overall quality of nursing care.

PMID:42106930 | DOI:10.1177/01939459261443177

Med Sci Monit. 2026 May 10;32:e951639. doi: 10.12659/MSM.951639.

ABSTRACT

BACKGROUND Patients with multiple sclerosis (MS) present with reduced muscle strength during dynamic and static contractions, with deficits primarily affecting lower limbs. This study aimed to evaluate the functional parameters of lower limbs in patients with MS following an exercise program. MATERIAL AND METHODS We conducted an exploratory individualized 12-week program of self-paced exercises aimed at improving functional parameters of the lower limbs. Foot pressure distribution, balance during a 60-second static trial with eyes open and closed, load on each limb, and center of pressure position were recorded using the Zebris Medical platform and analyzed. RESULTS The study included 24 women with MS (mean age, 36.8 years; mean disease duration, 9.0 years). The differences in body-weight distribution between dominant and nondominant leg were significant at baseline (54.8 vs 45.2 open eyes; 57.2 vs 42.8 closed eyes; P<0.001) and improved after exercises (51.9 vs 48.1 open eyes; 53.0 vs 47.0 closed eyes) but remained significant (P<0.001), resulting in significantly lower asymmetry after exercises (9.7 vs 3.8 open eyes; 14.5 vs 5.9; P<0.001). Numerical improvements were also observed across all balance test parameters; however, statistically significant changes were noted only for two parameters: the x-coordinate of mean center of pressure (17.4 vs 16.3; P=0.005 and 17.4 vs 16.1; P<0.002) and the y-coordinate of mean center of pressure (24.4 vs 22.6; P<0.001 and 24.2 vs 22.3; P<0.001). CONCLUSIONS Regular lower limb self-paced exercises significantly improved limb loading symmetry and selected balance parameters.

PMID:42106907 | DOI:10.12659/MSM.951639

J Crohns Colitis. 2026 May 8;20(5):jjag061. doi: 10.1093/ecco-jcc/jjag061.

ABSTRACT

BACKGROUND & AIMS: Robust evidence for most licensed Crohn’s disease therapies is lacking for perianal fistula outcomes due to a lack of dedicated clinical trials. This study aimed to use a Bayesian framework to determine the efficacy of medical therapies for perianal fistulizing Crohn’s disease (PFCD).

METHODS: A formal prior elicitation exercise was conducted by a group of 11 gastroenterologists and 5 statisticians. Consensus priors were developed leveraging both existing published data and clinical expertise, to determine one-year fistula remission rates for medical treatments with 5 different mechanisms of action (anti-TNF, anti-integrin, anti-IL-12/23, anti-IL-23, and JAK inhibitor). Consensus priors on efficacy of each treatment were determined relative to an elicited consensus prior for placebo control.

RESULTS: Consensus priors were obtained for the likelihood of fistula remission at 1 year. The prior mean, together with a 90% prior credible interval, of the one-year fistula remission rate was 0.22 (0.05, 0.46) for placebo, 0.58 (0.09, 0.96) for intravenous infliximab, 0.39 (0.06, 0.82) for adalimumab, 0.53 (0.09, 0.93) for subcutaneous infliximab, 0.24 (0.03, 0.60) for intravenous vedolizumab, 0.44 (0.05, 0.90) for upadacitinib, 0.34 (0.04, 0.77) for ustekinumab, and 0.36 (0.04, 0.82) for anti-IL-23 specific agents. Oral upadacitinib and subcutaneous infliximab demonstrated the highest probability for efficacy, alongside intravenous infliximab.

CONCLUSIONS: We have conducted the first Bayesian prior elicitation exercise in inflammatory bowel disease. The generated priors could be used to enhance the design and analysis of clinical trials in PFCD by improving estimation of treatment efficacy, minimizing sample sizes, and potentially reducing the need for placebo control arms.

PMID:42106904 | DOI:10.1093/ecco-jcc/jjag061

J Crohns Colitis. 2026 May 8;20(5):jjag046. doi: 10.1093/ecco-jcc/jjag046.

ABSTRACT

BACKGROUND AND AIMS: In women with IBD, there are few options to treat pain during pregnancy and prescribers sometimes rely on opioids. We investigated the prevalence of repeated opioid use during the pregnancy period as well as the impact on birth outcomes.

METHODS: Using the Danish national registries, we identified pregnancies of women with IBD from January 1, 1997, to June 1, 2023. We defined repeated opioid use as at least two opioid prescriptions with a minimum 30-day interval between them. We examined the prevalence in three separate time periods: (1) nine months before conception; (2) throughout pregnancy; and (3) nine months postpartum, and we calculated adverse birth outcomes.

RESULTS: Of 10 904 women with IBD, 237 (2.2%) had repeated use of opioids prior to pregnancy, 220 (2.0%) during pregnancy and 359 (3.3%) postpartum. Women with repeated opioid use prior to pregnancy were significantly more likely to have repeated use during pregnancy (adjusted odds ratio (aOR): 231.50 (95% CI, 159.80-335.36)). Women who had repeated use during pregnancy were significantly more likely to have repeated use during the postpartum period (aOR: 74.98 (95% CI, 53.76-104.57)). Women with repeated use of opioids during pregnancy had statistically significant risks of preterm birth (aOR: 1.87 (95% CI, 1.28-2.74)) and of delivering a small for gestational age infant (aOR: 2.46 (95% CI, 1.41-4.32)).

DISCUSSION: The proportions of women who used repeated opioids prior to pregnancy, during pregnancy, and in the postpartum period were low but consequences for neonates can be severe. Providers should screen for opioid use in this population.

PMID:42106903 | DOI:10.1093/ecco-jcc/jjag046

Biomark Res. 2026 May 9. doi: 10.1186/s40364-026-00927-x. Online ahead of print.

ABSTRACT

BACKGROUND: Niemann-Pick disease, type C1 (NPC1), is a rare, fatal, neurodegenerative lysosomal disorder caused by pathological variants in NPC1. Defects in lysosomal cholesterol transport result in the accumulation of unesterified cholesterol within the endo-lysosomal compartments. Delayed diagnosis, limited treatment options, and phenotypic heterogeneity characterized by a broad range of signs/symptoms underscore the urgent need for effective biomarkers to facilitate diagnosis, monitor disease progression and assess therapeutic response. The goal of this study was to identify serum protein biomarkers for NPC1.

METHODS: Proximal Extension Assays (PEA) were used to determine relative protein expression levels from 68 serum samples from NPC1 individuals and 20 age-appropriate control serum samples. Statistical models identified NPC1 disease-specific effects after adjusting for covariates. Selected proteins were orthogonally validated by ELISA and correlated with assessments of both disease severity (Age of Neurological Onset (ANO) and Annual Severity Increment Score (ASIS)) and disease burden (NPC Neurological Severity Score (NSS).

RESULTS: Quantifiable data was obtained on 2888 proteins, revealing 186 increased (adjusted log₂FC ≥ 1) and 286 decreased (adjusted log₂FC ≤ -1) proteins with adj. p-value < 0.1 when comparing NPC1 individuals not being treated with miglustat versus control serum samples. Using orthogonal assays, we confirmed significant elevations for seven proteins: TREM2, AgRP, CCL18, Cathepsin L, GPNMB, NPY, and HSD17B14, and a significant decrease of BDNF. We further identified 100 proteins whose abundance levels were significantly altered towards normal by miglustat treatment. We found the 17-domain NPC NSS to be correlated with protein levels in the PEA data. Orthogonally validated data correlated with the age of neurological onset. We also identified 25 differentially abundant serum proteins in NPC1 baseline samples which are predominantly expressed in brain regions.

CONCLUSIONS: The statistical analysis pipeline developed in this study is flexible and scalable and supports application to high-dimensional proteomic datasets. This study identified and validated serum proteins with altered expression in individuals with NPC1, responded to miglustat therapy, and correlated with disease severity or burden. These proteins may have clinical utility as biomarkers and provide insights into cellular mechanisms contributing to NPC1 disease pathology.

TRIAL REGISTRATIONS: NCT00344331 (Registration on 2006-06-23).

PMID:42106890 | DOI:10.1186/s40364-026-00927-x

Int J Retina Vitreous. 2026 May 9. doi: 10.1186/s40942-026-00834-1. Online ahead of print.

ABSTRACT

BACKGROUND: To provide population-level estimates of OCT-detected macular pathology in adults living in the Brazilian Amazon region.

METHODS: Population-based, cross-sectional study. Eligible participants were residents aged ≥ 45 years identified through cluster sampling (20 clusters: 14 urban and 6 rural) in Parintins City, Amazonas, Brazil. Ophthalmic examinations included visual acuity testing, biomicroscopy, fundoscopy, and subjective refraction. A subset of eligible participants underwent spectral-domain OCT (SD-OCT; iVue-100, Optovue) using macular mapping protocols. OCT images were graded for predefined abnormalities involving the vitreoretinal interface, inner retina, outer retina/retinal pigment epithelium (RPE)/choroid, and ganglion cell complex (GCC). Generalized estimating equations (GEE) were used to evaluate factors associated with any OCT abnormality. Statistical significance was set at p < 0.05.

RESULTS: Of 2,384 eligible individuals, 2,041 (85.7%) were examined and 588 (28.8%) underwent OCT (1,176 eyes), of which 1,069 eyes (90.9%) were gradable. OCT macular abnormalities were detected in at least one eye in 180 participants (30.6%). Overall, outer retinal layer changes were most frequent, followed by GCC thinning and epiretinal membrane. OCT abnormalities were independently associated with older age and lower educational level. Structural abnormalities were identified in 340 (31.8%) eyes; of these, 208 (19.5%) showed changes also detectable on dilated fundus examination, whereas 132 (12.3%) had a clinically normal funduscopic appearance. Clinically notable lesions were detected in 46 (4.3%) eyes, including signs of late AMD in 27 (2.5%) eyes, diabetic maculopathy in 6 (0.6%), lamellar macular hole in 6 (0.6%), full-thickness macular hole in 3 (0.3%), and central serous chorioretinopathy in 4 (0.4%) eyes. Among 774 eyes clinically normal at fundoscopy, OCT revealed subclinical disease in 127 (16.4%).

CONCLUSIONS: In this underserved Amazonian population, approximately one-third of gradable eyes showed OCT-detected macular abnormalities, many of them subclinical on fundoscopy. Diabetic maculopathy, choroidal neovascular membranes, and late AMD showed very low prevalence and limited epidemiologic weight in this setting. Incorporating OCT into population-based surveys enhances detection and refines burden estimates of subclinical retinal disease and vision-threatening conditions in aging populations.

PMID:42106887 | DOI:10.1186/s40942-026-00834-1