Nevin Manimala

BMC Complement Med Ther. 2026 Jan 9. doi: 10.1186/s12906-025-05243-9. Online ahead of print.

ABSTRACT

PURPOSE: Continuous positive airway pressure (CPAP) therapy remains the cornerstone of obstructive sleep apnea (OSA) treatment, considerably reducing the risk of cardiovascular complications and improving patient outcomes. However, adherence to CPAP therapy is a major challenge and poor compliance limits its efficacy. This study investigated the potential of aromatherapy, a noninvasive, cost-effective intervention, to improve CPAP adherence and enhance sleep quality in patients with OSA.

METHODS: A prospective observational pilot study was conducted in patients with obstructive sleep apnea who demonstrated poor CPAP adherence (< 70% usage and < 4 h/night). Participants were exposed to lavender or cypress aroma oil during sleep. Pre- and post-intervention subjective sleep measures Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and objective CPAP usage metrics were collected. Normally distributed variables were analyzed using paired t-tests, and non-normally distributed variables were analyzed using the Wilcoxon signed-rank test. Statistical significance was set at p < 0.05. A post hoc power analysis was performed based on observed effect sizes for the primary outcomes.

RESULTS: Eight patients with OSA (mean age 53.5 years; 4 males, 4 females) participated in the study. Following 67 days of treatment, the median PSQI score significantly improved from 9.0 to 6.5 (p = 0.006), and the median ESS score decreased from 9.0 to 6.5 (p = 0.034). Additionally, CPAP for more than 4 h increased from 5.0% to 25.7% (p = 0.028). The median usage duration improved from 149 to 231 min (p = 0.018). No significant change in apnea hypopnea index (AHI) was observed during CPAP use, decreasing from 3.2 events/h to 1.3 events/h (p = 0.226), which is consistent with the understanding that appropriately applied CPAP maintains effective control of respiratory events.

CONCLUSION: Aromatic stimulation with essential oils shows promise in improving both CPAP adherence and sleep quality, offering a novel approach to enhance OSA treatment efficacy.

PMID:41514226 | DOI:10.1186/s12906-025-05243-9

BMC Microbiol. 2026 Jan 9. doi: 10.1186/s12866-025-04623-y. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigates the impact of transitioning from restricted to 24/7 access to blood culture cabinets on blood culture processing.

METHOD: A post-hoc retrospective study and a prospective laboratory simulation to evaluate the effects of delayed incubation were conducted. Data analysis evaluated clinical data comparing incubation-to-detection (ITD) and Collection-to-detection (CTD) including Collection-to-incubation (CTI) comparing pre- and post-implementing the new protocol (Cut-point). ITD values were obtained using BD Synapsys™ software, with delays factored into CTD. Of 14,673 blood cultures collected from October 2019 to September 2023 at Rigshospitalet, Copenhagen, 3,323 met inclusion criteria. Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pneumoniae were selected as indicator organisms. In the simulation, cultures with 0-, 6-, and 18-hour incubation delays were assessed for growth and detection time.

RESULTS: Median ITD increased significantly post-cut-point: for E. coli from 7.8(IQR: 2.28-13.55) to 11.4(IQR: 9.8-14.7) hours, S. aureus from 9.9(IQR: 4.1-15.6) to 14.3 h(IQR: 11.5-19.5), P. aeruginosa from 14.0(IQR 5.3-19.95) to 16.3 h(IQR 11.75-26.1), and S. pneumoniae from 3.3(IQR: 1.55-9.9) to 11.7 h(IQR: 9-12.6) (all p < 0.01). CTD decreased post-cut-point: by 3h03m for E. coli (p < 0.0001), 3h51m for S. aureus (p = 0.0016), and 4h24m for S. pneumoniae (p < 0.0001). The reduction for P. aeruginosa (1h48m) was not statistically significant. In the simulation-study, delayed incubation increased CTD for all species in aerobic bottles: E. coli (p = 0.0036), S. aureus (p = 0.0036), P. aeruginosa (p = 0.0036), and S. pneumoniae (p = 0.0429); and in anaerobic bottles: E. coli (p = 0.0036), S. aureus (p = 0.0036), and S. pneumoniae (p = 0.0071). No anaerobic growth of P. aeruginosa was observed. An 18-hour delay notably reduced recovery of S. pneumoniae, with growth detected in only one bottle.

CONCLUSION: Minimizing incubation delays significantly reduces CTD and improves detection of fragile bacteria. These findings potentially have significant implications for clinical practice, emphasizing the importance of protocols that limit pre-analytical delays to optimize blood culture diagnostics.

PMID:41514207 | DOI:10.1186/s12866-025-04623-y

Scand J Caring Sci. 2026 Mar;40(1):e70175. doi: 10.1111/scs.70175.

ABSTRACT

INTRODUCTION: Turnover rates among health-care personnel are rising, which could jeopardise patient safety and the quality of care. One contributing factor to the high turnover is the prevalence of mental distress. Stress of conscience among healthcare personnel has been shown to affect them negatively, and feeling that they cannot provide the care their patients need increases their stress levels. Therefore, an increased understanding of stress of conscience, its relation to burnout and its consequences for healthcare can improve hospital care for both patients and staff.

AIM: This study aimed to investigate the correlation between stress of conscience and burnout among health care personnel at an acute care hospital in southern Sweden.

ETHICAL ISSUES AND APPROVAL: This study was approved by the Swedish Ethical Review Authority and followed the guidelines of the Declaration of Helsinki.

METHODS: The study used a descriptive cross-sectional design. A total of 167 healthcare personnel at an acute care hospital in southern Sweden completed a questionnaire based on the Stress of Conscience Instrument and Oldenburg Inventory Burnout Instrument.

RESULTS: There was a positive correlation between the stress of conscience and burnout (p = 0.01, Spearman’s rank correlation coefficient = 0.559). The results showed a statistically significant correlation between ‘living situation’ and stress of conscience, showing higher stress of conscience in groups living alone than in those living with a partner. The analysis also revealed a statistical significance between ‘working schedule’ and burnout, particularly in the groups working daytime and working shifts.

CONCLUSION: Stress of conscience is positively correlated with burnout among healthcare professionals. Shift workers were more likely to experience burnout, and HCP living alone reported higher levels of stress of conscience. These findings highlight the combined impact of personal and organisational factors, underscoring the need for interventions that address both domains to reduce burnout and support workforce wellbeing.

PMID:41514195 | DOI:10.1111/scs.70175

Artif Organs. 2026 Jan 9. doi: 10.1111/aor.70090. Online ahead of print.

ABSTRACT

BACKGROUND: In the last decades, various extracorporeal liver support systems were developed for hepatic failure with hyperbilirubinemia with the aim to clear the blood from protein-bound toxic molecules. Open albumin dialysis (OPAL) is a complex and expensive system that requires addition of human albumin. Plasma adsorption perfusion (PAP) using the anion exchange resin adsorber, BR-350, is an alternative liver support method that does not need additional blood products and is more cost-effective and less time-consuming.

METHODS: At the University Hospital Essen, PAP using BR-350 was performed in a cohort of 9 patients with a mean of 6 sessions per patient. In a retrospective analysis, we compared the detoxification ability of PAP with that of the OPAL system conducted among 24 patients and with standard medical treatment (SMT) including hemodialysis that was performed among 24 patients. In addition, the technical effectiveness of a single session of PAP with BR-350 was compared with OPAL among 12 patients who were treated with both methods in a crossover design.

RESULTS: The first single session (30.7.3 ± 13.5 mg/dL to 25.8 ± 13.4 mg/dL, p = 0.02) and the complete therapy (30.7 ± 13.5 mg/dL to 16.2 ± 6.3 mg/dL, p = 0.004) with PAP using BR-350 resulted in a statistically significant decrease of bilirubin concentrations. The median relative reduction of bilirubin achieved at the end of liver support treatment was comparable between PAP and OPAL (47% vs. 40%, p = 0.29). PAP was associated with a higher bilirubin reduction than the SMT plus dialysis (47% vs. -30%, p = 0.0001). The crossover comparison between the single session of PAP using BR-350 and OPAL revealed similar mean relative reduction rates of bilirubin (11% vs. 10%, p = 0.81). The single session of OPAL was associated with a more pronounced decrease of alkaline phosphatase, gamma-glutamyltransferase, hemoglobin, platelets, and leucocytes compared to PAP.

CONCLUSIONS: Both studied methods had comparable efficacy in reducing bilirubin in our studied patients in contrast to the retrospective control group. Since other substrates may also be relevant in treating liver failure, more studies are required. Patients with concomitant renal failure benefit from OPAL, whereas PAP might be more eligible for patients with a high risk of bleeding.

PMID:41514160 | DOI:10.1111/aor.70090

Oral Maxillofac Surg. 2026 Jan 10;30(1):16. doi: 10.1007/s10006-025-01501-9.

ABSTRACT

BACKGROUND: This study was conducted to investigate the clinical efficacy of Socket-Shield Technique on the adult first premolar bone preservation in Orthodontic Extraction Treatment.

METHODS: 26 patients who were underwent Orthodontic Extraction Treatment in the First Affiliated Hospital of Guangzhou Medical University were enrolled. Extracted teeth were paired and randomly allocated into two groups: test group (Socket-Shield Technique) and control group. Finally, the socket-shield was removed when the adjacent tooth moved proximate to the shield during the process of closing orthodontic gap. Cone beam computerized tomography were utilized to access the buccolingual resorption and vertical resorption at 1 mm, 3 mm and 5 mm from a reference plane of alveolar crest, as well as tooth movement rate.

RESULTS: The first premolar alveolar bone height resorption of test group were significantly lower than those in control group. Resorption of alveolar bone width at 1 mm and 3 mm above the reference plane at T1, T2 and T3 in the test group were significantly lower than those in the control group. There were no significant differences at 5 mm above reference plane. The tooth movement rate between the test group and the control group have no significant difference.

CONCLUSIONS: Socket-Shield Technique has a positive clinical effect on preserving the alveolar bone of the first premolar in adults with thin buccal alveolar bone and does not exert any discernible influence on the rate of orthodontic tooth movement in Orthodontic Extraction Treatment.

CLINICAL TRIAL REGISTRATION: The trial was registered in Clinical Trial Registry ( https://clinicaltrials.gov/ ) on 02/01/2024 and the registration number is NCT06510621.

PMID:41514150 | DOI:10.1007/s10006-025-01501-9

J Robot Surg. 2026 Jan 10;20(1):165. doi: 10.1007/s11701-025-03133-3.

ABSTRACT

Laparoscopic adrenalectomy (LA) is the standard minimally invasive approach, whereas robotic adrenalectomy (RA) is increasingly adopted for its ergonomic and technical advantages. Whether these benefits improve perioperative outcomes-particularly by adrenal laterality-remains unclear. This study compared RA and LA outcomes via structured side-specific analysis. A total of 198 patients were screened in this retrospective cohort study, which included adults who underwent minimally invasive adrenalectomy between June 2020 and September 2025. Patients with paragangliomas, recurrent disease, or open adrenalectomy were excluded. Clinical, operative, and postoperative variables were collected, and laterality-specific subgroup analyses and multivariable linear regression were performed. A total of 181 patients were analyzed (126 LA, 55 RA). The length of hospital stay was significantly shorter in the RA group (p = 0.019), whereas the operative time was significantly longer in the RA group than the LA group (p < 0.001). No significant differences were observed between techniques regarding complications, transfusions, or conversion rates (all p > 0.05). When stratified by laterality, the RA consistently demonstrated longer operative times for both right- and left-sided procedures (p = 0.001 and p < 0.001, respectively). In the multivariate analysis, only the surgical approach and tumor diameter independently affected the operative time (both p < 0.001). Robotic adrenalectomy demonstrated perioperative safety comparable to that of laparoscopy while providing the advantage of a shorter hospital stay despite longer operative times. Given its similar complication and conversion profiles, RA represents a feasible and ergonomically favorable procedure in endocrine surgery centers.

PMID:41514123 | DOI:10.1007/s11701-025-03133-3

J Autism Dev Disord. 2026 Jan 10. doi: 10.1007/s10803-025-07148-5. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this research was to investigate whether an intervention combining explicit and visually cued instruction could help upper primary students with ASD improve their social inferential reading comprehension performance.

METHODS: A multiple probe design was used to evaluate the effectiveness of the intervention on four children with ASD, aged 10 to 11 years. The study was conducted two to three times per week, each lasting 60 min, over ten weeks. The interventionist used think-alouds to explicitly model cognitive processes, error correction prompts to scaffold thinking, and a graphic organiser worksheet to simplify the social inferential reading comprehension process. All test probes used in the study were developed based on the ‘Strange Stories’ test by Happé (1994), and they were statistically equated using Rasch analysis. RESULTS: Results indicated a mean improvement ranging from 40% to 56% between baseline and intervention phases across different students. Supporting this finding, the effect size calculations using PND, PEM, PAND and Tau-U suggested an effective intervention. To reject the null hypothesis of no treatment effect, a randomization test was conducted using the SCRT-R software, yielding a p-value of 0.008.

CONCLUSIONS: With appropriate support, children with ASD may be able to develop the complex reading skills needed to interpret the emotions and intentions of story characters. While the findings of this study are promising, they should be considered preliminary. This exploratory research provides a foundation for future studies to build upon and to further investigate effective interventions for improving social inferential reading comprehension in students with ASD.

PMID:41514117 | DOI:10.1007/s10803-025-07148-5

J Autism Dev Disord. 2026 Jan 10. doi: 10.1007/s10803-025-07197-w. Online ahead of print.

ABSTRACT

PURPOSE: The PANSS Autism Severity Score (PAUSS) has recently become a popular measure of autistic features in psychosis populations, but evidence on its longitudinal reliability and factor configuration is poor. The aims of this investigation were to examine psychometric characteristics of the PAUSS in young patients with First Episode Psychosis (FEP) treated in an early intervention service, with primary interest for its long-term stability across 2 years of follow-up and factor configuration.

METHODS: All FEP participants completed the Positive And Negative Syndrome Scale (PANSS) and Autism Quotient (AQ) at baseline and across the follow-up. Statistical analysis mainly included Cronbach’s α to examine internal consistency of the PAUSS, Cohen’s k statistics and Spearman’s ρ correlation coefficients for its longitudinal stability and convergent validity with AQ scores, and exploratory factor analysis to explore its dimensions’ configuration.

RESULTS: 301 FEP participants were recruited (170 with Schizophrenia Spectrum Disorder [SSD]). Cronbach’s α value for the PAUSS was 0.806, but with unacceptable inter-item correlations for PANSS G5 and G15 items. K value for examining PAUSS convergent validity with AQ score was unacceptable (0.295), as well as ρ and k values to quantify long-term test-retest reliability (< 0.750 and < 0.600, respectively). No long-term stability of the PAUSS scores across the follow-up was also found using Wilcoxon’s test for repeated measure. Our EFA found a 2-factor model in the FEP total sample and a 3-factor configuration in the SSD subgroup.

CONCLUSION: Our results suggest that the PAUSS does not represent a valid instrument to assess autistic features in FEP and SSD. Indeed, the it probably captures psychotic symptom severity rather than autistic features, especially reflecting negative symptom load.

PMID:41514116 | DOI:10.1007/s10803-025-07197-w

Geroscience. 2026 Jan 9. doi: 10.1007/s11357-025-02080-z. Online ahead of print.

ABSTRACT

Social housing is desirable for the health and well-being of laboratory mice, as social interactions with conspecifics influence both behavioral and physiological outcomes. Although group housing benefits social species, it can introduce variability in mortality outcomes, and raise welfare concerns, particularly with the emergence of aggression or fluctuating cage densities. Despite this, few studies have evaluated how changes in the number of living cagemates over time are associated with survival, particularly in a sex-specific manner. We analyzed data from the National Institute on Aging’s Interventions Testing Program (ITP; n = 2635 UM-HET3 mice), across three research sites to assess whether housing density influenced longevity differently in male and female mice. Mice were housed in same-sex cages (median = 3 per cage) without reassignment after cagemate death. We applied Cox frailty models incorporating nested random effects for cage and site, with fixed effects for sex, treatment, and time-varying number of living cagemates to estimate hazard ratios, which allowed us to assess the instantaneous risk of death associated with changes in cagemate number. Results showed a significant main effect of the number of living cagemates on mortality and a significant interaction between sex and cagemate count, indicating sex-specific responses. Female mice exhibited a pronounced increase in mortality rate as cage density declined, suggesting a potential role of social buffering in longevity. These findings emphasize the importance of considering social housing dynamics, particularly for female mice, in both experimental design and animal welfare protocols.

PMID:41514094 | DOI:10.1007/s11357-025-02080-z

Aesthetic Plast Surg. 2026 Jan 9. doi: 10.1007/s00266-025-05590-5. Online ahead of print.

ABSTRACT

BACKGROUND: Previous studies on oncoplastic breast-conserving surgery (OBCS) have focused primarily on European-descent populations. However, Chinese women have distinct breast morphological characteristics, such as smaller volume and denser glandular tissue. These anatomical differences may influence the choice of procedure and postoperative outcomes. This study aimed to compare differences in aesthetic outcomes and patient-reported outcomes between volume replacement (VR) and volume displacement (VD) techniques in Chinese patients with breast cancer to clarify the applicability of different surgical approaches.

METHODS: This study analyzed patients who underwent OBCS with chest wall perforator flaps (CWPFs) or VD at the Affiliated Hospital of Southwest Medical University (Luzhou City, China) from 2022 to 2024. Demographic, surgical, oncological, and complication data were collected. Patients completed the BREAST-Q questionnaire preoperatively and at 12 months postoperatively, and aesthetic outcomes were evaluated using the criteria proposed by Ueda et al. Statistical analysis was performed on baseline characteristics, questionnaire scores, and aesthetic scores.

RESULTS: A total of 159 patients were included in the analysis. Of these, five underwent mastectomy due to positive margins. The two cohorts showed no significant difference in preoperative BREAST-Q scores. Patients who underwent OBCS with CWPFs reported significant improvements in satisfaction with breasts, physical well-being: chest, and aesthetic outcomes.

CONCLUSION: Chest wall perforator flaps demonstrated significant advantages in aesthetic and patient-reported outcomes compared with volume displacement. Therefore, they should be offered as an alternative to volume displacement for women with small-to-medium breasts.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

PMID:41514084 | DOI:10.1007/s00266-025-05590-5