Nevin Manimala

Neurourol Urodyn. 2026 Jan 28. doi: 10.1002/nau.70218. Online ahead of print.

ABSTRACT

BACKGROUND: Bladder filling rate has the potential to significantly impact the results of a urodynamics study (UDS). The International Continence Society (ICS) recommends two methods to determine the filling rate: Body weight divided by 4 (BW/4) and 10% of maximum voided volume (MVV) (10%MVV) from a bladder diary. However, there is no evidence if one method is superior to the other.

MATERIALS AND METHODS: This prospective study included patients undergoing UDS for non-neurological diseases, and the filling rate was calculated using both formulas. The study cohort consisted predominantly of patients with voiding lower urinary tract symptoms (LUTS). All the patients underwent UDS twice-once with the filling rate calculated by BW/4 method and once with the 10% MVV method. All UDS parameters, including the maximum cystometric capacity (MCC) were recorded and compared between the two methods used to calculate the fill rates. The MCC recorded during the UDS, with both methods, was further compared with the patient’s MVV documented on the bladder diary to assess its accuracy.

RESULTS: The study included 31 patients, and the calculated fill rate by the BW/4 method was 16 mL/min, and that with 10%MVV was 33 mL/min. The MCC on the UDS was 323 mL (IQR: 238-422) for the BW/4 method and 348 mL (IQR: 236-430) for the 10% MVV method, with no statistically significant difference from the MVV as recorded on the bladder diary (p = 0.961 and p= 0.549, respectively). Other urodynamic parameters, including first sensation, first desire to void, strong desire, bladder compliance, and detrusor overactivity, also showed no significant variation between the two methods to calculate the filling rate.

CONCLUSION: Both the BW/4 and 10% MVV formulas provide reliable estimates of MCC and do not significantly alter the urodynamic parameters. While the BW/4 method better aligns with the physiological filling rates, the 10% MVV method can result in faster filling and shorter duration of the urodynamic study, without adversely affecting its quality. These findings, however, may not apply to patients with storage LUTS, and studies in more diverse populations are warranted.

PMID:41603208 | DOI:10.1002/nau.70218

Epilepsia. 2026 Jan 28. doi: 10.1002/epi.70076. Online ahead of print.

ABSTRACT

OBJECTIVE: Forecasting epileptic seizures is a difficult task. Studies of seizure prediction have investigated many different EEG features, but none of them have been useful enough to be applied in clinical practice beyond trials. Moreover, most of these features have been applied to short-term intracranial EEG (iEEG) recordings, limiting the possibility of reliable statistical evaluation. This paper proposes a machine learning algorithm to forecast an epileptic seizure 2-4 mins before seizure. This allows patients to seek help, or stimulation devices to work.

METHODS: This paper investigates a large subset of features from the past and present to unravel which features and feature analysis methods will yield the best performance on long-term iEEG recordings (from 14 patients with focal epilepsy) and thus provide the most reliable step toward clinical utility. Specifically, this study implements a multiple long-time scale cycle feature analysis framework for seizure forecasting that considers the state-of-the-art time series features of critical slowing down (autocorrelation and variance) as well as interictal epileptiform discharge (IED) / spike rate, High Frequency Activity (HFA), seven different univariate features, and three Neural Mass Model (NMM) features based on brain dynamics.

RESULTS: Seizure phase histograms of all the features are then analyzed to investigate each feature’s potential for seizure forecasting by evaluating corresponding synchronization indices (SI) on fast (40 minutes to 2 days) and slow (2+ days) wideband time scales. Out of all combinations considered, the overall performance comparison across patients highlights that ‘autocorrelation + variance + NMM + spike rate’ features achieve the highest average AUC of 0.83, showcasing its performance in forecasting seizures.

SIGNIFICANCE: A model is proposed that has a similar performance compared to the state-of-the-art method, without the need of selecting the best channel prior to model building. Light is also shed on the comparative performance on long-term recordings of many of the seizure forecasting features considered in the past.

PMID:41603191 | DOI:10.1002/epi.70076

Endocr Metab Immune Disord Drug Targets. 2026 Jan 26. doi: 10.2174/0118715303412026251125095355. Online ahead of print.

ABSTRACT

INTRODUCTION: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, influenced by both genetic and environmental factors. Among the environmental factors, early childhood self-medication may be relevant in MS development. This study aimed to evaluate the association between MS risk and self-medication practices before the age of 15.

METHODS: Under a case-control approach, 260 demographically matched healthy controls from the Azeri community and 469 MS patients completed a comprehensive questionnaire on childhood self-medication history. Regarding the kind and frequency of drug usage, statistical comparisons were made among the groups using the chi-square test.

RESULTS: Self-medication was common in both cohorts; however, individuals with multiple sclerosis exhibited a markedly greater use of corticosteroids, analgesics, and hypnotics (p < 0.05). Conversely, healthy controls reported more frequent use of iron and calcium supplements, antihistamines, acetaminophen, antibiotics, and adult cold medications (p < 0.05). No significant differences were observed for multivitamins, vitamin D, or non-steroidal anti-inflammatory drugs (p > 0.05).

DISCUSSION: This study suggests that unsupervised use of certain medications, such as corticosteroids and hypnotics, before age 15 may increase the risk of developing multiple sclerosis, while common supplements and over-the-counter drugs may have a protective effect. Responsible drug use in childhood should be emphasized through education and regulation.

CONCLUSION: Early-life use of certain medications, especially corticosteroids and hypnotics, may be linked to increased MS risk, while the use of supplements and common over-the-counter drugs might have protective associations. Educational and regulatory efforts are needed to prevent unsupervised medication use in children.

PMID:41603186 | DOI:10.2174/0118715303412026251125095355

Ginekol Pol. 2026 Jan 28. doi: 10.5603/gpl.105643. Online ahead of print.

ABSTRACT

OBJECTIVES: Vaginal flatus is a common postpartum issue that can impact women’s quality of life. This study investigates the effectiveness of Kegel exercises in reducing vaginal flatus among postpartum women.

MATERIAL AND METHODS: In this study, forty postpartum women were enrolled between July 2022 and December 2022 at the Gynecology and Obstetrics Clinic of Istanbul Camlıca Medipol Hospital. The required sample size was calculated based on a power analysis assuming a medium effect size (Cohen’s d = 0.5), a power of 80%, and a significance level of 5%, resulting in a minimum of 17 participants per group. To account for potential dropouts, 20 participants were included in each group. Women in this study were randomly assigned to either an experimental or a control group. The experimental group performed Kegel exercises, whereas the control group received no intervention. Participants in the experimental group completed Kegel exercises three times daily in three different positions for three weeks. Additionally, a six-week home exercise program was implemented, including fast and slow contractions targeting both type I and type II muscle fibers. The assessment included vaginal flatus frequency and bother scores measured through a validated questionnaire, as well as sexual quality of life evaluated using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PSQ-12).

RESULTS: A significant reduction in vaginal flatus frequency and bother scores was observed in the experimental group following the intervention (p < 0.01). The mean vaginal flatus frequency score decreased from 2.95 to 2.0 in the experimental group. Comparisons of pre- and post-intervention vaginal flatus frequency/bother scores and PSQ-12 values revealed a statistically significant difference only in the experimental group (p < 0.05).

CONCLUSIONS: The findings indicate that Kegel exercises effectively reduce the frequency and bother associated with vaginal flatus in postpartum women. Incorporating pelvic floor exercise into postpartum care programs may improve overall well-being and sexual health outcomes.

PMID:41603160 | DOI:10.5603/gpl.105643

Epilepsia. 2026 Jan 28. doi: 10.1002/epi.70096. Online ahead of print.

ABSTRACT

OBJECTIVE: Pathogenic variants in γ-aminobutyric acid type A (GABA_A) receptor genes have been associated with a wide spectrum of neurological disorders. We aimed to delineate the clinical trajectories associated with gain-of-function (GoF) and loss-of-function (LoF) variants in GABRB2 and GABRB3, and to develop a risk-prediction model for gross motor dysfunction based on age at seizure onset.

METHODS: Clinical data, including seizure onset, epilepsy syndromes, cognitive outcomes, and gross motor function classification system (GMFCS), were collected through direct interviews, physician reports, and literature review. Kruskal-Wallis, Mantel-Cox and non-parametric analysis of variance (ANOVA) with Dunn’s corrected post hoc tests were used for statistical comparisons. A logistic ordinal regression model was developed to predict GMFCS outcomes based on age at seizure onset.

RESULTS: We analyzed a cohort of 117 individuals with pathogenic GABRB2 (n = 49) and GABRB3 (n = 68) variants. Fifty-three individuals carried GoF variants and 64 carried LoF variants. The GoF group was associated with earlier seizure onset, higher seizure frequency, and lower rates of seizure freedom. Gross motor dysfunction was markedly worse in the GoF group, with 64% classified as GMFCS IV or V (non-ambulation), compared to 7.5% in the LoF group. An inverse correlation was found between age at seizure onset and GMFCS severity in the GoF, but not the LOF group. The risk model predicted a >90% likelihood of non-ambulation for individuals with GoF variants and seizure onset before 1 month of age, decreasing to ~35% with seizure onset after 20 months.

SIGNIFICANCE: We found a clear genotype-phenotype correlation in GABRB2- and GABRB3-related disorders, demonstrating that GoF variants are associated with a more severe neurodevelopmental trajectory. The age at seizure onset serves as a biomarker for predicting motor outcomes in individuals with GoF variants. These findings provide guidance regarding prognosis, need for early intervention, and data for comparison of efficacy in targeted therapeutic interventions for GABA_A receptor-related disorders.

PMID:41603155 | DOI:10.1002/epi.70096

Transfusion. 2026 Jan 28. doi: 10.1111/trf.70097. Online ahead of print.

ABSTRACT

BACKGROUND: Blood collection agencies are shifting to gender-neutral risk assessment for donor eligibility. Pre-implementation data on donor eligibility and acceptance rates are essential to understand the likely impact of these changes locally.

STUDY DESIGN AND METHODS: A cross-sectional online survey was emailed to current Australian blood donors (donated in the last 12 months). Consistent with the recommendations of the United Kingdom’s For the Assessment of Individualised Risk (FAIR) project and the United States of America (USA) Food and Drug Administration (FDA) gender-neutral screening criteria, participants were asked about sexual behaviors in the last 3 months (multiple partners, new partners, anal sex) and whether being asked about these would deter them from donating. Demographic characteristics and behavioral responses were analyzed using descriptive statistics and chi-square tests.

RESULTS: Of 7938 respondents (11.3% response rate), only 0.6% (95% CI 0.4-0.8) would be ineligible under gender-neutral criteria (0.7%, 95% CI 0.2-1.8 of those who donated in the last 3 months). Those potentially ineligible were younger and less likely to identify as heterosexual. While tolerance for screening questions was generally high (≥70.0% indicated questions would not stop them donating), 12.7% (95% CI 12.0-13.4) indicated that one or more of the questions asked of all would stop or be quite likely to stop them attempting to donate. Some variation in tolerance was observed by demographic categories.

DISCUSSION: Implementation of gender-neutral screening criteria in Australia would result in minimal donor loss due to ineligibility. While questions would be generally tolerated, careful implementation considering demographic variations is warranted.

PMID:41603152 | DOI:10.1111/trf.70097

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