Nevin Manimala

BMC Psychol. 2026 May 9. doi: 10.1186/s40359-026-04716-x. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer is one of the leading causes of death worldwide. Oncology nurses play an essential role in the care of oncology patients. Providing care for cancer patients and managing complex treatment processes can be challenging for oncology nurses. The psychological effects of caring for cancer patients and facing their illness and death are often overlooked. The relationships between aging anxiety, job stress, and psychological resilience remain unclear. The aim of this study was to determine the relationship between aging anxiety, job stress, and psychological resilience in oncology nurses.

METHODS: This cross-sectional, correlational and descriptive study was conducted with 220 nurses working in an oncology hospital from December 2023 to February 2024. The Personal Information Form, Relational Aging Anxiety Scale (RASS), Nurse Stress Scale (NSS), and Resilience Scale for Nurses (RSN) were used to collect the data. Descriptive analyses, correlation analysis, and Structural Equation Modeling (SEM) were performed.

RESULTS: Correlation analyses revealed a statistically significant low positive correlation between the relational aging anxiety subscale and NSS scores (r = 0.240, p < 0.05), and a low negative correlation with RSN scores (r = – 0.182, p < 0.05). SEM indicated that RAAS scores were a significant negative predictor of RSN scores (β = -0.214, p < 0.05) and a significant positive predictor of NSS scores (β = 0.608, p < 0.05). No significant direct effect between RSN and NSS scores (β = -0.007, p > 0.05).

CONCLUSIONS: These findings suggest that higher aging anxiety among nurses is associated with greater stress and lower psychological resilience, highlighting the need for comprehensive training programs to reduce aging anxiety and job stress, and to enhance psychological resilience among oncology nurses. Interventions focusing on stress management, emotional regulation, and self-care are recommended. Experimental studies to evaluate the effectiveness of these interventions are encouraged.

PMID:42104429 | DOI:10.1186/s40359-026-04716-x

J Transl Med. 2026 May 8. doi: 10.1186/s12967-026-08252-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Cyclosporine A (CsA) is a widely used immunosuppressive drug, but its long-term use is associated with renal fibrosis. Despite its clinical importance, the molecular mechanisms underlying CsA-induced renal fibrosis remain poorly understood.

METHODS: We used C57BL/6 mice (n = 6 per group) treated with CsA (30 mg/kg/day, gavage) and Boston University mouse proximal tubular (BUMPT) cells (n = 6 per group) exposed to CsA (8 µM). Assessments included Masson’s trichrome staining, Western blot, quantitative real-time PCR, immunohistochemistry, and in situ hybridization. Mechanistic studies employed miR-212-5p mimics and inhibitors, activating transcription factor 6 (ATF6) overexpression, and the endoplasmic reticulum (ER) stress inhibitor 4-phenylbutyric acid (4-PBA). Data are presented as mean ± standard deviation; statistical significance was defined as p < 0.05.

RESULTS: CsA induced significant renal fibrosis in vivo and in vitro, evidenced by increased collagen deposition and elevated expression of alpha-smooth muscle actin (α-SMA), fibronectin, collagen type I and IV, and key profibrotic factors (p < 0.05). RNA analysis revealed that miR-212-5p was markedly upregulated in CsA-treated kidneys, predominantly in renal tubules. Concurrently, ATF6, a protective component of the unfolded protein response (UPR), was significantly downregulated. Bioinformatics prediction and luciferase reporter assays confirmed that miR-212-5p directly targets the 3′ untranslated region of Atf6 mRNA. Functionally, miR-212-5p mimic exacerbated CsA-induced ATF6 suppression and fibrosis, whereas anti-miR-212-5p restored ATF6 expression, attenuated ER stress, and significantly reduced fibrotic markers. Similarly, ATF6 overexpression or ER stress inhibition with 4-PBA ameliorated CsA-induced fibrosis.

CONCLUSIONS: Our findings position miR-212-5p as a previously unrecognized molecular target of CsA and establish the miR-212-5p/ATF6 axis as a central driver of CsA-induced nephrotoxicity. The findings provide new insights into the molecular mechanisms of CsA nephrotoxicity and identify a potential therapeutic target for preventing CsA-induced renal fibrosis.

PMID:42104426 | DOI:10.1186/s12967-026-08252-5

Alzheimers Res Ther. 2026 May 8. doi: 10.1186/s13195-026-02067-8. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between income dynamics-including sustained income level, income changes, and income variability-and early-onset dementia (EOD) has not been well established. This study investigated the association between income dynamics and the risk of EOD.

METHODS: This cohort study included 2,247,461 adults aged 40-60 years who underwent health examinations in 2012 through the Korean National Health Insurance Service, with a median follow-up duration of 5.4 years till 2018. Income status was assessed for 2012 and the 4 preceding years using monthly health insurance premiums, and income-related parameters were derived from this pre-baseline 5-year window. Income variability was defined as the intra-individual standard deviation of four consecutive annual percentage changes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to evaluate the relationship between income dynamics and EOD risk, adjusting for potential confounders.

RESULTS: Sustained low-income status over five years was associated with an increased risk of EOD (HR for 5 years vs. 0 years 1.63, 95% CI 1.49-1.78; P-trend < 0.001), whereas sustained high-income status was associated with a reduced EOD risk (HR for 5 years vs. 0 years 0.55, 95% CI 0.51-0.59; P-trend < 0.001). Notably, higher income variability was linked to a greater risk of EOD (HR for highest vs. lowest quartile 1.37, 95% CI 1.28-1.48; P-trend < 0.001). The decline in income-particularly to the lowest level (Medical Aid beneficiaries)-was associated with an elevated risk of EOD, irrespective of the initial income status.

CONCLUSIONS: Sustained low income, income decline, and greater income variability were associated with higher EOD risk. These findings may help identify socioeconomically vulnerable middle-aged adults for targeted dementia risk assessment and prevention.

PMID:42104420 | DOI:10.1186/s13195-026-02067-8

BMC Nurs. 2026 May 8. doi: 10.1186/s12912-026-04728-3. Online ahead of print.

ABSTRACT

BACKGROUND: Operating room nurses (ORNs) are at high risk for compassion fatigue (CF), which significantly impairs individuals’ well-being, undermines the stability of the nursing workforce, and jeopardizes patients’ safety. The study aimed to analyze the prevalence and symptom characteristics of CF among ORNs, construct and compare predictive models using machine learning, and determine the relative contribution of distinct features to the models.

METHODS: This is a multi-center cross-sectional study. The questionnaires used in the study included a sociodemographic questionnaire, the Professional Quality of Life Scale (ProQoL), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Pittsburgh Sleep Quality Index (PSQI). LASSO regression was used to select critical variables, and predictive models such as decision tree, logistic regression, random forest, SVM, and XGBoost were constructed and compared. SHapley Additive exPlanation (SHAP) were drawn to show the contribution of each feature to the models. SPSS version 26.0 and R software version 4.4.0 were used for statistical analyses.

RESULTS: In this study, a total of 1024 ORNs from 20 cities across China were recruited. According to ProQoL, 326 (31.8%) reported severe CF, 311 (30.4%) moderate CF, and the remaining 387 (37.8%) no or mild CF. Among the three dimensions, the incidence of secondary traumatic stress was most common (95.4%), followed by low compassion satisfaction (61.3%) and burnout (35.0%). In five machine learning-based predictive models, the RF model stood out with the highest AUC at 0.851 (95%CI: 0.795-0.907) in testing set. Following closely, the XGBoost model showed favorable efficacy with the AUC at 0.824 (95%CI: 0.769-0.879) in testing set, outperforming the remaining algorithms. The results of the two SHAP plots (RF and XGBoost) were consistent: depression, anxiety, self-mental health training, sleep quality, and length of service emerged as the five most significant contributors to the models.

CONCLUSION: This study identified severe CF among ORNs, and the most serious symptom was secondary traumatic stress. The RF model exhibited the best performance in identifying high-level CF among ORNs, and SHAP improved the interpretability of the model. The findings of this study could help medical managers and researchers better understand CF and provide timely interventions for ORNs.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42104411 | DOI:10.1186/s12912-026-04728-3

Health Qual Life Outcomes. 2026 May 8. doi: 10.1186/s12955-026-02549-1. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to perform a cultural adaptation of the Child Health Utility 9D (CHU-9D), a health-related quality of life (HRQoL) instrument, into Traditional Chinese specifically for use in Hong Kong, and evaluating its psychometric properties among a sample of local adolescents.

METHODS: A cross-sectional survey design was employed for data collection. Adolescents aged 13 to 17 years were recruited from diverse local community settings to complete a self-administered questionnaire that included the adapted CHU-9D and relevant demographic items. Psychometric evaluations encompassed assessments of ceiling and floor effects, factorial validity through confirmatory factor analysis, convergent validity via correlation analysis, and known-group validity to examine differences across predefined risk groups.

RESULTS: A total of 627 adolescents successfully completed the survey, providing a robust dataset for analysis. The unidimensionality of the CHU-9D was confirmed, demonstrating excellent model fit indices. A ceiling effect was observed, with 27% of participants reporting full health status on the CHU-9D descriptive system, indicating potential limitations in capturing variations at the upper end of health. Convergent validity was supported by significant correlations between CHU-9D and conceptually relevant items and subscales from another HRQoL instrument. The instrument exhibited strong known-group validity, effectively discriminating HRQoL differences across various risk groups with statistically significant results.

CONCLUSION: The culturally adapted Traditional Chinese version of the CHU-9D demonstrates sound psychometric properties in Hong Kong adolescents, supporting it as a valid tool for measuring and valuing HRQoL in this population and cultural context.

PMID:42104409 | DOI:10.1186/s12955-026-02549-1

Parasit Vectors. 2026 May 9. doi: 10.1186/s13071-026-07376-3. Online ahead of print.

ABSTRACT

BACKGROUND: Cutaneous leishmaniasis (CL) is a neglected tropical skin disease. In Ethiopia, CL is a public health concern; about 29 million people are at risk, with an estimated incidence of up to 50,000 new cases annually. In endemic communities, access to diagnosis, treatment, and prevention is crucial but often limited. Understanding the prevalence and access to care, as well as exploring its relationship to agroecological factors, is crucial to inform control strategies.

OBJECTIVES: The aim of this work is to estimate the pooled prevalence, access to care service facilities, and spatial distribution and relationship to agroecological factors.

METHODS: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) framework. The metafor and metadata packages from R Studio were used to obtain pooled prevalence and odds ratio using a random-effects model with a double arcsine transformation. The CL endemicity at the woreda level was overlaid with the locations of CL treatment centers and agroecological zones using ArcGIS.

RESULTS: The pooled prevalence of CL was 6.75% (95% confidence interval (CI) 3.37-11.17). Sociodemographic factors (male gender, rural living) and environmental factors (muddy walls, outdoor sleeping, proximity to rocky habitats, and hyrax populations) were significantly associated with CL. CL cases were reported from 85 woredas with a broad spatial distribution; a higher proportion of them were from the Weyna Dega, Dega, and Upper Kola agroecological zones. Access to care is generally poor, with service centers for CL often centralized at the zone level.

CONCLUSIONS: The estimated pooled prevalence likely underrepresents the true burden of CL. The identified risk factors are more related to rural livelihoods and living conditions, and most of the endemic woredas are in the most productive agrarian agroecological zones, which underlines the health and socioeconomic significance of CL in Ethiopia. Thus, decentralizing healthcare services and improving surveillance for CL are crucial steps in breaking the vicious cycle of poverty.

PMID:42104399 | DOI:10.1186/s13071-026-07376-3

BMC Nurs. 2026 May 8. doi: 10.1186/s12912-026-04736-3. Online ahead of print.

ABSTRACT

BACKGROUND: Compassion fatigue is an occupational hazard among nurses that arises from prolonged exposure to patient suffering and to work-related stress. In resource-limited healthcare settings, such as public district hospitals in Bangladesh, high patient loads, staffing shortages, and limited organizational support may increase nurses’ vulnerability to CF. However, evidence from district-level hospitals in low- and middle-income countries is limited.

METHODS: A cross-sectional study was conducted between January and June 2025 among nurses working at a 250-bedded district hospital in Bangladesh. Using stratified random sampling, 380 nurses from the medicine, surgery, pediatrics, and intensive care/emergency units were recruited. Compassion fatigue was assessed using the Professional Quality of Life Scale (ProQOL-5). Descriptive statistics were used to estimate the prevalence. Chi-square tests and multivariate logistic regression were performed to identify the demographic and occupational predictors of high compassion fatigue.

RESULTS: Overall, 44.2% of nurses reported high compassion fatigue, and 37.6% reported moderate levels. The highest prevalence was observed among nurses working in intensive care/emergency units (52%). Multivariate analysis identified lack of organizational support (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.6-4.1), more than 10 years of service (OR 2.3, 95% CI 1.4-3.8), and intensive care/emergency assignment (OR 1.9, 95% CI 1.2-2.9) as significant predictors of high compassion fatigue scores. Subscale analyses indicated higher burnout and secondary traumatic stress among nurses working in high-acuity departments.

CONCLUSIONS: Compassion fatigue is highly prevalent among nurses in a resource-limited district hospital in Bangladesh, particularly among those working in high-acuity settings and those reporting insufficient organizational support. These findings highlight the need for targeted organizational strategies, including improved support systems, workload management, and mental health interventions, to promote nurses’ well-being and sustain quality patient care in similar healthcare contexts.

PMID:42104394 | DOI:10.1186/s12912-026-04736-3

Phys Med. 2026 May 7;146:105812. doi: 10.1016/j.ejmp.2026.105812. Online ahead of print.

ABSTRACT

PURPOSE: To develop an automated class-solution treatment-planning workflow for biologically guided dose-painting based on combined FDG- and FMISO-PET in head and neck cancer (HNC), and to compare its performance with manual planning.

MATERIAL AND METHODS: The workflow incorporating image-processing and treatment planning via a class-solution template was implemented in RayStation-10B-R and applied to patients imaged with FDG- and FMISO-PET/CT. The workflow converted FMISO- and FDG-PET uptake into oxygen partial pressure and clonogenic cell-density distributions, respectively. Accordingly, simultaneous integrated boost plans aiming at 95% tumour control probability (TCP) and using a dose-painting-by-contours approach for TV1, TV2, the GTV, and the hypoxic target volume (HTV), were created. For nine patients, automated and manual plans were compared using equivalent dose in 2-Gy fractions (EQD2)-based target metrics, organ-at-risk (OAR) doses, plan-complexity parameters, planning time, TCP and normal tissue complication probability (NTCP).

RESULTS: The automated workflow generated plans achieving target coverage; however not all plans met mandatory OAR constraints. In the nine-patient comparison, no statistically significant differences were found in OAR metrics or TCP/NTCP, except for the right parotid EQD2_mean, which favoured manual plans. Target results were mixed: template plans performed better for inner volumes, whereas manual plans showed higher EQD2_mean in the TV1-TV2 and HTV. Manual planning required ∼ 1 h, whereas automated planning required ∼ 5 h with no user interaction.

CONCLUSIONS: A scripting-based, biologically guided class-solution for dose-painting in HNC is feasible and achieves plan quality and radiobiological outcomes comparable to manual planning, providing a platform for standardised and adaptive radiotherapy workflows.

PMID:42102428 | DOI:10.1016/j.ejmp.2026.105812

Cortex. 2026 Apr 23;201:10-39. doi: 10.1016/j.cortex.2026.04.006. Online ahead of print.

ABSTRACT

The contralateral delay activity (CDA) is a widely used electrophysiological marker of visual working memory (VWM), yet recent work has questioned whether typical sample sizes in CDA studies are sufficient to robustly detect set size effects and brain-behavior correlations. As part of the #EEGManyLabs initiative, the present multi-site replication study aimed to rigorously test replicability of the key findings of Vogel and Machizawa (2004)using a large sample of 304 participants across 10 laboratories and a preregistered analysis plan. We replicated the expected contralateral-ipsilateral asymmetry and observed increases in CDA amplitude from set size 2 to 4 and from set size 2 to 6. In contrast, the hypothesized positive correlation between the CDA increase from set size 2 to 4 and individual VWM capacity was not replicated in the preregistered meta-analytic correlation. Across different pipelines and statistical analyses, the meta-analytic correlation estimate was small (r = .15) and substantially attenuated relative to the original effect size in Vogel and Machizawa (2004)study (r = .78). To contextualize these findings, we applied a funnel-plot diagnostic combining published effects with the #EEGManyLabs data, indicating small-study inflation and publication bias. Taken together, our results indicate that reports of strong correlations between CDA amplitude and VWM capacity may have been overestimated, in part because statistically significant findings were selectively reported. Our results highlight the importance of open science practices, including well-powered, preregistered studies with transparent data and analysis pipelines, in order to characterize the magnitude and robustness of individual-difference associations in psychophysiology.

PMID:42102425 | DOI:10.1016/j.cortex.2026.04.006

J Neurosurg Spine. 2026 May 8:1-8. doi: 10.3171/2025.10.SPINE241562. Online ahead of print.

ABSTRACT

OBJECTIVE: Interventional pain management physicians (IPMPs) and spine surgeons are allies in treating spinal disorders. In addition to medical management, IPMPs can perform procedures such as epidural injections, rhizotomies, or kyphoplasties to bring relief to patients. However, some IPMPs perform procedures traditionally performed by spine surgeons, such as minimally invasive spine surgery, neural decompression, and spinal fusion. The line between spine procedures performed by spine surgeons and interventional pain management procedures performed by IPMPs has blurred. This study aimed to determine the incidence of IPMPs performing interventional spinal procedures traditionally performed by spine surgeons.

METHODS: IPMPs were identified through the American Society of Interventional Pain Physicians (ASIPP) DoctorFinder database. Each physician’s Scopus profile was evaluated to determine academic productivity. Personal physician websites were queried to determine whether they offered minimally invasive or open spinal procedures. Potential associations and differences among IPMPs performing interventional spinal procedures were analyzed using descriptive statistics, independent-sample t-tests, and chi-square analyses.

RESULTS: After neurosurgeons and orthopedic surgeons were removed from the initial list of 325 registered healthcare providers, 269 providers were included in the analysis (mean [SD] age, 56.3 [9.6] years). Physician degrees included MD (n = 237) and DO (n = 32). Some physicians held an additional degree (MS [n = 4], PhD [n = 4], and unspecified [n = 38]). Of the 269 healthcare providers, 130 had Scopus research profiles (mean publications, 24.2; mean h-index, 6.0; mean citations, 925.6). Seventy-four physicians (27.5%) performed interventional spinal procedures: 35 (13.0%) performed minimally invasive lumbar decompression (mild procedure), 33 (12.3%) performed Superion or Vertiflex interspinous spacer insertion, 18 (6.7%) performed spinal arthrodesis or fusion, 26 (9.7%) performed discectomies, 11 (4.1%) performed Minuteman interspinous-interlaminar fusion, 1 (0.4%) performed disc replacement, and 14 (5.2%) performed other unspecified decompressive spinal procedures. There were no significant differences in age (p = 0.62), publication number (p = 0.19), h-index (p = 0.53), citation count (p = 0.44), and fellowship incidence (p = 0.19) between IPMPs who performed interventional spine procedures and those who did not. No significant associations were found between sex (p = 0.19), medical degree (MD: p = 0.07, DO: p = 0.11), or number of publications (p = 0.38) and whether interventional spinal procedures were performed.

CONCLUSIONS: The incidence of invasive spine procedures performed by IPMPs is high. Future studies must analyze patient-reported outcomes, and differences in the training for traditional spine surgery interventions performed by surgeons and interventional pain spinal procedures performed by IPMPs must be better defined.

PMID:42102410 | DOI:10.3171/2025.10.SPINE241562