Nevin Manimala

J Cancer Res Clin Oncol. 2026 May 10. doi: 10.1007/s00432-026-06469-x. Online ahead of print.

ABSTRACT

PURPOSE: The sensitivity of bladder cancer detection using a single biomarker from single sample type is limited. This study aimed to investigate whether a combined approach utilizing multiple biomarkers from different clinical samples could improve detection sensitivity.

METHODS: A total of 85 patients with bladder cancer and 30 healthy individuals were enrolled in this study. Urine and blood samples were collected for the isolation of urine-derived epithelial cells (UDECs) and circulating tumor cells (CTCs). These cells were then analyzed via PD-L1 assay and fluorescence in situ hybridization (FISH) targeting chromosomes 7 and 8. In parallel, matched urine samples from patients underwent conventional urine exfoliation cytology testing (UEC). All data were analyzed in conjunction with pathological information using specialized statistical software.

RESULTS: Analysis of CTCs demonstrated a significantly higher bladder cancer detection rate (78.6%) compared to UEC (36.7%). The combination of UDEC-FISH and CTC analysis utilizing urine and blood samples achieved a higher detection rate (94.1%) than the combination of UDEC-FISH with UEC performed on the same urine sample (79.8%). Furthermore, combined analysis of three markers of CTC, UEC, and UDEC-FISH (96.5%) or CTC, UEC, and UDEC-PD-L1 (90.6%) yielded significantly higher detection rates than any single biomarker analysis alone.

CONCLUSION: Integrating multiple biomarkers from distinct sample types significantly enhances the detection sensitivity for bladder cancer.

PMID:42107019 | DOI:10.1007/s00432-026-06469-x

JAMA. 2026 May 10. doi: 10.1001/jama.2026.7886. Online ahead of print.

ABSTRACT

IMPORTANCE: Digitalis glycosides may be used as additional therapy in patients with heart failure with mildly reduced ejection fraction (HFmrEF) or HF with reduced EF (HFrEF).

OBJECTIVE: To assess the effect of digitalis glycosides on clinical outcomes in patients with HFmrEF or HFrEF.

DATA SOURCES AND STUDY SELECTION: PubMed was searched from inception to March 1, 2026, using medical subject headings and keywords related to digitalis glycosides and HF. The review was restricted to placebo-controlled randomized clinical trials including more than 1000 patients and articles published in the English language.

DATA EXTRACTION AND SYNTHESIS: Data were extracted by 2 reviewers who followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Risk of bias was assessed with the Cochrane Risk of Bias tool (version 2). A fixed-effects model was used to estimate the hazard ratios (HRs) with 95% CIs.

MAIN OUTCOMES AND MEASURES: The primary end point was the composite of time to cardiovascular death or first worsening HF event. Secondary outcomes included individual components of the composite outcome and time to all-cause death.

RESULTS: A total of 3 studies met the inclusion criteria and included 9013 patients with HFmrEF or HFrEF (weighted mean age, 64.5 [weighted SD, 11.2] years; 22% female and 78% male). The composite outcome of cardiovascular death or first worsening HF event occurred in 1852 of 4510 patients (41%) in the digitalis glycoside group vs 2037 of 4503 patients (45%) in the placebo group (HR, 0.85 [95% CI, 0.80-0.90]; P < .001). First worsening HF event occurred in 1183 (26%) patients in the digitalis glycoside group vs 1474 (33%) patients in the placebo group (HR, 0.75 [95% CI, 0.69-0.81]; P < .001). There were 1224 cardiovascular events in the digitalis glycoside group vs 1224 in the placebo group (27% of participants in each group; HR, 0.99 [95% CI, 0.92-1.07]; P = .81) and there were 1466 vs 1497, respectively, all-cause deaths (32% of participants vs 33%; HR, 0.97 [95% CI, 0.90-1.04]; P = .41). There was no statistically significant heterogeneity by trial, type of digitalis glycoside treatment, or extent of background HF therapy.

CONCLUSIONS AND RELEVANCE: Treatment with digitalis glycosides was associated with a lower risk of the composite of cardiovascular death or first worsening HF event in patients with HFmrEF or HFrEF, mainly through a lower risk of worsening HF events. There was no statistically significant interaction with important study characteristics, including the extent of HF background therapy or type of digitalis glycosides treatment. These results suggest digitalis glycosides may be used as additional medical therapy to reduce worsening HF events in patients with HFmrEF or HFrEF.

PMID:42106991 | DOI:10.1001/jama.2026.7886

Psychol Rep. 2026 May 10:332941261450508. doi: 10.1177/00332941261450508. Online ahead of print.

ABSTRACT

This study examined whether the relationship between impulsivity and Internet addiction (IA) levels among university students varies depending on the indirect pathway mediated by the meaning-seeking in life and whether this indirect pathway is dependent on self-esteem levels. The study was conducted using data collected from 500 university students in Türkiye via valid self-report measures, employing a cross-sectional, correlational design. Controlling for daily internet usage time, the assumed direct, indirect, and conditional associations were tested using Hayes’ PROCESS macro (Model 14). Correlation analyses found that impulsivity was negatively related to meaning-seeking in life (r = -.120, p < .01) and positively related to IA (r = .261, p < .001). In the conditional process analysis, impulsivity was negatively associated with meaning-seeking in life (B = -0.180, p = .003) and positively associated with IA (B = 0.592, p < .001). The interaction between meaning-seeking in life and self-esteem was significantly associated IA (B = 0.180, p = .009) and contributed additional explanatory power to the model (ΔR² = 0.0125, p < .01; total R² = .117). The direct association between meaning-seeking in life and IA in the regression model was statistically significant (B = 0.214, p = .004); however, the indirect pathway through meaning-seeking in life was moderated by self-esteem. The moderated mediation index was significant (Index = -0.032, 95% CI [-0.076, -0.007]), and the findings indicate that the indirect component of the relationship between impulsivity and IA level, mediated by meaning-seeking in life, varies according to self-esteem level; the indirect association is more pronounced at lower self-esteem scores. These findings were interpreted within a cross-sectional design framework and suggest that impulsivity is related to IA levels and that the conditional indirect mechanism is present, although its magnitude appears modest.

PMID:42106983 | DOI:10.1177/00332941261450508

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