Nevin Manimala

Drug Alcohol Depend. 2026 Jul 26;286:113282. doi: 10.1016/j.drugalcdep.2026.113282. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examined the change in alcohol crash fatalities among 21-24y/o drivers in Utah in comparison to its contiguous states before (2016) and after (2019) Utah enacted its.05g/dL blood alcohol concentration (BAC) per se law in 2018.

METHODS: Data from the Fatality Analysis Reporting System (FARS) were used. A difference-in-differences (DID) analysis was conducted to compare pre-law (2016) with post-law (2019) crash fatalities across four BAC levels (≥.01, ≥.05, ≥.08, and ≥.15g/dL) between Utah and contiguous states for 21-24y/o drivers involved in alcohol-impaired driving fatal crashes. We also present 11-year trends (2013-23) in alcohol-related crash fatalities per 100 million vehicle miles traveled (VMT) for 21-24y/o drivers.

RESULTS: Of the 820 21-24y/o drivers involved in fatal crashes in Utah and six contiguous states, 371 (45.2%) were alcohol involved. Across 2013-2023, Utah consistently showed lower alcohol-related crash fatality per 100 million VMT across BAC thresholds compared to contiguous states. Following implementation of the.05 BAC law, Utah experienced notable post-policy declines over the 2016-2019 period, particularly among highly impaired drivers. DID models showed statistically significant reductions in crash fatalities for drivers with BAC ≥ .15 in Utah compared to contiguous states (p < .001), while effects at lower BAC levels were directionally protective but not statistically significant.

CONCLUSIONS: Utah’s.05 BAC law was associated with a significant reduction in the most severe alcohol-impaired crashes among young adult drivers, supporting lower BAC limits as an effective population-level injury prevention strategy for this known vulnerable population.

PMID:42546367 | DOI:10.1016/j.drugalcdep.2026.113282

Acta Psychol (Amst). 2026 Aug 3;269:107570. doi: 10.1016/j.actpsy.2026.107570. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to investigate the relationship between university students’ passive use of short-video media and their intuitive eating behaviors.

METHODS: A cross-sectional survey included 1084 university students in Wuhan, Hubei Province, China. Data were collected using general demographic data, the Surveillance Use Scale (SUS), the Intuitive Eating Scale-2 (IES-2), the Consideration of Future Consequence-food (CFC), and the Social Appearance Anxiety Scale (SAAS). A theory-informed serial mediation model and an exploratory eight-node psychological network were estimated.

RESULTS: Higher SUS scores were associated with lower IES-2 scores (total effect = -0.335, 95% CI: -0.489, -0.180). Indirect associations through CFC and SAAS were statistically detectable, but the serial pathway was small. Body-food choice congruence and reliance on hunger and satiety cues had the highest expected influence, whereas future-oriented dietary consequences had the highest bridge expected influence.

CONCLUSION: Higher SUS scores were associated with lower intuitive eating, and the network analysis further highlighted future-oriented dietary cognition and intuitive-eating dimensions. Based on these relevant factors, it is necessary to enhance the attention of society, schools, and families to university students’ dietary health and take effective measures to promote their healthy development.

PMID:42546361 | DOI:10.1016/j.actpsy.2026.107570

Schizophr Res. 2026 Aug 3;297:76-88. doi: 10.1016/j.schres.2026.07.026. Online ahead of print.

ABSTRACT

BACKGROUND: Concerns about haematological toxicity and absolute neutrophil count (ANC) monitoring may limit clozapine use, particularly in multi-ethnic populations where benign ethnic neutropenia (BEN) and lower baseline ANC are common. We characterised baseline ANC distribution, nationality-derived BEN-risk, post-initiation ANC outcomes, and haematological monitoring patterns in a multi-ethnic United Arab Emirates clozapine cohort.

METHODS: We conducted a retrospective cohort study at a tertiary psychiatric hospital in the United Arab Emirates. Adults with documented clozapine administration and at least one post-initiation ANC between 1 January 2018 and 31 July 2024 were included. Nationality-derived BEN-risk, baseline ANC, post-initiation ANC outcomes within a five-band hierarchy, monitoring intensity, and pre-specified sensitivity and exploratory analyses were examined.

RESULTS: Among 239 patients, 179 formed the final study cohort, contributing 284.7 on-clozapine person-years. Overall, 158 patients (88.3%) had no post-initiation ANC <2.0 × 10⁹/L, 16 (8.9%) entered the 1.5-2.0 × 10⁹/L low-ANC monitoring range, 2 (1.1%) reached conventional-threshold neutropenia, 3 (1.7%) reached severe neutropenia, and none reached agranulocytosis range. Five patients (2.8%) met the clinically meaningful ANC <1.5 × 10⁹/L threshold; all were BEN-risk, all had concomitant valproate exposure, and four had concomitant lithium exposure. Baseline ANC was lower in BEN-risk patients and statistically accounted for much of the BEN-risk-to-outcome association in an exploratory analysis.

CONCLUSIONS: Low ANC during clozapine treatment was uncommon and strongly shaped by baseline ANC and BEN-risk context. Baseline ANC-informed and BEN-aware interpretation may reduce unnecessary treatment interruption while preserving haematological safety. BEN-risk was inferred from nationality, not confirmed genetically; all five low-ANC cases received concomitant valproate; associations are observational.

PMID:42546354 | DOI:10.1016/j.schres.2026.07.026

Fam Med. 2026 Aug 3. doi: 10.22454/FamMed.2026.866657. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Competency in clinical documentation is a core entrustable professional activity expected of graduating medical students, and multiple national organizations have established expectations for documentation training and assessment. However, limited guidance exists on how these competencies are operationalized and assessed in clinical settings, and little is known about current educational practices. This study aimed to characterize how family medicine clerkships teach and assess outpatient documentation competency.

METHODS: We conducted a cross-sectional analysis using five documentation-related items embedded in the 2025 Council of Academic Family Medicine Educational Research Alliance clerkship directors survey. The survey was distributed to 174 US and Canadian family medicine clerkship directors. Descriptive statistics summarized the responses.

RESULTS: The response rate was 57.4% (100/174). Most directors (78.7%) rated assessing documentation competency as important or very important. At clerkship entry, 60.2% of students required intermittent prompting, while 32.3% needed repeated direction. Teaching methods varied: 33.3% reported no formal instruction, and only 19.4% used a common rubric. Informal assessment predominated (56.4%), and 8.5% reported no formal process. Regarding accuracy and integrity, 37.6% had no formal evaluation, while 25.8% used direct observation and 22.6% employed standardized patients or simulations.

CONCLUSIONS: Teaching and assessment of outpatient documentation competency in family medicine clerkships are highly variable, with many programs lacking structured approaches. These findings underscore the need for standardized guidelines and curricular integration to ensure that all students achieve competency prior to residency.

PMID:42546339 | DOI:10.22454/FamMed.2026.866657

Fam Med. 2026 Jul 15. doi: 10.22454/FamMed.2026.238874. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: We developed the Mayo Outpatient Precepting Evaluation Tool (MOPET) to assess and improve clinical teaching for family medicine residents. Given the scheduling challenges of peer evaluation, we sought to improve the MOPET’s usefulness by evaluating the reliability of self- and resident-reported teaching behaviors during clinical precepting compared to peer observation.

METHODS: Forty-eight half-day sessions in a family medicine residency clinic were assessed with parallel observer, preceptor, and resident MOPET forms. Interrater reliability was calculated using the κ (kappa) statistic.

RESULTS: Residents reported that preceptors used 14 of 20 teaching behaviors more often than observers. Observers and preceptors significantly agreed on the use of five teaching behaviors, while residents agreed with observers on two teaching behaviors.

CONCLUSIONS: Although self-assessment and resident-based feedback of preceptor teaching behavior may improve practicality, they are less reliable compared to direct peer observation with the validated MOPET.

PMID:42546324 | DOI:10.22454/FamMed.2026.238874

Am J Dermatopathol. 2026 Aug 3. doi: 10.1097/DAD.0000000000003404. Online ahead of print.

ABSTRACT

Mycosis fungoides (MF) is a cutaneous T-cell lymphoma that typically progresses slowly and has a favorable initial prognosis; however, the clinical course worsens in advanced stages. The aim of this study was to investigate the levels of programmed death-1 (PD-1), PD-L1, and PD-L2 immunoexpression in the biopsies of patients with MF. Paraffin blocks from biopsies of 82 patients diagnosed with MF between 2019 and 2025 were selected for this study. Early-phase (initial) and later-phase lesion groups, as well as CD4-positive and CD8-positive disease groups were formed based on histological findings. Immunohistochemical staining was performed for PD-1, PD-L1, and PD-L2. Positivity scores were generated for tumor cells, cells in the tumor microenvironment, and combined positivity scores. Immune scores were statistically compared across the lesion phase, CD4‑CD8 positivity status, age, and sex. Of the patients, 56 (68%) had later-phase lesions, 26 (32%) had early-phase lesions, 64 (78%) were CD4-positive, and 18 (22%) were CD8-positive. PD-1, PD-L1, and PD-L2 expression levels are higher in later-phase lesions than in early-phase lesions. The effect size was found to be small to moderate. CD4 or CD8 positivity, age, and sex did not affect PD-1, PD-L1, or PD-L2 levels. Immune checkpoint inhibitors could be beneficial in the management of MF, a disease that is difficult to treat in the advanced stages. Studies with larger patient series, in which evaluation can be performed alongside clinical staging, are needed.

PMID:42546315 | DOI:10.1097/DAD.0000000000003404

Plant Biol (Stuttg). 2026 Aug 3. doi: 10.1111/plb.70272. Online ahead of print.

ABSTRACT

Sugarcane (Saccharum spp.) is an important crop for food and energy security. Identifying SNPs and genes associated with sugarcane yield and related traits is crucial for developing high – yielding sugarcane cultivars through molecular breeding. Here, we measured nine phenotypic traits across 160 sugarcane genotypes and employed multiple statistical models (namely MLM, CMLM, MLMM, FarmCPU and SUPER) in GWAS to identify stable and pleiotropic loci. A total of 200 SNPs corresponding to 137 QTLs were detected to be significantly associated with nine traits using multiple statistical models, among which 18 QTLs were consistently identified by two or more models. Notably, the SNP S9A_47793177 on chromosome 9A showed the strongest association with phenotypic variation in aboveground biomass, with a phenotypic explanation rate of 70.54%. Additionally, several QTLs significantly associated with tillering – related traits were identified, suggesting that these QTLs may play crucial roles in the regulation of tillering. The QTLs and SNPs identified in this study provide a significant foundation for molecular marker – assisted breeding in sugarcane. This advancement can significantly enhance the efficiency of genetic improvement for sugarcane yield and tillering – related traits.

PMID:42546290 | DOI:10.1111/plb.70272

Liver Transpl. 2026 Jul 30. doi: 10.1097/LVT.0000000000000972. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty adversely affects post-transplant outcomes in chronic liver disease (CLD). This study evaluated the feasibility and the impact of preoperative supervised aerobic and resistance exercises (SARE) on frailty and outcomes after living donor liver transplantation (LDLT).

METHODS: This single-centre randomized controlled trial assigned the LDLT recipients to standard medical therapy (SMT) or SARE+SMT for 4 weeks pre-LDLT. Liver Frailty Index (LFI), Short Physical Performance Battery (SPPB), pulmonary function tests (PFTs) and postoperative outcomes were compared.

RESULTS: Sixty patients, [54 (90%) males, 26 (43.33%) alcoholic liver disease, 18 (30%) NASH, median MELDNa of 22 (19-27) and CTP A 5 (8.33%), B 22 (36.67%), C 33 (55%) were randomised (30/group)]. Baseline parameters, LFI and SPPB were comparable. At enrolment, 46(76.67%) were pre-frail, 7(11.67%) frail and 53(88.33%) were sarcopenic. Seven(11.66%) patients died during workup, four lost to follow-up and 49 underwent LDLT. In SARE arm, 40% patients attended ≥5 exercise sessions. No adverse events occurred; recurrent admissions were hinderance to study adherence. Adjusted analysis showed similar LFI (p=0.92), SPPB (p=0.71) and PFT between groups. A borderline improvement in NIV discontinuation (p=0.05) and earlier chair and bipedal ambulation (p=0.10 and p=0.09, respectively) was observed with SARE. Significant correlations were observed for POD30 LFI [MV duration- r=0.56 (p=0.00), NIV duration- r=0.509 (p=0.00), hospital stay- r=0.547 (p=0.00) and ICU stay- r=0.563 (p=0.00)], with similar statistically significant correlations for POD14 and POD30 LFI, SPPB and PFTs.

CONCLUSIONS: Preoperative SARE is safe and feasible in high MELD/ Child patients. LFI, SPPB, PFT, and postoperative outcomes were comparable between groups. SARE showed borderline improvement in ambulation and NIV discontinuation. Better LFI, SPPB, PFTs predicted improved clinical outcomes.

PMID:42546288 | DOI:10.1097/LVT.0000000000000972

J Chem Phys. 2026 Aug 7;165(5):050901. doi: 10.1063/5.0341335.

ABSTRACT

Single-molecule surface-enhanced Raman scattering (SM-SERS) should no longer be judged mainly by whether it can detect Raman signals from individual molecules but by what conclusions those signals can support under heterogeneous local conditions. In the single-molecule regime, the recorded spectrum is the product of a coupled molecule-interface-nanocavity-excitation-detection system, shaped by local geometry, molecule-metal coupling, cavity evolution, and readout conditions. The central challenge, therefore, shifts from achieving extreme enhancement to defining measurement conditions well enough for reliable interpretation. Here, we propose different evidential standards for four classes of SM-SERS claims-occupancy, assignment, local state, and mechanism-and argue that multimodal and correlative validation should increase with the strength of the claim. We assess how major platform classes reduce different sources of uncertainty and identify the field’s most tractable priorities: transparent reporting of observables, assumptions, and data-processing pipelines; quantitative statistics and reproducibility metrics for the events on which conclusions rest; and hypothesis-driven controls matched to the claim being made. SM-SERS will become a trustworthy nanospectroscopic tool only when each claim is supported by evidence strong enough to address the uncertainties of the coupled local system that produced the spectrum.

PMID:42546279 | DOI:10.1063/5.0341335

J Pediatr Orthop B. 2026 Aug 3. doi: 10.1097/BPB.0000000000001392. Online ahead of print.

ABSTRACT

This study evaluates the clinical, radiographic, and caregiver-reported outcomes of two palliative hip surgery (PHS) techniques – Egermann resection and Girdlestone resection – in nonambulatory children with cerebral palsy. A retrospective cohort of 30 Gross Motor Function Classification System (GMFCS) V children (41 hips) who underwent PHS between 2014 and 2025 at two tertiary referral centers was reviewed. Proximal femoral migration (PFM) was assessed on anteroposterior pelvic radiographs obtained immediately after surgery, at 6-12 months, and at final follow-up. Clinical outcomes were evaluated using the caregiver-reported Cerebral Palsy Quality of Life Questionnaire for Children (CP QOL-Child), and pain using a visual analog scale. Postoperative complications were recorded and classified according to the Clavien-Dindo-Sink (CDS) system. Both surgical techniques were associated with satisfactory pain relief and caregiver-reported quality of life. At final follow-up, PFM did not reach a statistically significant difference between the two groups (3 ± 20 mm vs 14 ± 18 mm; P > 0.05). Technique 2 was associated with fewer painful heterotopic ossifications requiring surgical revision. The overall complication rate was 32% of hips (13/41), with CDS III complications requiring reintervention in 12% of hips (5/41). Caregiver-reported CP QOL-Child scores were comparable between groups. PHS provides effective pain relief and satisfactory caregiver-reported quality of life in GMFCS V children. Both techniques represent viable palliative options, with distinct profiles of PFM and soft tissue-related complications. Surgical decision-making should be individualized according to patient anatomy and anticipated functional needs.

PMID:42546262 | DOI:10.1097/BPB.0000000000001392