Nevin Manimala

Neurourol Urodyn. 2026 Feb 9. doi: 10.1002/nau.70231. Online ahead of print.

ABSTRACT

OBJECTIVES: Stress urinary incontinence (SUI) has been linked to excessive urethral mobility, yet clinical evaluation has been largely limited to assessing maximal excursion rather than capturing the full dynamics of visible urethral movement. In this study, we hypothesize that an automated, ultrasound-based method can objectively differentiate urethral mobility patterns between women with SUI and continent controls.

METHODS: We used a previously validated optical flow-based algorithm to automatically track urethral motion from transperineal ultrasound images during cough, Valsalva maneuver, and pelvic muscle contraction (PMC) in 11 women with SUI and 10 continent controls. Urethral motion was assessed by defining three regions of interest along the urethra (proximal, mid, and distal). Segmental urethral kinematics were computed and statistically compared between groups.

RESULTS: Substantial variability and overlap between groups were observed, with coefficient of variation ranging 25%-90%. On average, women with SUI demonstrated significantly larger urethral displacement compared to controls, particularly at the proximal segment during Valsalva (10.6 ± 1.2 mm vs. 6.0 ± 0.6 mm, p < 0.01), with pronounced inferior-posterior motion. Additionally, displacement between the upper and lower urethra was significantly larger in the SUI group (0.47 ± 0.10 mm/mm vs. 0.13 ± 0.03 mm/mm, p < 0.05), indicating localized hypermobility particularly near the proximal urethra. Maneuver-specific differences were also noted within the SUI group, with Valsalva producing significantly larger and less uniform urethral movements compared to cough (10.6 ± 1.2 mm vs. 6.6 ± 0.5 mm, p < 0.05).

CONCLUSION: Our results demonstrate that the automated method is capable of capturing urethral mobility characteristics associated with SUI. Significant inter-individual variability in both continent and SUI groups indicates that urethral kinematics are heterogeneous. The detailed kinematic data have the potential to identify distinct sub-types of urethral mobility, facilitating systematic comparisons with underlying structural and neuromuscular defects. This approach can move clinical evaluation from simple group comparisons toward personalized SUI diagnosis and targeted treatment selection. Future studies with larger sample sizes and inclusion of additional pelvic floor conditions will be needed to validate these findings and advance their translation into clinical practice.

PMID:41657287 | DOI:10.1002/nau.70231

Microsurgery. 2026 Feb;46(2):e70190. doi: 10.1002/micr.70190.

ABSTRACT

BACKGROUND: Dangling protocols are widely used in the postoperative management of lower extremity free flaps to promote microvascular adaptation. To optimize outcomes, surgeons use dangling protocols, gradually increasing limb dependency, to enhance venous adaptation. However, wide variability exists in their design, and the impact of dangling duration and frequency on complication rates remains unclear.

METHODS: A systematic meta-analysis was performed to evaluate pooled complication rates associated with dangling protocols and to assess whether protocol duration (minutes per session) or frequency (number of sessions) was associated with adverse outcomes. Following PRISMA 2020 guidelines, we searched Medline, Embase, Web of Science, and Cochrane for relevant studies published through 2024. Then, a random-effects model was used to estimate pooled rates of partial flap loss, total flap loss, venous congestion, arterial compromise, hematoma, infection, wound dehiscence, return to the operating room, and donor site complications. Meta-regression was performed to examine associations with dangling protocol characteristics.

RESULTS: Across pooled studies, overall complication rates were low, including total flap loss (0.30%), arterial compromise (0.30%), and venous congestion (0.73%). No statistically significant associations were found between dangling duration and any complication type. While increased frequency of dangling was significantly associated with higher return-to-OR rates in the full model (slope = 0.0224; p = 0.0002), this relationship was entirely driven by a single study reporting 24 sessions/day. When this outlier was excluded, the association became non-significant.

CONCLUSION: Dangling protocols appear safe and well tolerated, with low rates of major complications. While the duration of dangling sessions does not affect complication risk, higher frequency may increase the likelihood of surgical re-intervention. These findings support the need for standardized, evidence-based protocols and further research into the physiologic and clinical thresholds guiding postoperative flap care. A meta-analysis of lower extremity free flap studies demonstrated low complication rates across common endpoints including total flap loss (0.30%), arterial compromise (0.30%), and venous congestion (0.73%).

PMID:41657266 | DOI:10.1002/micr.70190

J Holist Nurs. 2026 Mar;44(1):37-48. doi: 10.1177/08980101241302509. Epub 2024 Dec 29.

ABSTRACT

The aim is to determine nurses’ professional values and individualized care experiences and the affecting factors. This cross-sectional study was conducted with 470 nurses in a city hospital between September and November 2021. Information Form, Nurses Professional Values Scale (NPVS), and The Individualized Care Scale-Nurse Version (ICS-Nurse) were used for data collection. The average score on the NPVS was 118.16 ± 21.9. The total ICS-Nurse score of the participants was 3.96 ± 0.7. A positive, weak and statistically significant relationship was found between the NPVS and ICS-Nurse in terms of clinical status, personal life, and decision-making subdimension scores (p < .05). The professional values of nurses were found to be at a moderate level which directly affect their approaches to individualized care. Having high levels of professional values can help nurses provide better individualized care to their patients.

PMID:41657265 | DOI:10.1177/08980101241302509

Am J Trop Med Hyg. 2025 Nov 20;114(1):47-54. doi: 10.4269/ajtmh.25-0534. Print 2026 Jan 7.

ABSTRACT

The selection of authors for editorials reflects perceptions of expertise and influence. Our objectives were to determine author geographic and gender distribution, determine temporal trends in editorial authorship, and identify factors associated with the inclusion of authors affiliated with low- and middle-income countries (LMICs) in editorials on research conducted in LMICs. We conducted a cross-sectional study of editorials on research in LMICs published in 15 global health, pediatrics, and general medicine journals from 2014 to 2024. To assess temporal changes in authorship, we plotted the proportion of editorial authors affiliated with LMICs and those with female names by year. We used multivariable logistic regression to identify factors associated with the inclusion of one or more LMIC-affiliated authors. There were 107,629 publications and 1,350 editorials on research in LMICs with 2,401 authors. Authors of editorials were most often affiliated with institutions in North America (38.1%) and high-income countries (71.6%). The proportion of authors of editorials affiliated with institutions in high-income countries decreased from 84.9% in 2014 to 65.3% in 2024. Authors of editorials more commonly had male names than female (60.1% versus 38.7%, P <0.001). The proportion of editorial authors with female names increased from 32.1% in 2014 to 48.2% in 2024. Editorials accompanying publications reporting studies with larger sample sizes (aOR = 1.52, 95% CI: 1.03-2.26) and research conducted in sub-Saharan Africa (aOR = 2.84, 95% CI: 1.74-4.68) were more likely to include LMIC-affiliated authors. Additional efforts are needed to include authors affiliated with LMICs in editorials on research conducted in LMICs.

PMID:41657262 | DOI:10.4269/ajtmh.25-0534

Nurs Crit Care. 2026 Mar;31(2):e70361. doi: 10.1111/nicc.70361.

ABSTRACT

BACKGROUND: Leadership styles play a crucial role in shaping nurses’ psychological well-being and communication behaviours, especially in high-stress settings like critical care. Paternalistic leadership-characterised by benevolence, moral integrity and authority-has gained recognition for its impact on healthcare outcomes. However, its influence on organisational dissent, particularly through the lens of psychological well-being, remains underexplored.

AIM: To Investigate the Mediating Role of Psychological Well-Being in the Relationship Between Paternalistic Leadership and Organisational Dissent Among Nurses in Critical Care Settings.

STUDY DESIGN: A cross-sectional descriptive study was conducted. A convenience sample from 23 critical care units in a large educational government hospital participated. Data were collected using the Paternalistic Leadership Scale, Psychological Well-Being Scale and Organisational Dissent Scale. Statistical analyses included Pearson correlation, regression and path analysis.

RESULTS: Among 460 nurses, paternalistic leadership was positively correlated with psychological well-being (r = 0.263, p < 0.001) and negatively correlated with organisational dissent (r = -0.278, p < 0.001). Psychological well-being also negatively correlated with dissent (r = -0.258, p = 0.001). Regression and path analysis confirmed that psychological well-being partially mediated the relationship between paternalistic leadership and organisational dissent. The mediation model showed statistically significant direct and indirect effects.

CONCLUSIONS: Paternalistic Leadership Enhances Nurses’ Psychological Well-Being and Reduces Organisational Dissent. Psychological Well-Being Acts as a Partial Mediator, Emphasising Its Importance in Translating Leadership Support Into Reduced Dissent Behaviours.

RELEVANCE TO CLINICAL PRACTICE: Fostering paternalistic leadership and supporting nurses’ psychological well-being are critical to maintaining constructive communication and reducing harmful dissent. Healthcare institutions should implement leadership development and mental health support initiatives to improve workforce morale and patient care.

PMID:41657259 | DOI:10.1111/nicc.70361

Nucleic Acids Res. 2026 Feb 5;54(4):gkag072. doi: 10.1093/nar/gkag072.

ABSTRACT

Gene regulatory mechanisms control cell differentiation and homeostasis but are often undetectable, particularly at the single-cell level. We introduce bayesReact, which quantifies regulatory activities from bulk or single-cell omics data. It is based on an unsupervised generative model, exploiting the fact that each regulator typically targets many genes sharing a sequence motif. Using mRNA expression data, we illustrate and evaluate bayesReact on microRNAs (miRNAs). It outperforms existing methods on sparse bulk data and improves activity inference on single-cell data. Inferred miRNA activities correlate with miRNA expression across pan-cancer TCGA and healthy GTEx tissue samples. The activities capture cancer-type-specific miRNA patterns, e.g., for miR-122-5p and miR-124-3p, which also correlate more strongly with their target genes than their measured expression. This includes a strong negative correlation between miR-124-3p and the anti-neuronal REST transcription factor in nervous system cancers. Analyzing single-cell data, bayesReact detects prominent miRNAs during murine stem cell differentiation, including miR-298-5p, miR-92-2-5p, and the Sfmbt2 cluster (miR-297-669). Furthermore, spatio-temporal inference shows increasing miR-124-3p activity in differentiating neurons during embryonic spinal cord development in mice. bayesReact enables large-scale hypothesis-generating screens for novel regulatory factors and the discovery of condition-specific activities. It is implemented as a user-friendly R package (https://github.com/JakobSkouPedersenLab/bayesReact).

PMID:41657247 | DOI:10.1093/nar/gkag072

Anaesthesia. 2026 Feb 9. doi: 10.1111/anae.70142. Online ahead of print.

NO ABSTRACT

PMID:41657241 | DOI:10.1111/anae.70142

Circ Genom Precis Med. 2026 Feb 9:e005159. doi: 10.1161/CIRCGEN.125.005159. Online ahead of print.

ABSTRACT

BACKGROUND: Circulating proteins represent robust drug targets with therapeutic potential. Many discoveries have focused on European-ancestry populations, disregarding minuscule yet substantial proteomic differences that may contribute to disease and alter drug generalizability in other ancestry groups.

METHODS: Using 2-sample Mendelian randomization and colocalization, we analyzed the effects of 1562 circulating proteins on 145 cardiometabolic-centric outcomes to identify robust protein-phenotype associations in African-ancestry populations and reveal African-ancestry associations with heterogeneous effects. We further replicated these findings using the proteomic data available from the UK Biobank Pharma Proteomics Project and tested the effect of protein quantity in association with select phenotypes. Population branch statistics were also constructed to examine whether protein-genetic instruments under natural selection could lead to significant protein-outcome associations specific to the African ancestry.

RESULTS: We identified 115 robust protein target-outcome associations in African-ancestry populations. Among these, 51 demonstrated heterogeneous effects between African- and European-ancestry populations. We further replicated 4 cross-platform African-ancestry associations in the UK Biobank Pharma Proteomics Project and also revealed 4 significant, direct associations between protein levels and phenotypes. Ultimately, based on our prioritization criteria, we found that CD36 (glycoprotein IIIb), APOC1 (apolipoprotein C1), GSTA1 (glutathione S-transferase alpha 1), and FOLH1 (folate hydrolase 1) were shown to influence lipids and heart diseases, and were uniquely represented in African-ancestry populations. In addition, using population branch statistics, we showed that 47.5% of the 115 significant protein-outcome associations were possibly driven by cis-acting protein quantitative trait loci under natural selection.

CONCLUSIONS: Multiple lines of evidence were used to interrogate proteomic determinants of cardiometabolic diseases and traits in African-ancestry populations. We highlighted actionable circulating protein targets that could represent potential drug targets for cardiovascular diseases specific to populations with African ancestry.

PMID:41657222 | DOI:10.1161/CIRCGEN.125.005159

Huan Jing Ke Xue. 2026 Feb 8;47(2):1305-1315. doi: 10.13227/j.hjkx.202412064.

ABSTRACT

The soil of villages around a historical smelting area in Jiangxi Province was taken as the research object， and the contents of heavy metals As， Sb， Cu， Pb， Zn， Cr， Ni， and Cd were collected and determined in 40 soil samples； the pollution degree of heavy metals was evaluated using statistical methods； and the sources of heavy metals in the soil were determined using the positive matrix factorization （PMF）， coupled with the Monte Carlo simulation health risk assessment （HRA） model to quantitatively assess the health risks of different sources to human beings. It was also coupled with the HRA model of Monte Carlo simulation to quantitatively assess the health risks of different sources to human beings and determine the priority control factors. The results showed that the average contents of heavy metals were higher than the background values， except for Cu， Zn， and Pb. The ground accumulation index （I_geo） of As， Sb， Ni， and Cd reached the medium pollution level， while 60% of the samples were in the light pollution level in the pollution load index （PLI）. The PMF source analysis study identified three soil heavy metal pollution sources， including natural sources， smelting activities， and industrial activities， contributing 50.27%， 30.21%， and 19.52%， respectively. The Monte Carlo probabilistic HRA showed that the carcinogenic risk for all populations was in the acceptable range （1E-06≤TCR&lt;1E-04）； the non-carcinogenic risk for adults was negligible （HI&lt;1）， and the non-carcinogenic risk for children was at a high level （HI&gt;1）. The proportion of children with non-carcinogenic risk exceeding the control value was 48.35%. Smelting activity was the largest contributor to carcinogenic risk （69.22%） and non-carcinogenic risk （55.77%）， and smelting activity was identified as a priority source of contamination for human health risk control， with As being the main target pollutant. The results of the study can provide a scientific basis for governmental departments to formulate soil pollution control strategies.

PMID:41657184 | DOI:10.13227/j.hjkx.202412064

Huan Jing Ke Xue. 2026 Feb 8;47(2):1283-1292. doi: 10.13227/j.hjkx.202412162.

ABSTRACT

In order to study the current situation and sources of heavy metal pollution in Zhangbei County， Bashang Grassland， 69 surface soil samples， 16 ancient weathering crust soil samples， and 35 rock samples were collected to test and analyze the contents of eight heavy metals such as Cd， Pb， Hg， Zn， Cu， As， Cr， and Ni. The enrichment factor method and potential ecological risk index method were used to study the characteristics of heavy metal enrichment and ecological risk assessment. Multivariate statistical analysis and the positive matrix factorization （PMF） model were combined to analyze the sources of heavy metals in the soil. The results showed that the average content of eight heavy metal elements in the soil of the study area was lower than the screening value for soil pollution risk in agricultural land and the average content of surface soil in Hebei Province. Only Cd showed slight enrichment in heavy metals， while the rest of the heavy metal elements were not enriched overall. The potential ecological risks of a single indicator were ranked from high to low as follows： Cd&gt;Hg&gt;Pb&gt;As&gt;Ni&gt;Cu&gt;Zn&gt;Cr. The comprehensive index of potential ecological risks showed that the study area was mainly mild， with only two samples reaching a moderate risk level， and the main contributing factors were Cd and Hg. The results of multivariate statistical analysis and PMF model source analysis indicated that heavy metals in the soil of the study area were mainly controlled by the weathering of the parent rock. The high-value areas of Cr， Ni， Cu， Zn， and Cd were mainly controlled by the basalt parent rock， while the high-value areas of Pb and As were mainly controlled by parent rocks such as detrital rocks and granite. Hg was a composite pollution source of multiple factors such as coal burning， atmospheric dust deposition， and parent rock weathering. As， Cr， Pb， and Zn were also affected by industrial activities， agricultural activities， transportation， and household waste.

PMID:41657182 | DOI:10.13227/j.hjkx.202412162