Nevin Manimala

J Holist Nurs. 2026 Mar 27:8980101261430888. doi: 10.1177/08980101261430888. Online ahead of print.

ABSTRACT

Aim: This study aims to examine the use and attitudes of complementary and alternative medicine (CAM) in patients undergoing cardiac surgery from a holistic nursing perspective. Methods: This descriptive study was conducted with 156 patients undergoing cardiac surgery in a research hospital. Data were collected using a questionnaire and the “Attitudes Toward Holistic Complementary and Alternative Medicine Scale.” Analysis involved descriptive statistics and bivariate correlation. Results: Findings indicate that 16.7% of participants considered conventional medical treatment inadequate. Reasons for CAM use included strengthening the immune system (10.3%) and seeking physical/psychological relaxation (15.4%). Crucially, 71.8% of CAM users failed to disclose this information to healthcare personnel. The mean attitude score was 31.38 ± 4.40, revealing significant positive correlations between CAM use, education level, and the perception of benefit. Conclusion: Consistent inquiry into patients’ use of supportive methods is essential for effective postoperative management. This planning must prioritize the integrity of the patient’s body, mind, and spirit, ensuring that care is fully aligned with a holistic nursing approach.

PMID:41891180 | DOI:10.1177/08980101261430888

Autism Res. 2026 Mar 27:e70238. doi: 10.1002/aur.70238. Online ahead of print.

ABSTRACT

Healthy lifestyle behaviors, including physical activity, screen time, sleep, and diet quality, are important determinants of mental health, yet little is known about how these behaviors cluster among children with neurodevelopmental disorders. This study identified lifestyle profiles in children with autism and ADHD and examined associations with internalizing, externalizing, and irritability symptoms. Parents of children with a diagnosis of autism and ADHD (n = 523, 7-12 years, 67% male) reported on lifestyle behaviors and mental health outcomes. Latent profile analysis supported a four-profile solution that balanced statistical fit, parsimony, and theoretical interpretability. Profile 1 (19%) was characterized by very high levels of physical activity, moderate sedentary screen time, relatively high sleep, and above average diet quality. Profile 2 (50%) represented a balanced lifestyle, with moderate activity and sedentary screen time, adequate sleep, and the highest diet quality. Profile 3 (20%) showed low activity, elevated sedentary screen time, adequate sleep, and poor diet quality, while Profile 4 (11%) was defined by extremely high sedentary screen time, low activity, adequate sleep, and poor diet. Children in less healthy profiles characterized by high screen time and poor diet quality reported significantly higher internalizing symptoms compared to the highly active group. However, externalizing symptoms were highest in the highly active profile, and irritability was lowest in the balanced profile relative to both high activity and high screen time groups. Findings suggest that while very high physical activity may protect against internalizing symptoms, a balanced lifestyle combining moderate activity, limited screen use, adequate sleep, and good diet quality may best mental health in children with autism and ADHD.

PMID:41891157 | DOI:10.1002/aur.70238

J Biophotonics. 2026 Mar;19(3):e70262. doi: 10.1002/jbio.70262.

ABSTRACT

Photodynamic therapy (PDT) for skin lesions requires optimized photosensitizer accumulation. Since protoporphyrin IX (PpIX) synthesis is linked to mitochondrial activity, photobiomodulation (PBM) may modulate this process. This exploratory study examined the effects of PBM at 780 or 808 nm on MAL-induced PpIX in normal human skin. Eleven volunteers received paired-arm treatments (5, 10, or 15 J/cm²). Following 30 min of MAL, PBM was applied, with total incubation lasting 210 min. PpIX was assessed via spectroscopy and widefield imaging. Although mean PBM/no-PBM ratios were nominally above 1, no statistically significant differences were found among fluences or against unity, primarily due to high interindividual variability (CV up to 35%). These findings suggest that while PBM shows a trend toward modulating photosensitizer accumulation, the response is highly heterogeneous. This study provides a rationale for further investigation into personalized PBM-assisted PDT protocols to manage biological variability and refine clinical outcomes.

PMID:41891138 | DOI:10.1002/jbio.70262

J Back Musculoskelet Rehabil. 2026 Mar 27:10538127261435672. doi: 10.1177/10538127261435672. Online ahead of print.

ABSTRACT

BackgroundAdolescent idiopathic scoliosis (AIS) is a common spinal deformity during growth, and Physiotherapeutic Scoliosis-Specific Exercises (PSSE) are widely used interventions, while the effectiveness of PSSE-based combined interventions remains unclear.ObjectiveTo systematically evaluate the comparative effectiveness of PSSE-based combined interventions versus PSSE alone in adolescents with AIS.MethodsRandomized controlled trials (RCTs) on PSSE-based combined interventions for AIS, published between June 30, 2015, and June 30, 2025, were searched in PubMed, the Cochrane Library, Web of Science, and Embase. Data on author, intervention, treatment duration, and outcomes (Cobb angle, ATR, SRS-22) were extracted. Analyses were conducted with CMA 3.0.ResultsNine RCTs involving 348 participants were included. Both PSSE-based combined interventions and PSSE alone were associated with significant improvements in Cobb angle, ATR, and SRS-22 scores (all P < 0.001). Compared with PSSE alone, combined interventions demonstrated statistically significant additional improvements in Cobb angle (MD = -0.74, 95% CI: -1.46 to -0.02; I² = 0%), ATR (MD = -0.68, 95% CI: -1.20 to -0.15; I² = 0%), and SRS-22 scores (MD = 0.19, 95% CI: 0.11 to 0.28; I² = 0%). These between-group differences were modest in magnitude.ConclusionPSSE-based combined interventions were associated with greater, yet modest, additional improvements compared with PSSE alone in adolescents with AIS. These findings suggest incremental benefits beyond an already effective conservative strategy.

PMID:41891125 | DOI:10.1177/10538127261435672

Ann Neurosci. 2026 Mar 23:09727531261429764. doi: 10.1177/09727531261429764. Online ahead of print.

ABSTRACT

BACKGROUND: The fear of missing out (FoMO) is characterised by constant worry about missing out on rewarding experiences. However, the worry arising from FoMO affects both self-regulation and executive functioning.

PURPOSE: The main purpose of the study was to explore the relationship between FoMO and executive functioning, keeping self-regulation as the mediating variable.

METHODS: A cross-sectional correlational design was used. The sample size was 455 university students with an age range of 18-24 years. The Fear of Missing Out Scale, Short Self-Regulation Questionnaire and Executive Skills Questionnaire were used. Regression analysis was done using Statistical Package for the Social Sciences v26, and mediation analysis results were obtained through PROCESS Macro (Model 4).

RESULTS: Regression results pointed out that FoMO explained 18% of variance in executive functioning (β = -0.43, p < .001) and 16% of variance in self-regulation (β = -0.39, p < .001). Higher FoMO was related to poorer self-regulation and executive functions. Mediation analysis revealed that self-regulation partially mediated the FoMO-executive functioning relationship, with significant indirect effects (B = -0.66, SE = 0.07, 95% CI [-0.83, -0.52]) and direct effects (B = -0.83, SE = 0.13, 95% CI [-1.10, -0.56]).

CONCLUSION: FoMO negatively affects both self-regulation and executive functions, with self-regulation acting as a significant mediator through both direct and indirect pathways. These findings suggest the need for building self-regulatory skills to protect oneself from FoMO’s negative effects.

PMID:41891119 | PMC:PMC13013036 | DOI:10.1177/09727531261429764

Biomater Res. 2026 Mar 25;30:0301. doi: 10.34133/bmr.0301. eCollection 2026.

ABSTRACT

Early detection and nonintrusive assessment of inflammatory bowel disease (IBD) remain an unmet clinical challenge. Spectral computed tomography (CT) presents a potential modality for gastrointestinal (GI) imaging; however, clinical CT contrast agents are unable to achieve targeted detection of IBD in spectral CT imaging. In this study, we developed neodymium-hyaluronic acid nanoparticles (Nd-HA NPs) as novel contrast agents for spectral CT imaging of IBD. Nd-HA NPs were synthesized by conjugating HA units with lanthanide complex neodymium-diethylenetriamine-pentaacetic acid (Nd-DTPA). The physical properties, biotoxicity, and CT imaging ability of Nd-HA NPs were systematically evaluated in vitro. Subsequently, the applicability of Nd-HA NPs for GI tract imaging was assessed in both healthy and colitis mouse models. Nd-HA NPs exhibited excellent stability, biocompatibility, and potent x-ray attenuation property in vitro as novel spectral CT contrast agents. Attributed to HA’s high affinity for cluster of differentiation 44 receptor, which is abundantly expressed at inflammatory sites, Nd-HA NPs successfully achieved targeted spectral CT imaging of IBD, and showed greater accumulation in the lesions of colitis mice compared with the clinical contrast agent iohexol. More importantly, after oral administration of Nd-HA NPs, the CT values of GI tract in healthy mice, 2.5% DSS-induced mice (moderate colitis), and 5% DSS-induced mice (severe colitis) were 90.19, 140.99, and 264.07 HU, respectively, with statistically significant difference (P < 0.001). These results indicated that Nd-HA NPs had the potential to realize severity assessment of IBD in spectral CT imaging, which was further confirmed by inductively coupled plasma optical emission spectrometry analysis and histopathological evaluation. The study suggested that Nd-HA NPs could serve as effective spectral CT contrast agents, enabling noninvasive early detection and severity assessment of IBD.

PMID:41891115 | PMC:PMC13014110 | DOI:10.34133/bmr.0301

Subst Abuse Rehabil. 2026 Feb 5;17:570414. doi: 10.2147/SAR.S570414. eCollection 2026.

ABSTRACT

BACKGROUND: China’s drug landscape is rapidly evolving, yet existing research remains fragmented, lacking a comprehensive national perspective. This study analyzes current drug use patterns, trends, and regional differences in China, providing critical insights to guide effective anti-drug policies.

METHODS: We conducted a comprehensive multilevel analysis of secondary data of drug use data from the China Drug Situation Report (2005-2023) and 34 academic articles (1990-2021). Our analysis includes descriptive statistics, time series, regional differences, and population-specific trends.

RESULTS: This study identifies a declining trend in traditional drug use, while the use of new synthetic drugs and new psychoactive substances (NPS) is increasing. Strong negative correlations were found between law enforcement intensity and overall drug use (r: -0.89 to -0.92). Significant regional disparity in NPS use was identified, with prevalence substantially higher in southern China than in the north (p = 0.019). Traditional drugs are more prevalent in the northwest and central regions, while new drugs and NPS are more commonly found in the eastern coastal and central urban areas. The use of NPS is notably higher among adolescents in economically developed regions.

CONCLUSION: The analysis delineates a clear shift in China’s drug landscape from traditional drugs to NPS, with concentrations in southern, coastal, and adolescent demographics. These patterns suggest that effective policy responses should be regionally tailored and prioritize youth prevention in economically advanced areas. Future research is needed to verify these associations and explore underlying causal mechanisms.

PMID:41891108 | PMC:PMC13016123 | DOI:10.2147/SAR.S570414

Clin Ophthalmol. 2026 Mar 19;20:575268. doi: 10.2147/OPTH.S575268. eCollection 2026.

ABSTRACT

PURPOSE: To determine the short-term patterns of regression of neovascularization after panretinal photocoagulation (PRP) in eyes with proliferative diabetic retinopathy (PDR) without clinically significant macular edema.

METHODS: The study was a prospective, observational pilot study conducted at a tertiary care hospital in India from January 2023 to April 2024. The single eye (worst eye) of 30 patients with PDR without diabetic macular edema was selected using convenient sampling. This approach was chosen to avoid inter-eye correlation bias. The patients meeting the inclusion criteria underwent PRP laser using Green LASER (532nm), and visual acuity (VA), central macular thickness (CMT), and fundus photographs were analyzed at baseline, 1 month, and 3 months post-PRP.

RESULTS: The VA at baseline remained similar at 1-month and 3-month post-PRP. The CMT increased significantly at 1-month and 3 months but was within 300 microns, remaining below the threshold for clinically significant macular edema. No regression was seen at one month in most eyes. However, at 3 months, complete regression was seen in 10% of cases, incomplete regression in 47%. There was no difference in the regression rates based on the amount of neovascularization at baseline. NVD showed a higher odds ratio for non-regression; however, this did not reach statistical significance, and a 25-micron increment in spot size demonstrated a non-significant trend toward reduced likelihood of non-regression. Every 1gm% HbA1c increment was associated with a 2.7 times higher likelihood of CME.

CONCLUSION: In this pilot study, short-term regression of neovascularization following PRP was variable. Exploratory trends suggested possible differential regression between NVD and NVE.

PMID:41891101 | PMC:PMC13012863 | DOI:10.2147/OPTH.S575268

Clin Ophthalmol. 2026 Feb 4;20:545641. doi: 10.2147/OPTH.S545641. eCollection 2026.

ABSTRACT

BACKGROUND: Research on metformin, sulfonylureas, and open-angle glaucoma risk in type 2 diabetes mellitus (T2DM) has yielded inconsistent findings. This study examined associations between hypoglycemic treatments and glaucoma diagnosis rates.

METHODS: This retrospective cohort study analyzed electronic health records of newly diagnosed T2DM patients from the Merative™ Explorys^® Therapeutic Dataset (2010-2022), comparing three groups: metformin monotherapy, sulfonylureas plus metformin combination, and untreated controls. Propensity score matching balanced demographics, glycemic control, body mass index, blood pressure, lipid levels, and comorbidities. Cox proportional hazards models calculated adjusted hazard ratios for incident glaucoma.

RESULTS: After 1:1 propensity score matching, metformin monotherapy (N=100,387) showed a non-significant trend toward higher glaucoma diagnosis rates compared to matched controls (HR 1.106, 95% CI 1.014-1.207, p=0.023; adjusted HR 1.076, 95% CI 0.995-1.163, p=0.067). Patients receiving combination therapy with sulfonylureas and metformin (N=38,692) demonstrated statistically significantly higher glaucoma diagnosis rates relative to matched controls (HR 1.235, 95% CI 1.077-1.417, p=0.002; adjusted HR 1.194, 95% CI 1.075-1.326, p=0.001). Direct comparison between combination therapy and metformin monotherapy did not reach statistical significance (adjusted HR 1.084, 95% CI 0.973-1.207, p=0.144).

CONCLUSION: This observational study found associations between diabetes medications and increased glaucoma diagnosis rates but cannot establish causality. Multiple competing explanations exist: reverse causation (clinicians preferentially prescribing metformin to diabetic patients with emerging glaucoma based on prior protective literature), confounding by indication (sicker patients requiring medication having inherently higher glaucoma risk), and detection bias (differential surveillance patterns). The non-significant metformin monotherapy finding (p=0.067) aligns with recent meta-analyses showing no association. While the statistically significant combination therapy association warrants investigation, it should not be interpreted as definitive causation. Prospective studies controlling for disease severity, surveillance patterns, and treatment indication are needed to disentangle these explanations and inform clinical practice.

PMID:41891096 | PMC:PMC13016381 | DOI:10.2147/OPTH.S545641

Clin Ophthalmol. 2026 Feb 9;20:569805. doi: 10.2147/OPTH.S569805. eCollection 2026.

ABSTRACT

OBJECTIVE: To evaluate changes in blood selenium concentrations and associated clinical outcomes following selenium supplementation in patients with Graves’ orbitopathy (GO) with varied severity.

STUDY DESIGN: A retrospective study.

PATIENTS AND METHODS: We retrospectively reviewed the medical records of patients with GO who received selenium supplementation with a total daily dose of 210 µg for six months at a single tertiary care center between January 2019 and January 2021. Clinical parameters, including visual acuity, exophthalmos, eyelid aperture, Clinical Activity Score (CAS), GO severity, Graves’ Ophthalmopathy Quality of Life (GO-QoL) scores, and selenium concentrations were assessed at baseline and post-treatment. Subgroup analysis was performed for patients who received no concurrent GO treatment.

RESULTS: Forty-eight patients (52.1% female, mean age 46.33±11.47 years) were included, with disease severity classified as mild (22.9%), moderate-to-severe (70.8%), and sight-threatening (6.3%). The mean selenium concentrations increased from 90.46±16.40 µg/L to 113.67±19.64 µg/L (mean difference: 23.21±24.75 µg/L; 95% CI: 16.02-30.39, P<0.001). Of 37 patients who did not receive other GO treatments, CAS improved significantly in 13 (35.13%; P=0.02), and the prevalence of eyelid edema decreased from 22.2% to 5.6% (P=0.03). GO-QoL appearance subscale scores significantly improved (mean change: 8.16±23.14; 95% CI: 0.33-15.99; P=0.04), while the changes in visual function scores were not statistically significant.

CONCLUSION: Selenium supplementation was associated with a significant increase in selenium concentrations and clinically significant improvements in CAS, eyelid edema, and quality of life among patients with GO. These findings support the potential role of selenium therapy in GO management. However, larger randomized controlled trials are warranted to confirm these observations and guide dosage recommendations.

PMID:41891094 | PMC:PMC13016390 | DOI:10.2147/OPTH.S569805