Nevin Manimala

Medicine (Baltimore). 2026 May 1;105(18):e48582. doi: 10.1097/MD.0000000000048582.

ABSTRACT

This study aimed to comprehensively assess the prognostic value of routinely obtained blood-based systemic inflammatory indices in predicting all-cause mortality among individuals with chronic obstructive pulmonary disease (COPD). This retrospective cohort study analyzed data from the National Health and Nutrition Examination Survey (NHANES) cycles 2007-2010. A total of 1109 eligible adults with COPD were included, with 333 deaths recorded during the follow-up period. Eleven systemic inflammatory indices were derived from baseline hematological parameters. The associations between these indices and all-cause mortality were initially evaluated using multivariate Cox proportional hazards models. To manage high-dimensional data and identify complex patterns not captured by conventional statistical methods, machine learning (ML) algorithms were applied for feature selection, model development, and performance evaluation. Model discrimination and clinical utility were assessed using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis. Among the 1109 participants (mean age 57.9 ± 15.5 years, 52.2% male), non-survivors (n = 333) were significantly older and had a higher baseline burden of comorbidities. After full adjustment for covariates, several inflammatory indices showed statistically significant associations with all-cause mortality. The neutrophil percentage-to-albumin ratio (NPAR) and neutrophil-to-lymphocyte ratio exhibited the strongest associations, with HRs of 2.46 (95% CI: 1.64-3.69) and 2.14 (95% CI: 1.42-3.22), respectively, in the highest quartile (Q4) compared to the lowest (Q1). The neutrophil-to- high-density lipoprotein ratio also demonstrated a significant positive association (HR for Q4 vs Q1: 1.79, 95% CI: 1.18-2.70). In contrast, higher levels of the C-reactive protein-albumin-lymphocyte index index were associated with reduced risk, indicating a protective effect (HR for Q4 vs Q1: 0.49, 95% CI: 0.33-0.72). The ML-derived NPARTEST model, based on the NPAR index, achieved an AUC of 0.828 for predicting all-cause mortality, demonstrating good discriminative performance and clinical utility. Systemic inflammatory indices, particularly the NPAR and neutrophil-to- high-density lipoprotein ratio, are independently associated with all-cause mortality in patients with COPD, often exhibiting nonlinear relationships. The ML-based NPARTEST model demonstrates promising predictive performance. These findings underscore the potential of cost-effective, routinely measured blood-based biomarkers to enhance risk stratification in COPD management. External validation in diverse populations is warranted to confirm the generalizability of these results.

PMID:42065179 | DOI:10.1097/MD.0000000000048582

Medicine (Baltimore). 2026 May 1;105(18):e48381. doi: 10.1097/MD.0000000000048381.

ABSTRACT

To explore the risk factors and predictive value of Mycoplasma pneumoniae (MP) infection in children. A total of 2042 children with suspected Mycoplasma pneumoniae infection who were treated for the first time at Civil Aviation General Hospital from October 2023 to December 2023 were selected as the study subjects. Among them, 1637 cases were confirmed as Mycoplasma pneumonia-infected and were included in the pneumonia group, while the remaining 405 cases were non-Mycoplasma pneumonia-infected and were included in the non-Mycoplasma pneumonia group. The clinical data of the 2 groups of children (including gender, age, initial symptoms, laboratory indicators, etc) and the risk factors of MP infection in children were compared, and the receiver operating characteristic curve was analyzed. This study showed that the percentage of neutrophils in the non-MP infection group was significantly lower than that in the MP infection group, and the difference was statistically significant (P < .001). When comparing the percentages of lymphocyte percentage (LY) and hemoglobin in the 2 groups of children, the Mycoplasma pneumonia-infected group was lower than the non-Mycoplasma pneumonia-infected group, and the differences were both statistically significant (P < .05). Logistic regression analysis revealed that white blood cell and neutrophil-to-lymphocyte ratio (NLR) might be valuable markers for predicting MP infection. The Spearman correlation indicated that LY was collinear with the occurrence of MP infection, and Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis demonstrated that both LY and NLR might be valuable markers for predicting MP infection (P < .05). Receiver operating characteristic curve analysis revealed that the area under the curve of the NLR for diagnosing MP infection was 0.624, with a cutoff value of 1.36 (sensitivity of 0.798 and specificity of 0.558). In the diagnosis of MP infection, the consistency between the RNA method and the immunogold colloidal method was poor (Kappa = 0.108, P < .05). The consistency between the RNA method and the immunogold colloidal method in the diagnosis of MP infection is poor. Both the white blood cell and NLR are valuable markers for MP infection.

PMID:42065166 | DOI:10.1097/MD.0000000000048381

Medicine (Baltimore). 2026 May 1;105(18):e48424. doi: 10.1097/MD.0000000000048424.

ABSTRACT

BACKGROUND: Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and inflammation. Rebamipide 2% ophthalmic suspension, a mucin secretagogue, has been investigated as a potential treatment due to its unique mechanism targeting mucin deficiency and ocular surface repair.

METHODS: A systematic search of PubMed, Embase, and Cochrane Library was conducted for studies published between January 2013 and March 2025. Non-randomized and randomized controlled trials evaluating topical 2% rebamipide in patients with DED were included. Outcomes assessed included tear breakup time, Schirmer I test, fluorescein staining scores, ocular surface disease index, and adverse events. Data were synthesized using standard meta-analytic techniques and subgroup analyses.

RESULTS: Thirteen studies, including both randomized and non-randomized trials, were analyzed, comprising a total of 575 participants. Meta-analysis showed that rebamipide nonsignificantly increased tear breakup time at 2 weeks (standardized mean difference [SMD] = 1.04; 95% confidence interval (CI):-0.94 to 3.03; P = .30; I2 = 89.3%), significant at 4 weeks (SMD = 1.19; 95% CI: 0.74-1.64; P < .0001; I2 = 85%) and nonsignificant at 12 weeks (SMD = 0.97; 95% CI:-0.15 to 2.08; P = .09; I2 = 80.1%) indicating enhanced tear film stability. Schirmer I test values showed no significant improvement (SMD = 0.04; 95% CI: -0.35-0.43; P = .83), suggesting limited effect on aqueous tear production. Fluorescein staining scores showed a reduction approaching statistical significance (SMD = -0.68; P = .051), while symptom scores measured by ocular surface disease index trended toward improvement, also approaching significance (SMD = -1.17; P = .055). Subgroup analyses revealed greater efficacy in contact lens wearers and postsurgical patients. Safety analysis indicated excellent tolerability, with a high adherence rate (96.8%) and only mild adverse effects such as dysgeusia and nasopharyngitis.

CONCLUSION: Rebamipide 2% ophthalmic suspension improves tear stability and ocular surface health in mucin-deficient DED with a favorable safety profile. Further high-quality trials in diverse populations are warranted to confirm its role in global clinical practice.

PMID:42065158 | DOI:10.1097/MD.0000000000048424

Medicine (Baltimore). 2026 May 1;105(18):e48516. doi: 10.1097/MD.0000000000048516.

ABSTRACT

BACKGROUND: Peripherally inserted central catheters (PICCs) are commonly used vascular access devices in clinical practice. Due to their numerous advantages, PICCs are widely used globally. However, after decades of iteration and clinical application, while benefiting patients, PICCs also face new opportunities and challenges. Therefore, this study systematically analyzes the current status of global PICCs research through bibliometric methods and predicts future research directions and hotspots, aiming to provide references for further development and innovation of PICCs.

METHODS: CiteSpace, VOSviewer, and the bibliometrix R-package were used to perform descriptive statistics and data visualization analyses on literature from the Web of Science Core Collection. A total of 2102 articles were selected, originating from 2722 institutions across 105 countries.

RESULTS: The United States has the greatest influence in the field of PICC research, with the Michigan Health System being the most prolific institution, and Vineet Chopra being the most influential scholar. Keyword and co-citation analysis reveal hot topics: PICC catheterization techniques, complications, and clinical quality control of PICCs.

CONCLUSION: Research on PICCs is showing trends of global collaboration and interdisciplinary approaches. Artificial intelligence and other medical auxiliary technologies demonstrate great potential in addressing PICC complications and insertion challenges. Establishing efficient vascular access teams and solving PICC care issues based on evidence-based practices are crucial for ensuring quality control during PICC usage.

PMID:42065152 | DOI:10.1097/MD.0000000000048516

Medicine (Baltimore). 2026 May 1;105(18):e48551. doi: 10.1097/MD.0000000000048551.

ABSTRACT

Coronary artery disease is a major cause of mortality worldwide, particularly in developing countries. Treatments such as coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) are common; however, their long-term effects on patient quality of life (QoL), particularly in developing nations, are not well understood. This study assessed and compared the QoL of cardiac patients 6 months after post-angioplasty and bypass surgery. A prospective cohort study was conducted over 5 months in 100 patients with Coronary artery disease who underwent PTCA or CABG at the Cardiology Follow-up Clinic of the same hospital. The data were collected using structured questionnaires. The result of this study shows baseline characteristics were similar between PTCA and CABG groups, except for a higher SYNTAX score in the CABG group (29.1 ± 8.6 vs 22.5 ± 7.4; P = .002). At 6 months, symptom relief was reported by 98% (PTCA) and 94% (CABG), with return-to-work rates of 94% and 88%, respectively. The rates of dyspnea, angina, and hospitalization were low and did not differ significantly between the groups. Both groups showed significant improvements in SF-36 and WHO-QoL Physical domain scores (P < .05). No deaths were recorded during follow-up period. Both PTCA and CABG significantly improved patients’ QoL at 6 months, particularly in the physical health domain. While CABG showed slightly more consistent improvements in angina and dyspnea, this was not statistically significant during the short-term follow-up.

PMID:42065151 | DOI:10.1097/MD.0000000000048551

Medicine (Baltimore). 2026 May 1;105(18):e48318. doi: 10.1097/MD.0000000000048318.

ABSTRACT

Improving the ability of humanistic care can enhance the professional identity of nursing students and establish a harmonious nurse-patient relationship. This study aims to explore the current status and influencing factors of the humanistic care ability of undergraduate nursing students. The results of this study will provide the scientific basis for cultivating nursing students with high humanistic care ability, increasing clinical nurses, and improving nursing quality. This is a cross-sectional study. From September 2024 to November 2024, we conducted a questionnaire survey on 367 nursing undergraduate students from 3 medical colleges in China. Participants self-reported general demographic questionnaires, care ability assessment scales, emotional intelligence scales, and self-efficacy scales. The collected data were analyzed using various statistical methods, including descriptive analysis, independent sample t-tests, 1-way analysis of variance tests, and multiple linear regression analysis. All analyses were performed using the SPSS (IBM Corp., Armonk) software (version 27.0). P < .05 indicated that the difference was statistically significant. In this study, the humanistic care ability score of 367 undergraduate nursing students was (194.99 ± 33.31). Cognition is the dimension with the highest score, while patience is the dimension with the lowest score. Multiple regression analysis showed that emotional intelligence, gender, and self-efficacy were the main factors affecting undergraduate nursing students’ ability to provide humanistic care (P < .05). The humanistic care ability level of undergraduate nursing students in this study is at a moderate level. To improve this level, nursing educators should develop targeted intervention measures for various influencing factors. It is recommended that nursing education personnel strategically incorporate training on humanistic care abilities into practical teaching projects, stimulate nursing students to practice the virtue of humanistic care in their daily lives, and ultimately improve the quality of nursing services in clinical practice.

PMID:42065148 | DOI:10.1097/MD.0000000000048318

Clin Exp Allergy. 2026 May 1. doi: 10.1111/cea.70331. Online ahead of print.

NO ABSTRACT

PMID:42065142 | DOI:10.1111/cea.70331

ACS Nano. 2026 May 1. doi: 10.1021/acsnano.6c04149. Online ahead of print.

ABSTRACT

Understanding how nanoparticles move near liquid-solid interfaces is central to nanoscale transport in catalysis, biology, and soft materials. Here, we uncover the physical mechanisms governing anomalous surface diffusion of PEG-coated gold nanorods (AuNRs) near the silicon nitride (SiN_x) membrane in liquid-phase transmission electron microscopy (LPTEM). By systematically tuning the ionic environment (H₂O, 5 mM H₂SO₄, 1.5 mM NaCl, 5 mM PBS), we show how electrostatic screening and ion-specific surface interactions modulate the interaction landscape, altering the strength and abundance of binding sites that govern the confinement and mobility of nanoparticles. Statistical analyses and deep learning classification of particle trajectories reveal a tunable transition between fractional Brownian motion (FBM) in strongly interacting systems (H₂O, H₂SO₄) and annealed transient time motion (ATTM) in screened environments (NaCl, PBS). These results establish electrostatic screening and specific ion effects as external controls that program near-surface transport, shifting the diffusion mechanism from FBM to ATTM and tuning the particle mobility. To further elucidate the interfacial dynamics, we introduce a passive nanorheology framework in LPTEM, modeling the near-surface environment of FBM-classified conditions as an effective viscoelastic medium. Leveraging translational and rotational trajectories as nanoscale rheological probes, we reconstruct frequency-dependent viscoelastic moduli to extract relaxation times and elastic-to-viscous crossover moduli that report on interaction strength at the SiN_x interface. Together, these advances provide both control and diagnosis of interfacial mechanical response in LPTEM, positioning it as a quantitative tool for probing nanoscale transport in complex soft-matter and interfacial systems.

PMID:42065132 | DOI:10.1021/acsnano.6c04149

Int J Dev Neurosci. 2026 May;86(3):e70135. doi: 10.1002/jdn.70135.

ABSTRACT

OBJECTIVE: This study aimed to evaluate serum levels of the microglia-regulating cytokines IL-34 and CSF-1, as well as T-helper cytokines IL-12, IFN-γ, IL-4, IL-10, TGF-β, IL-17 and IL-23, in individuals with autism and healthy controls, and to investigate the relationships between these parameters and the severity of autism symptoms.

METHODS: The study sample consisted of 42 children diagnosed with autism spectrum disorder (ASD) and 40 healthy participants. The severity of autism in the patient group was assessed using the Childhood Autism Rating Scale (CARS). Serum levels of IL-34, CSF-1, IL-12, IFN-γ, IL-4, IL-10, TGF-β, IL-17 and IL-23 were measured using the ELISA method.

RESULTS: Serum levels of IL-34, CSF-1, IFN-γ, IL-4, IL-10 and IL-17 were significantly higher in the ASD group compared to the control group. IL-34, CSF-1, IFN-γ, IL-4, IL-10 and IL-17 showed significant discriminative power in distinguishing ASD (p < 0.05). ROC analysis indicated that IL-10 had the highest area under the curve (AUC = 0.743; p < 0.001), and Delong test results demonstrated that its discriminative ability was statistically stronger than that of the other parameters. No significant correlations were observed between the examined cytokine levels and autism severity.

CONCLUSION: Our findings indicate that IL-34 and CSF-1, along with T-helper-related cytokines (IFN-γ, IL-4, IL-10 and IL-17), were elevated in the ASD group. These alterations may reflect underlying pathophysiological processes. However, due to the cross-sectional design and limited sample size, the findings should be interpreted with caution, and their clinical utility requires further investigation in larger, longitudinal studies.

PMID:42065128 | DOI:10.1002/jdn.70135

J Undergrad Neurosci Educ. 2025 Dec 31;24(1):38-46. doi: 10.59390/001c.154559. eCollection 2025.

ABSTRACT

Scaling relationships are central to interpreting patterns of morphological variation in brain composition. However, allometric scaling can be a difficult concept for students to understand, requiring the integration of evolutionary biology with mathematical relationships. The differential scaling of brain components over evolutionary time is particularly complex. The challenges associated with these concepts are further compounded by the lack of practical activities to allow students to explore these concepts in a neuroscience context. In this study, we present a novel practical session to teach these ideas to second year biology and zoology undergraduate students by combining traditional sheep and pig brain dissections with accessible staining techniques, and imaging using freely available software, that together enable allometric scaling relationships among brain components to be visualised and analysed in both an intraspecific and interspecific manner. Objectively, our data shows a statistically significant improvement (p=<0.0001) in performance on questions related to the scaling concepts following the practical session. Subjectively, 93% of students wanted the lecturer to continue teaching this practical (with 0% of students against it being reused in future), with 89% believing the practical had increased their interest in studying neuroscience. Most students believed the practical had improved their understanding of the concepts and enhanced their ability to critically analyse literature on the topic of allometric scaling and brain anatomy. Students’ perceptions of the practical were positive with the average rating of perceived learning 8.11 out of 10 (where 10 is an excellent learning experience and 1 is a terrible learning experience). Aside from minor technical suggestions, the main improvements suggested by students were that they wished they had more time for the practical.

PMID:42065109 | PMC:PMC13127676 | DOI:10.59390/001c.154559