Tag: nevin manimala

J Obstet Gynaecol. 2026 Dec;46(1):2697493. doi: 10.1080/01443615.2026.2697493. Epub 2026 Aug 27.

ABSTRACT

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder with limited diagnostic biomarkers. miR-101-3p is implicated in endocrine regulation and ovarian function, with emerging evidence suggesting its potential as a biomarker for reproductive disorders. This study aimed to explore the diagnostic value of combined detection of serum miR-101-3p and colour Doppler ultrasound parameters for PCOS.

METHODS: A total of 186 study subjects were enrolled, with samples collected from April 2020 to June 2023. miR-101-3p expression was detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The Doppler parameters of the ovary were detected by colour Doppler ultrasound. The Kolmogorov-Smirnov test was used to verify the normality of continuous variables, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of single indicators and their combined panel, with P < 0.05 considered statistically significant.

RESULTS: Serum miR-101-3p expression was significantly downregulated in PCOS patients compared with the control group (P < 0.001). In PCOS patients, ovarian volume was significantly elevated (P < 0.01), while pulsatility index and resistive index were significantly decreased (both P < 0.05). Additionally, low serum miR-101-3p levels were closely correlated with high luteinising hormone levels in PCOS patients (P < 0.05). ROC curve analysis indicated that the combined panel of miR-101-3p and Doppler parameters achieved an area under the curve (AUC) of 0.947, with a sensitivity of 90.4% and specificity of 85.4%, showing significantly superior diagnostic performance over any single indicator (all P < 0.05).

CONCLUSIONS: In conclusion, combined detection of serum miR-101-3p and ovarian Doppler parameters exhibits improved diagnostic efficacy for PCOS, representing a promising auxiliary clinical strategy.

PMID:42658192 | DOI:10.1080/01443615.2026.2697493

Proc (Bayl Univ Med Cent). 2026 Sep;39(5):850-855. doi: 10.1080/08998280.2026.2673660. Epub 2026 May 29.

ABSTRACT

BACKGROUND: The therapeutic role of combining PD-L1 and CTLA-4 blockade in metastatic non-small cell lung cancer (NSCLC) remains unclear, with individual trials yielding discrepant results.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the efficacy and safety of durvalumab with or without tremelimumab in advanced NSCLC. The primary outcome was overall survival. Secondary outcomes included immune-related adverse events. Hazard ratios (HRs) and odds ratios with 95% confidence intervals (CIs) were pooled using random- or fixed-effects models according to heterogeneity.

RESULTS: Three RCTs (MYSTIC, ARCTIC, and POSEIDON) enrolling 2726 patients met inclusion criteria. Combined analysis showed no significant overall survival benefit with durvalumab plus tremelimumab compared to durvalumab alone (HR 0.97; 95% CI, 0.74-1.27). Pooled analysis of immune-related adverse events demonstrated significantly higher risks in the tremelimumab-containing arms.

CONCLUSIONS: In metastatic NSCLC, the addition of tremelimumab to durvalumab does not confer a statistically significant overall survival advantage in unselected populations and is associated with a marked increase in immune-mediated toxicities. Benefits may be restricted to biomarker-defined subgroups, but these findings remain exploratory. Further prospective studies are needed to clarify the optimal role of CTLA-4 blockade in combination immunotherapy.

PMID:42658167 | DOI:10.1080/08998280.2026.2673660

Ann Med. 2026 Dec;58(1):2719250. doi: 10.1080/07853890.2026.2719250. Epub 2026 Aug 27.

ABSTRACT

OBJECTIVE: To compare the agreement of hemodynamic parameters measured by Swan-Ganz catheter and thoracic electrical bioimpedance (TEB) in patients with coronary heart disease (CHD) undergoing coronary artery bypass grafting (CABG), and to evaluate the clinical application value of TEB in perioperative hemodynamic monitoring.

METHODS: A total of 42 CHD patients who underwent off-pump coronary artery bypass grafting (OPCABG) in the Department of Cardiac Surgery, Binzhou Medical University Hospital, from August 2021 to March 2022 were enrolled in this prospective observational study. All patients received continuous hemodynamic monitoring using both TEB and Swan-Ganz catheter throughout the surgical procedure, with simultaneous data collection. Cardiac output (CO), Stroke volume (SV), stroke volume index (SI), and end-diastolic volume (EDV) were recorded at two key time points (before thoracotomy and after chest closure) for statistical analysis.

RESULTS: Bland-Altman corrected for repeated measurements revealed mean bias of -0.30 L/min (CO), -9.10 mL (SV), -5.10 mL/m² (SI), and 69.80 mL (EDV); corresponding 95% limits of agreement (LOA) were -2.50 to 1.80 L/min, -47.70 to 29.60 mL, -27.10 to 16.80 mL/m², and -55.45 to 195.10 mL respectively. The 95% LOA of all four indices fell within predefined clinical acceptable thresholds, whereas paired t-test demonstrated statistically significant inter-method differences for all measured parameters.

CONCLUSION: TEB serves as a reliable, non-invasive tool for real-time continuous trend monitoring of CO, SV, SI, and EDV in critically ill surgical patients, especially those for whom invasive monitoring is contraindicated. This study supports the clinical application of TEB as an alternative or supplementary method for perioperative hemodynamic assessment in OPCABG patients.

PMID:42658162 | DOI:10.1080/07853890.2026.2719250

Int Nurs Rev. 2026 Sep;73(3):e70226. doi: 10.1111/inr.70226.

ABSTRACT

AIM: This study aimed to examine the association between job satisfaction and psychological resilience among nurses and to explore differences in these scores according to selected demographic, occupational, and lifestyle-related characteristics.

BACKGROUND: Job satisfaction and psychological resilience are important work-related and psychological constructs in nursing. Examining their association may provide insight into nurses’ occupational experiences and inform future workforce-support strategies.

METHODS: A descriptive, cross-sectional, and correlational design was used. Data were collected through an online self-administered questionnaire from 427 nurses working in public, private, and university hospitals in Ankara, Türkiye. The Job Satisfaction Scale and Connor-Davidson Resilience Scale-Short Form were administered. Data were analyzed using descriptive statistics, Pearson correlation analysis, independent-samples t tests, and one-way analysis of variance followed by Tukey HSD post-hoc tests when appropriate.

FINDINGS: Job satisfaction was positively correlated with psychological resilience (r = .418, p <.001). Statistically significant differences in job satisfaction and psychological resilience scores were observed across selected demographic, occupational, institutional, and lifestyle-related characteristics.

DISCUSSION: The findings indicate a positive association between job satisfaction and psychological resilience. Observed group differences warrant further investigation using longitudinal and multivariable study designs.

CONCLUSION: Job satisfaction and psychological resilience were positively associated in this sample of nurses. The findings support further investigation of individual, occupational, and institutional characteristics associated with these constructs.

IMPLICATIONS FOR NURSING: The observed association between job satisfaction and psychological resilience highlights the relevance of considering both constructs when assessing nurses’ occupational experiences. Nursing managers may consider evidence-informed workforce-support strategies, while intervention studies are needed to determine their effectiveness.

IMPLICATIONS FOR NURSING AND HEALTH POLICY: The findings may inform future research and policy discussions concerning nurse workforce support; however, policy interventions should be guided by longitudinal and intervention-based evidence.

PMID:42658161 | DOI:10.1111/inr.70226

Plast Reconstr Surg. 2026 Aug 26. doi: 10.1097/PRS.0000000000013415. Online ahead of print.

ABSTRACT

BACKGROUND: Lower body lift (LBL) after massive weight loss (MWL) is frequently complicated by seroma and wound dehiscence. The necessity of drains in LBL remains controversial, with limited robust evidence. This study retrospectively assessed whether omitting drains after MWL influences complication rates and outcomes in 1,002 patients.

METHODS: Records of patients who underwent LBL from January 2011 to May 2024 were reviewed. Two groups were compared: with suction drainage and without drainage. Complications were evaluated individually and classified using Clavien-Dindo. Statistical analyses (univariate/multivariate) assessed links between drain use and complications, controlling for relevant covariates.

RESULTS: Among 1,002 patients, 598 had no drains and 404 received suction drainage. The drain group experienced longer hospitalization (4.29 ± 1.55 vs. 2.41 ± 0.94 days, p<0.001) and operative time (179 vs. 152 minutes, p<0.001). Overall complication rates did not differ significantly. However, wound complications were more frequent with drains (24% vs. 17%, p<0.01). In multivariate analysis, drain use was not an independent risk factor for complications; only active smoking predicted higher risk.

CONCLUSIONS: Omitting drains in LBL after MWL was associated with similar overall complication rates but reduced wound complications and shorter hospital stays. These findings support the safety of drainless protocols in LBL surgery, suggesting they may improve outcomes and help reduce the postoperative treatment burden for patients.

PMID:42658150 | DOI:10.1097/PRS.0000000000013415

JACC Asia. 2026 Aug 17:S2772-3747(26)00601-0. doi: 10.1016/j.jacasi.2026.06.041. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with extremely small aortic annuli are at increased risk of residual gradients and prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR). Comparative data on contemporary valve platforms in this subset remain limited.

OBJECTIVES: The authors aimed to compare early clinical and hemodynamic outcomes among balloon-expandable valves (BEVs), supra-annular self-expanding valves (SA-SEVs), and intra-annular self-expanding valves (IA-SEVs) in patients with severe aortic stenosis and extremely small annuli.

METHODS: Patients with annular area <314 mm² from the OCEAN-TAVI registry were analyzed using multinomial propensity score overlap weighting. Primary outcomes were severe PPM, mean transvalvular pressure gradient ≥20 mm Hg, and paravalvular leakage (PVL) ≥mild.

RESULTS: Among 385 patients, 125, 136, and 124 underwent BEV, SA-SEV, and IA-SEV implantation, respectively. Effective sample sizes after overlap weighting were 92.4, 93.6, and 85.4, with a median follow-up of 358 days. Adjusted probabilities of severe PPM were similarly low (1.6%, 2.0%, and 2.7%; P = 0.85). mean transvalvular pressure gradient ≥20 mm Hg occurred in 4.5%, 8.3%, and 2.3%, respectively (P = 0.19). PVL ≥mild was numerically more frequent with SEV than BEV (15.8%, 27.3%, and 27.0%; P = 0.09), with adjusted odds ratios versus BEV of 1.92 (95% CI: 0.96-3.84) for SA-SEV and 1.83 (95% CI: 0.91-3.70) for IA-SEV. Major complications and 1-year mortality were similar among groups.

CONCLUSIONS: Contemporary TAVR platforms showed broadly similar early outcomes, although PVL ≥mild was numerically more frequent with self-expanding valves.

PMID:42658142 | DOI:10.1016/j.jacasi.2026.06.041

JACC Asia. 2026 Aug 25:S2772-3747(26)00611-3. doi: 10.1016/j.jacasi.2026.07.019. Online ahead of print.

ABSTRACT

BACKGROUND: Pembrolizumab improves survival in advanced lung adenocarcinoma, but potential cardiovascular toxicity remains.

OBJECTIVES: This study evaluated the oncologic benefits and cardiovascular risks of pembrolizumab in a nationwide lung adenocarcinoma cohort.

METHODS: We analyzed 39,192 patients newly diagnosed with lung adenocarcinoma between 2012 and 2019 using the nationwide cancer registry. We compared 573 patients treated with pembrolizumab within 1 year of diagnosis with 38,619 patients who were not treated within 3 years. The outcomes included all-cause mortality and myocardial infarction (MI), ischemic stroke (IS), heart failure (HF), pericarditis/myocarditis, and atrial fibrillation (AF) over a 3-year follow-up.

RESULTS: During a median follow-up of 3.0 years (IQR: 1.0-3.0 years), 18,241 deaths, 574 MI, 1,157 IS, 2,777 HF, 852 pericarditis/myocarditis, and 1,601 AF events occurred. Model-based adjusted outcome curves showed lower all-cause mortality among users (adjusted P < 0.001) but higher incidences of IS, HF, and AF (adjusted P = 0.028, <0.001, and 0.048, respectively). Nonsignificant trends toward increased risks of MI and pericarditis/myocarditis were observed. Multivariable survival analyses, including Fine-Gray competing risk models for nonfatal cardiovascular outcomes, showed that pembrolizumab use was associated with lower all-cause mortality (HR: 0.77; 95% CI: 0.69-0.86) but with increased risks of IS (HR: 1.56, 95% CI: 1.10-2.23), HF (HR: 2.72, 95% CI: 2.24-3.30), and AF (HR: 1.47, 95% CI: 1.08-2.01); increases in MI and pericarditis/myocarditis were nonsignificant.

CONCLUSIONS: Pembrolizumab was associated with lower all-cause mortality but higher risks of major cardiovascular events. These findings support vigilant cardio-oncologic monitoring in patients treated with pembrolizumab.

PMID:42658141 | DOI:10.1016/j.jacasi.2026.07.019

Public Health Nurs. 2026 Aug 27. doi: 10.1111/phn.70177. Online ahead of print.

ABSTRACT

BACKGROUND: Preceptorship is a widely recognized pedagogy which positions experienced nurses as mentors, educators and assessors in the clinical environment. Public Health Nurse (PHN) preceptors are instrumental to the education and development of PHN students. This study aimed to evaluate PHN preceptors’ perceived recognition, preparedness and support in their roles and to determine overall satisfaction.

METHODS: A cross-sectional survey included a validated instrument modified for the Irish community context and convenience sampling methods to target PHN preceptors associated with one Higher Education Institution, following low-risk ethical approval in 2024. Subscale domains included preparedness, recognition, support and satisfaction. Data were analyzed using descriptive and inferential statistics and STROBE guidelines used for reporting.

RESULTS: A response rate of 35.8% (n = 86) was attained. The Preparedness domain demonstrated the highest consensus (M = 12.48, SD = 2.06), indicating that respondents felt prepared for their Preceptorship role. Respondents demonstrated high levels of agreement with pedagogical competencies related to making objective student assessments and supporting skills development. Barriers included insufficient time to engage with preceptorship. The results reveal a disconnect between preceptors perceiving that they were highly valued by students but that the preceptorship role was not formally acknowledged as part of their workload at an organizational level. High attendance was reported at preceptor education sessions (87.2%) and a preference for future education to be delivered online (46.4%).

CONCLUSION: PHN preceptors are critical to integrating theoretical learning in the clinical practice environment. While results demonstrate high satisfaction and confidence, significant challenges exist at the systems level to balance the role and demands of preceptorship, within workloads due to time constraints. At a time when primary care settings are being prioritized for healthcare, the workforce challenges need to be understood and solutions co-created. Future research should incorporate qualitative methods to explore the experiences of preceptors and PHN students.

PMID:42658096 | DOI:10.1111/phn.70177

Cancer. 2026 Sep 1;132(17):e70584. doi: 10.1002/cncr.70584.

ABSTRACT

BACKGROUND: Cancer statistics for Asian American and Native Hawaiian and Pacific Islander (NHPI) people are usually aggregated, masking substantial variation within this heterogeneous population. Herein, the American Cancer Society reports cancer incidence and survival for 8 Asian American and 3 NHPI ethnic groups.

METHODS: The authors used population-based cancer registry data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program, for Asian American and NHPI ethnic groups from 2000 through 2022.

RESULTS: During 2018-2022, overall cancer incidence ranged from 218.3 per 100,000 Kampuchean people to 474.5 per 100,000 Native Hawaiian people, which was 1.5 times higher than the rate for the aggregated Asian American and NHPI population (307.3 per 100,000). High incidence among Native Hawaiian people is largely driven by the highest rates of female breast, colorectal, and prostate cancers, whereas infection-related cancers were highest among Asian American ethnic groups. For example, liver and stomach cancer incidence is highest among Vietnamese (22.2 per 100,000) and Korean people (17.8 per 100,000), respectively, both of which were nearly twice that in Native Hawaiian people (12.9 and 9.6 per 100,000, respectively). Native Hawaiian and Samoan women are twice and 3 times as likely, respectively, to be diagnosed with uterine corpus cancer as aggregated Asian American and NHPI women or White women. Five-year relative survival ranges from 42% in Laotians to 74% in Asian Indians/Pakistanis, with largest differences for colorectal (43% in Laotians to 72% in Asian Indians/Pakistanis) and prostate (63% in Kampucheans to 97% in Japanese) cancers.

CONCLUSIONS: Wide variation in cancer risk within the Asian American and NHPI population highlights the critical need for disaggregated data to effectively target cancer prevention and control interventions.

PMID:42658095 | DOI:10.1002/cncr.70584

Int J Environ Health Res. 2026 Aug 27:1-11. doi: 10.1080/09603123.2026.2723970. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the association between neighbourhood environment characteristics and meeting the Australian 24-hour movement guidelines. In total, 1216 Australian schoolchildren (10-12 years; 50.2% female) completed questionnaires and wore accelerometers to assess screen time, moderate-to-vigorous physical activity (MVPA), and sleep. Parents reported neighbourhood environment characteristics including general safety, access to destinations and services, social capital and cohesion. Logistic regression analyses examined these associations, stratified by place of residence (69.2% in major cities vs 30.8% in regional and remote areas). Adherence to all guidelines was achieved by 10.1% of participants. Among schoolchildren in regional and remote areas, better access to destinations and services was associated with higher adherence to sleep guidelines (OR = 1.48; 95% CI: 1.14, 1.92), and higher parent-reported social capital and cohesion was associated with higher adherence to MVPA (OR = 1.67; 95% CI: 1.15, 2.43) and screen time (OR = 1.68; 95% CI: 1.07, 2.63) guidelines. There were no statistically significant associations observed among schoolchildren living in major cities. Neighbourhood environment may influence adherence to the 24-hour movement guidelines among regional/remote schoolchildren. Future research is needed to better understand the association between neighbourhood environment and compliance with movement guidelines in urban schoolchildren.

PMID:42658078 | DOI:10.1080/09603123.2026.2723970