Tag: nevin manimala

Eur J Pain. 2026 Jul;30(6):e70317. doi: 10.1002/ejp.70317.

ABSTRACT

BACKGROUND: Obesity is considered a risk factor for pain, and comorbid obesity and pain have a cumulatively worse impact on function and quality of life than either condition alone. The aim of this study was to estimate the prevalence of pain and describe the multidimensional biopsychosocial pain profiles of people with obesity (PwO).

METHODS: This pre-specified cross-sectional study reports the baseline data from a longitudinal cohort study. We recruited 519 PwO from three specialist obesity clinics in Ireland. Participants completed pain-, obesity- and health-related questionnaires to capture the multidimensional biopsychosocial characteristics of their pain experience. Data were analysed using descriptive and inferential statistics.

RESULTS: Pain prevalence was 77% (95% CI: 73.1%-80.6%) (70.7% female; mean age 46.6 ± 12.7 years). Participants’ pain characteristics reflected heterogeneity in the pain experiences of PwO, including (mean; SD): pain intensity (0-10 numerical rating scale) (3.97 ± 2.9), number of pain locations (0-35) (5.06 ± 5.3), levels of pain-related disability and self-efficacy. The prevalence of nociplastic pain was 54% (95% CI: 49.3%-58.6%) and neuropathic pain was 30% (95% CI: 25.6%-34.8%). Clinically significant levels of pain-related worrying and kinesiophobia were reported by 20.9% (95% CI: 17.3%-24.8%) and 49.9% (95% CI: 45%-54.7%) of participants.

CONCLUSION: The majority (77%) of PwO attending specialist obesity treatment services report experiencing pain. The intensity, nature, and impact of their pain vary. Over half reported nociplastic pain, one-third neuropathic pain, one-fifth significant pain-related worrying, and half kinesiophobia. These findings have implications for pain management in PwO.

SIGNIFICANCE STATEMENT: This is the first multicentre prospective cohort study to investigate the multidimensional pain profiles of PwO. Pain prevalence was 77%. This is the first study to estimate (i) baseline prevalence of nociplastic-dominant pain in PwO (54%); (ii) baseline prevalence of neuropathic pain in PwO (30%); (iii) clinically significant levels of pain-related fear (20.9%); and (iv) clinically significant levels of kinesiophobia (49.9%), in PwO attending specialist obesity treatment services. These findings have clinical implications for the treatment of pain in PwO.

PMID:42397681 | DOI:10.1002/ejp.70317

JMIR Res Protoc. 2026 Jul 3;15:e96094. doi: 10.2196/96094.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a common inflammatory skin disease associated with substantial disease burden. Traditional Chinese medicine (TCM) has shown beneficial effects in improving AD symptoms and reducing recurrence. Inflammation Formula Number 1 (IFN-1), a TCM prescription consisting of 10 herbal ingredients, has demonstrated favorable efficacy in clinical practice. However, traditional decoction preparation is time-consuming and inconvenient for long-term standardized use. Granule formulations may improve convenience, stability, and quality control, but their dose-response relationship and equivalence to traditional decoction remain unclear.

OBJECTIVE: This multicenter, prospective, randomized equivalence trial aims to evaluate the efficacy, safety, and dose-response relationship of IFN-1 granule formulations compared with traditional decoction in patients with mild to moderate AD.

METHODS: A total of 300 patients with mild to moderate AD aged 18 to 60 years will be recruited from 5 hospitals between April 2026 and January 2027. Participants will be randomly assigned in a 2:2:1:1 ratio to the traditional decoction group (n=100, 33.3%), standard-dose granule group (n=100, 33.3%), two-thirds dose granule group (n=50, 16.7%), or one-tenth dose granule group (n=50, 16.7%). All groups will receive 4 weeks of treatment. The primary end point is the proportion of patients achieving at least 50% improvement in the Eczema Area and Severity Index (EASI) at week 4. Secondary outcomes include EASI75, EASI90, Investigator Global Assessment score of 0 or 1, body surface area involvement, Dermatology Life Quality Index, pruritus numerical rating scale, Patient-Oriented Eczema Measure, and TCM syndrome scores. Outcomes will be assessed at baseline and weeks 1, 2, and 4. Statistical analyses will be conducted using SAS (version 9.4). Equivalence will be evaluated using a 2-sided 95% CI approach with a predefined equivalence margin of -15% to +15%.

RESULTS: Funding for this study was obtained in 2025. Ethical approval was granted by the Ethics Committee of Shanghai Skin Disease Hospital in December 2025, and the trial was registered with the International Traditional Medicine Clinical Trial Registry (ITMCTR2026000452). Participant recruitment is scheduled to begin in April 2026 and continue through January 2027. No patients were recruited at the time of manuscript submission. Data analysis is expected to commence in March 2027, and the primary study findings are anticipated to be published in 2028.

CONCLUSIONS: This trial will determine whether IFN-1 granules achieve efficacy comparable to traditional decoction while improving treatment convenience. The findings may provide evidence for dose optimization and standardized clinical application of TCM granule formulations in AD management.

PMID:42397675 | DOI:10.2196/96094

JMIR Form Res. 2026 Jul 3;10:e95867. doi: 10.2196/95867.

ABSTRACT

BACKGROUND: In recent years, artificial intelligence (AI) has ushered in a promising era in medicine, particularly in medical education. However, studies assessing the knowledge, attitudes, and practices related to AI among medical students in Vietnam remain limited.

OBJECTIVE: This study aimed to evaluate AI knowledge, attitudes, and practices among Vietnamese medical students in learning and research, and to identify factors associated with their AI practices.

METHODS: A cross-sectional study was conducted among medical students at Thai Binh University of Medicine and Pharmacy from November to December 2025. Data were collected using an online structured questionnaire covering demographic characteristics and AI knowledge, attitudes, and practices. The main outcome of interest was AI practices in learning and research. Descriptive statistics and multivariable linear regression were used to examine associated factors. Regression coefficients (β), 95% CIs, and P values are reported.

RESULTS: A total of 1002 medical students (mean age 21.00, IQR 19.00-23.00 years; n=596, 59.5% female) were included. The median percentage of maximum possible (POMP) score of AI knowledge was 66.67 (IQR 33.33-83.33), with a high level of familiarity with common tools (n=798, 79.6%). AI attitudes were generally positive (median POMP score 70.00, IQR 53.33-76.67). AI-related practices were lower (median POMP score 50.00, IQR 46.88-71.88), with AI being used primarily for information retrieval and literature research support. In the multivariable analysis, knowledge POMP score (β=0.12, 95% CI 0.08-0.16) and attitudes POMP score (β=0.42, 95% CI 0.34-0.51) were significantly associated with AI practices POMP score (P<.001). Age, gender, major, grade point average classification, and having participated in an AI seminar or training were not associated with AI practices.

CONCLUSIONS: Medical students showed favorable knowledge and positive attitudes, but their AI practices remained limited. Integrating AI into medical curricula, including fundamentals, applications, and ethical aspects, is essential to prepare future physicians for AI-driven health care.

PMID:42397674 | DOI:10.2196/95867

Curr Psychiatry Rep. 2026 Jul 3;28(1):46. doi: 10.1007/s11920-026-01697-x.

ABSTRACT

PURPOSE OF REVIEW: The Far East is highly vulnerable to natural disasters and mass trauma, underscoring the critical need for child and adolescent psychiatrists (CAPs) equipped to deliver disaster mental health care. To understand regional capacity and preparedness, we conducted the third wave of a 12-year longitudinal survey tracking CAP postgraduate training systems and workforce trends in the Far East.

RECENT FINDINGS: In 2024, representatives from 16 of 17 countries and functionally self-governing areas completed a standardized online questionnaire. Data regarding CAP training structures, specialty recognition, and workforce size were descriptively compared with previous survey waves (2012 and 2017). The CAP workforce has steadily increased, with new specialists emerging in Cambodia, Mongolia, and Myanmar. By 2024, 75% (12/16) of regions offered postgraduate CAP training-up from 59% in 2017-and recognition of CAP as a distinct specialty increased to 75%. Curricula have diversified, frequently integrating school consultation (83%) and forensic psychiatry (58%). However, national guidelines, board certification (44%), and institutional support remain highly uneven across the region. While CAP training in the Far East has significantly expanded, persistent workforce disparities limit the region’s ability to deploy skilled specialists during humanitarian emergencies. Strengthening CAP training systems is an essential public health measure to fortify regional resilience and address child and family disaster psychiatry needs.

PMID:42397655 | DOI:10.1007/s11920-026-01697-x

Int J Implant Dent. 2026 Jul 3. doi: 10.1186/s40729-026-00700-7. Online ahead of print.

ABSTRACT

PURPOSE: Zygomatic implants (ZIs) are indicated for severely atrophic maxillae where conventional implant (CI) placement is difficult. Although ZIs show favourable outcomes, factors influencing their survival remain unclear. This retrospective study evaluated implant- and patient-related factors associated with ZI survival in full-arch immediate-loading rehabilitation using the all-on-four concept combining ZIs and CIs.

METHODS: A total of 923 implants (323 ZIs and 600 CIs) placed in 203 patients between 2010 and 2021 were analysed. Cumulative survival rates were estimated using the Kaplan-Meier method, and intergroup comparisons were performed using the log-rank test. Cox proportional hazards regression analyses were performed to calculate hazard ratios (HRs). Statistical significance was set at p < 0.05.

RESULTS: Cumulative survival rates at 3-13 years were 94.5% and 95.9% at the patient and implant levels, respectively, for ZIs, and 97.9% and 98.7%, respectively, for CIs. ZIs showed significantly lower implant-level survival than CIs (p = 0.0178). Palatal positioning of the ZI platform was significantly associated with reduced implant-level survival (HR = 18.177, 95% CI: 1.418-233.053, p = 0.026). Systemic disease was significantly associated with reduced patient-level ZI survival after adjustment for sex and smoking status (HR = 14.872, 95% CI: 1.812-122.077, p = 0.012).

CONCLUSIONS: Immediate full-arch rehabilitation combining ZIs and CIs achieved high long-term survival; however, palatal platform positioning and systemic disease were associated with ZI failure.

PMID:42397653 | DOI:10.1186/s40729-026-00700-7

Discov Oncol. 2026 Jul 3. doi: 10.1007/s12672-026-05485-0. Online ahead of print.

ABSTRACT

OBJECTIVE: Uric acid (UA) is the end product of purine metabolism. Numerous studies have reported an association between serum UA levels and the risk of several solid tumors, but its association with gastric cancer (GC) remains controversial. This study aims to explore the relationship between serum uric acid (SUA) and GC, to inform GC prevention and treatment strategies.

METHOD: Literature searches were conducted in PubMed, Embase, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI). Mean differences (MD) with 95% confidence intervals (95% CI) were calculated using fixed or random effects models. Subgroup analysis was performed to explore heterogeneity sources. Additionally, bioinformatics analyses were carried out using publicly available datasets from the Gene Expression Omnibus (GEO), STRING, and DAVID databases to identify shared molecular pathways.

OUTCOME: Six studies met the inclusion criteria. Meta-analysis revealed significantly higher SUA levels in GC patients compared to controls (pooled MD: 48.74; 95% CI 35.23-62.25; P < 0.00001; pooled SMD: 1.52, 95% CI 0.69-2.34), with extreme high heterogeneity was observed (I² = 89%, P < 0.00001; I² = 98%, P < 0.00001). Subgroup analysis based on control types presented numerical differences in pooled MD values between healthy control group (MD: 55.73; 95% CI 51.29-60.17; P = 0.33) and non-healthy control group (MD: 27.82; 95% CI – 7.87-63.51; P = 0.0006), while no statistically significant difference was detected in the healthy control subgroup. No publication bias was detected (P = 0.175). Bioinformatics analysis identified 188 overlapping differentially expressed genes (DEGs) between hyperuricemia and GC. Protein-protein interaction (PPI) network analysis highlighted IL6, TNF, and CXCL8 as central hub genes. Functional enrichment analysis showed enrichment trends in inflammatory pathways such as the IL-17 signaling axis, as well as interactions between viral proteins and cytokine receptors. These enrichment results provide preliminary bioinformatic clues that the correlation between SUA and GC may be associated with inflammatory response, immune microenvironment alteration and gastric mucosal barrier-related biological processes.

CONCLUSION: Our findings suggest a possible correlation between elevated SUA levels and GC, with a more obvious numerical trend in studies adopting healthy population controls. Elevated SUA may correlate with GC, especially in studies using healthy controls. Inflammation and immune dysregulation pathways likely underlie this association. SUA shows preliminary potential as a GC-related biomarker, though clinical use is unconfirmed. Large-sample prospective studies and basic experiments are needed to verify the correlation and mechanisms.

PMID:42397651 | DOI:10.1007/s12672-026-05485-0

Psychiatr Q. 2026 Jul 3. doi: 10.1007/s11126-026-10297-0. Online ahead of print.

ABSTRACT

The February 2023 earthquakes in Turkey exposed frontline resident physicians to personal trauma, occupational stress, and the psychological burden of caring for traumatized survivors. This study aimed to evaluate post-traumatic stress disorder (PTSD) symptoms, post-traumatic growth (PTG), and associated factors among resident physicians in Turkey after the earthquakes. A cross-sectional study was conducted using an online survey administered to resident physicians at the Faculty of Medicine of XXX University between October and November 2023. The survey consisted of sociodemographic characteristics, earthquake-related exposure variables, the PTSD Checklist for DSM-5 (PCL-5), and the PTG Inventory. A total of 157 physicians participated, with a mean age of 29.6 ± 4.25 years and 7.6% reported receiving psychological treatment after the disaster. The mean PCL-5 score was 33.8 ± 18.4, with 23.6% meeting criteria for probable PTSD. The mean PTG score was 46.2 ± 26.9. A moderate positive correlation was observed between PTSD and PTG (r = 0.439, p < 0.001). In bivariate analysis, only religiosity showed a statistically significant association with PTSD (χ²(2) = 6.547, p = 0.038), with the highest prevalence among moderately religious physicians (31.0%). In the multivariable model, no independent predictor was significantly associated with PTSD symptoms. Higher PTG scores were independently associated with male gender (B = 8.55, 95% CI: 0.27-16.82, p = 0.043), greater religiosity (B = 7.90, 95% CI: 1.70-14.10, p = 0.013), and previous trauma experience (B = 10.48, 95% CI: 1.43-19.53, p = 0.024). After the earthquakes, physicians demonstrated moderate levels of PTG, and approximately one-quarter exhibited PTSD symptoms, highlighting the need for ongoing mental health monitoring and accessible psychological support.

PMID:42397616 | DOI:10.1007/s11126-026-10297-0

Environ Monit Assess. 2026 Jul 3;198(8):805. doi: 10.1007/s10661-026-15634-1.

ABSTRACT

This study employed a greenhouse gas flux monitoring system equipped with LI-COR 7810/7820 portable trace gas analyzers to measure daily fluxes of CO₂, CH₄, and N₂O across asphalt pavement sections during three time periods (8:00-9:00 AM, 1:00-2:00 PM, 6:00-7:00 PM). Using high-frequency data obtained from the analyzers, precise fluxes were calculated via an exponential fitting model in SoilFluxPro software. A comprehensive assessment, integrating spatiotemporal statistical analysis and global warming potential (GWP), was conducted. The results revealed the following: (i) Spatial distribution: Asphalt road surfaces act as carbon sources along both sides, with an average GWP of 920.762 nmol·m⁻²·s⁻¹ per day, while the central section serves as a weak carbon sink, with an average GWP of -73.685 nmol·m⁻²·s⁻¹ per day. (ii) Temporal distribution: Greenhouse gas emissions from asphalt pavements are higher during the daytime and lower at night. (iii) Gas composition: CO₂ is the dominant contributor to greenhouse gas fluxes from asphalt pavements, accounting for over 98% of total emissions. (iv) Primary drivers: The primary source of greenhouse gas emissions from asphalt pavements is the organic debris covering the soil and vegetation along roadside areas.

PMID:42397608 | DOI:10.1007/s10661-026-15634-1

Arch Orthop Trauma Surg. 2026 Jul 3;146(1):244. doi: 10.1007/s00402-026-06406-0.

ABSTRACT

INTRODUCTION: Tranexamic acid (TXA) effectively reduces blood loss and transfusion requirements in shoulder arthroplasty. However, concerns regarding thromboembolic, neurologic, cardiac, and renal complications have limited its use in medically high-risk patients. This study evaluated temporal trends and the safety of TXA in high-risk patients undergoing total shoulder arthroplasty (TSA).

METHODS: A retrospective cohort study was conducted using TriNetX, identifying patients who underwent shoulder arthroplasty (2012-2025). Patients were stratified by preexisting high-risk conditions, including prior thromboembolism, renal failure, atrial fibrillation, seizure disorders, and visual disturbances. Within each subgroup, patients receiving TXA were propensity score-matched to those who did not. Perioperative TXA utilization trends were assessed. Ninety-day postoperative outcomes were compared, including transfusion requirements, thromboembolic events, cardiac complications, renal failure, neurologic events, infections, readmissions, emergency department visits, and mortality. Outcomes were reported as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Reported perioperative TXA use began in 2012 and increased through 2025, with over 70% of patients in both standard- and high-risk cohorts receiving TXA. TXA use was associated with significantly lower transfusion rates (OR range 0.53-0.62) and readmissions (OR range 0.63-0.75) across all high-risk cohorts (all p ≤ 0.01). TXA use was not associated with increased risk of deep vein thrombosis, pulmonary embolism, stroke, or postoperative seizures in any subgroup. Notably, TXA demonstrated a protective association against myocardial infarction, cardiac ischemia, acute renal failure, and mortality in select high-risk populations. No increase in infection-related complications was observed.

CONCLUSIONS: In patients undergoing shoulder arthroplasty, TXA use was safe across multiple high-risk medical populations and was consistently associated with lower transfusion and readmission rates, with reduced mortality in select cohorts. These findings support the broader use of TXA for blood conservation in shoulder arthroplasty, even among patients with traditionally high-risk comorbidities, while underscoring the need for future prospective, shoulder-specific safety studies.

LEVEL OF EVIDENCE: III, Retrospective Cohort Study.

PMID:42397605 | DOI:10.1007/s00402-026-06406-0

HNO. 2026 Jul 3. doi: 10.1007/s00106-026-01784-8. Online ahead of print.

ABSTRACT

BACKGROUND: A wide range of methods for speech audiometry to evaluate the outcome after cochlear implant (CI) fitting exist in German-speaking countries. Various procedures are used to determine the speech recognition threshold in noise (SRT). As an adaptive test with a simple lexical structure, the digits-in-noise (DiN) test offers an alternative to list-based speech tests or matrix tests. The aim of this study was to evaluate the clinical relevance of DiN in postoperative follow-up, particularly in comparison to the Freiburg speech test (FBS) and the Oldenburg sentence test (OlSa), as well as for supporting individualized CI settings.

MATERIALS AND METHODS: In a prospective study, 73 adult CI users were examined. Speech comprehension was assessed monaurally in a free field using the FBS, OlSa, and DiN. The participants were divided into three groups based on their hearing loss for numbers (HVZ). The OlSa in noise was only performed if speech comprehension was sufficient. The evaluation was carried out using descriptive statistics, the Kruskal-Wallis test, and Bland-Altman analysis.

RESULTS: The test-retest reliability of the DiN was high and independent of the time of measurement. The SRTs differed significantly between groups, with better audibility showing lower thresholds. Speech tests in quiet and noise confirmed these differences. The DiN could be performed in all participants.

CONCLUSION: The DiN can be used in all phases of audiological CI follow-up care and enables early differentiation and progress monitoring, provides information on audibility, complements the FBS, and may be used in future studies on optimal fitting of CI systems.

PMID:42397601 | DOI:10.1007/s00106-026-01784-8