Tag: nevin manimala

Orbit. 2026 May 18:1-5. doi: 10.1080/01676830.2026.2673568. Online ahead of print.

ABSTRACT

PURPOSE: To determine whether prophylactic antibiotic administration following the development of an orbital floor fracture or after orbital floor fracture repair is associated with a reduced risk of orbital or periorbital cellulitis.

METHODS: A multicenter retrospective cohort study was designed using data obtained from the TriNetX United States Collaborative Network. Patients with orbital floor fractures were categorized by antibiotic exposure within 14 days of diagnosis. Similarly, patients who underwent orbital floor fracture repair were queried to determine whether or not they received antibiotics either at the time of surgery or in the immediate postoperative period. The primary outcome was orbital or periorbital cellulitis within 180 days, assessed after 1:1 propensity-score matching for demographic and clinical variables. Statistical analyses were then performed to determine differences in the two groups.

RESULTS: Among 3,169 matched pairs, antibiotic use was associated with higher cellulitis incidence after incident orbital floor fracture (1.93% vs 0.57%, respectively; RR = 3.40, p < 0.0001). In 1,116 matched pairs who underwent orbital floor fracture repair, patients who received antibiotics were more likely to develop orbital cellulitis than those that did not (2.69% vs. 1.08%, respectively; RR = 2.50, 95% CI [1.29-4.86], p = 0.005).

CONCLUSION: Prophylactic antibiotics did not reduce infection risk after incident orbital floor fracture or after floor fracture repair and were associated with higher cellulitis rates. While clinical decision making may depend on a variety of factors, routine use of antibiotics in these settings may not be appropriate.

PMID:42151747 | DOI:10.1080/01676830.2026.2673568

Muscle Nerve. 2026 May 18. doi: 10.1002/mus.70286. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Given limited research on patient perspectives of speech-language pathology (SLP) services in ALS care, this study aimed to assess the satisfaction with, and understanding of, SLP services by people with ALS (pwALS) and to examine the alignment between services received and patient-reported impairments.

METHODS: A cross-sectional survey assessing pwALS’ perceptions of SLPs was distributed from October 2024 to January 2025 through electronic mailing lists of relevant professional organizations. A questionnaire examined pwALS’ understanding of the SLP role, satisfaction levels, alignment between patient-reported impairments and SLP interventions, and perceived gaps in care. Responses were analyzed using descriptive statistics, with open-ended items analyzed using qualitative analysis.

RESULTS: The 81 survey respondents consisted of pwALS (81.5%), caregivers (11.1%), family members (4.9%), and others (2.5%). Overall satisfaction with SLP care was high, though open-ended responses revealed gaps in understanding. Many were unaware of the full scope of SLP services; only 17.3% recognized cognitive evaluation and 8.6% cognitive therapy, compared with speech (77.8%) and swallowing (81.5%) evaluations. Reported services often did not align with communication and swallowing needs, but patients educated about a service were significantly more likely to use it.

DISCUSSION: Overall satisfaction with SLP care was high; however, open-ended responses revealed gaps in understanding, unmet needs, and limited awareness of the full scope of SLP services. This misalignment highlights the need for improved patient and caregiver education regarding the role and timing of SLP involvement to enhance engagement, appropriate service use, and outcomes in ALS care.

PMID:42151746 | DOI:10.1002/mus.70286

JMIR Form Res. 2026 May 13. doi: 10.2196/78701. Online ahead of print.

ABSTRACT

BACKGROUND: Emergency trauma care (ETC) in the “golden hour” can reduce the fatality rates by 20% – 50%. Imparting ETC training in undergraduate Indian medical graduate (IMG) curriculum can prepare them for both pre-hospital and hospital set-up management as a first responder, thus saving lives. However, teaching these lifesaving skills for managing acute trauma patient like spinal injury in competency based medical education (CBME) curriculum, is challenging. These skills can be taught on standardized patient, allowing the learner, to safely learn the skills on a living responding human being, thus achieving a higher level of clinical competency and better communication skills. However, their availability is limited. In such a scenario, video demonstration of such skills is an easy and reliable teaching learning method.

OBJECTIVE: The study aims to evaluate the effectiveness of using standardized patient versus video demonstration for teaching psycho-motor skills in the management of spinal injury to under graduate students.

METHODS: A prospective interventional comparative study was carried out in the Orthopaedics department of a teaching hospital from September 2024 to February 2025, with Institutional Ethics Committee approval. Thirty undergraduate students posted in Orthopaedics, were divided into two groups (15 each) based on their even and odd roll numbers (systematic sampling). One group was shown video demonstration (VD) of skills like application of an improvised cervical collar and log rolling maneuver in the management of spinal injury patient in primary setting and other group was taught on a standardized patient (SP). The students were assessed by objective structured clinical examination (OSCE) and maneuvers were performed by them on mannequins. Pre-test and Post Test evaluation with peer validated questionnaire along with student’s feedback was taken. The data was analyzed by unpaired t test for OSCE scores and paired t test for pre and post test scores with statistical significance set at p < 0.05 (Confidence interval 95%). Student feedback questionnaire based on 5-point Likert scale was evaluated.

RESULTS: There was significant difference in the mean OSCE scores obtained by VD group 15.47 and by SP group is 18.27 (p value 0.004). However, in comparing the OSCE scores obtained in individual skill demonstration stations for log rolling maneuver and cervical spine immobilization (a pure psycho-motor skill), the mean scores of VD group were 2.27 and 3.20 and SP group was 2.33 and 3.27 respectively. This difference was not significant (p value 0.74 and 0.79 respectively). The student feedback showed teaching with standardized patient, was marginally more interesting and effective method, giving them more confidence to apply these skills in primary setting if needed.

CONCLUSIONS: The study shows both methods are equally effective for teaching lifesaving psycho-motor skills in the management of spinal injury. However, SP group students had better student engagement . Hence a blended approach , where a video demonstration is used to teach large groups or can be given to students prior to the sessions, followed by teaching or assessing on standardized patient for application of these skills will lead to optimum results and save time.

PMID:42151725 | DOI:10.2196/78701

Neurocrit Care. 2026 May 18. doi: 10.1007/s12028-026-02533-z. Online ahead of print.

ABSTRACT

BACKGROUND: Dexmedetomidine (DEX), a selective alpha-2 adrenergic receptor agonist, is widely used in various surgical settings, including cardiac and general surgeries, for its sedative, analgesic, and neuroprotective properties. Patients undergoing brain surgery are particularly susceptible to postoperative delirium (POD). Given the established benefits of dexmedetomidine in other surgical fields, its potential to mitigate delirium in neurosurgery warrants investigation.

METHODS: A systematic search of PubMed, Embase, Scopus, and Cochrane databases was conducted from inception to January 2025 and updated in April 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed, and a meta-analysis was performed using Review Manager 5.4.1. Five randomized controlled trials were included, evaluating the efficacy of DEX in preventing POD in adult patients undergoing brain surgery.

RESULTS: A total of 646 patients were enrolled, with DEX administered with a loading dose ranging from 0.5 to 1 μg/kg over 10 min, followed by a maintenance infusion rate of 0.1 to 0.5 μg/kg/h during the surgical procedure. The pooled risk ratio (RR) for POD with DEX was 0.47 (95% confidence interval (CI): 0.35-0.63; p < 0.00001); reflecting a 53% reduction in the risk of postoperative delirium, with no statistical heterogeneity detected (χ² = 2.09, degrees of freedom (df) = 4, p = 0.72; I² = 0%). Subgroup analyses showed similar effect estimates across brain tumor and other cranial procedures. Adverse events were comparable between groups and generally mild.

CONCLUSIONS: This meta-analysis found that perioperative dexmedetomidine was associated with a significant reduction in postoperative delirium risk in neurosurgical patients. Further multicenter trials are needed to confirm these findings and to refine optimal administration strategies.

PMID:42151722 | DOI:10.1007/s12028-026-02533-z

Stat Med. 2026 May;45(10-12):e70591. doi: 10.1002/sim.70591.

ABSTRACT

In progressive diseases such as Alzheimer’s, treatments that slow progression should start early to preserve higher levels of functioning for a longer period. In corresponding clinical trials, treatment effects are usually expressed as mean differences on a clinical scale at fixed time points. Early in the disease course, however, these mean differences may appear small but may nonetheless correspond to an important slowing of disease progression. This complicates the appreciation of the relevance of observed treatment effects. We introduce a class of target parameters that quantify treatment effects on the time scale in longitudinal studies; for instance, in terms of time saved or percentage slowing of progression. We focus on data from randomized trials where the target parameters are identified under regularity assumptions. These target parameters remain well defined if treatment was not randomized, but additional untestable assumptions are required for identification. We propose general two-step estimators. In the first step, the data can be analyzed with standard methods for longitudinal data and standard software can thus be used. In the second step, summary statistics from the first step are used for inferences about the target parameters. The second step has been implemented in the TCT R package. We study the asymptotic properties and efficiency of these two-step estimators, and evaluate them in an extensive simulation study. These estimators are used in a phase 2/3 clinical trial for Alzheimer’s disease, leading to important additional insights into the treatment effect.

PMID:42151713 | DOI:10.1002/sim.70591

Gen Thorac Cardiovasc Surg. 2026 May 18. doi: 10.1007/s11748-026-02312-9. Online ahead of print.

ABSTRACT

OBJECTIVE: Gastrointestinal complications and acute pancreatitis after cardiac surgery are relatively rare; however, they may sometimes progress to serious conditions and can be challenging to manage. We aimed to investigate the association between lower-body circulatory arrest (LCA) time under mild-to-moderate hypothermia with antegrade selective cerebral perfusion (ASCP) and postoperative visceral complications in patients undergoing thoracic aortic surgery.

METHODS: We retrospectively analyzed 221 patients who underwent thoracic aortic surgery for degenerative aneurysms involving the ascending aorta and aortic arch with LCA under mild-to-moderate hypothermia between 2015 and 2025. The associations between LCA time and postoperative complications, including gastrointestinal complications and pancreatitis, were evaluated using logistic regression analyses.

RESULTS: Prolonged LCA time was significantly associated with an increased incidence of postoperative gastrointestinal (P = 0.006) and lung complications (P = 0.02) in logistic regression models adjusted for minimal temperature. A similar trend was observed for AKI without statistical significance (P = 0.08). In contrast, acute pancreatitis was not associated with LCA time. Within the studied temperature range, minimal temperature was not significantly associated with visceral complications.

CONCLUSIONS: Prolonged LCA time under mild-to-moderate hypothermia using ASCP was significantly associated with increased postoperative gastrointestinal and lung complications, whereas pancreatitis was not associated. The duration of lower-body ischemia may be an important determinant of visceral organ injury within the studied temperature range.

PMID:42151699 | DOI:10.1007/s11748-026-02312-9

Methods Mol Biol. 2026;3000:47-60. doi: 10.1007/978-1-0716-5174-2_3.

ABSTRACT

This chapter has the aim to propose a theoretical framework for describing the qualitative changes in the deformation behavior of isolated human breast cancer cells under varying gravitational conditions. We describe interdisciplinary principles of statistical thermodynamics and nonlinear dynamics of eukaryotic cells. The framework aims to capture how microgravity-induced alterations in cytoskeletal organization lead to distinct mechanobiological phenotypes.

PMID:42151673 | DOI:10.1007/978-1-0716-5174-2_3

Discov Oncol. 2026 May 18. doi: 10.1007/s12672-026-05150-6. Online ahead of print.

ABSTRACT

BACKGROUND: The non-invasive detection of cancer via exhaled breath condensate (EBC) represents a promising frontier in oncology. This study explores the metabolic profiles of EBC to identify biomarkers for the early detection of thyroid cancer (TC) and breast cancer (BC), and to investigate potential metabolic interrelationships between them.

METHODS: We conducted gas chromatography-mass spectrometry (GC-MS) analysis of EBC samples from 74 individuals, including 65 cancer patients (TC and BC) and 9 non-cancer controls. Comparative statistical analyses and machine learning were employed to identify discriminant metabolites.

RESULTS: 305 metabolites were identified in total. Comparative analysis revealed 16 differential metabolites in cancer patients versus controls, with 14 specific to TC and 7 to BC. Notably, five metabolites were common to both cancers: 1,2-Bis(trimethylsilyl)benzene, 1,4-Phthalazinedione,2,3-dihydro-6-nitro-, Eicosane, Methyltris (trimethylsiloxy) silane, and Octadecane, highlighting metabolites that were commonly altered in both cancer types. ROC analysis demonstrated strong diagnostic potential: 1,2-Bis(trimethylsilyl)benzene effectively discriminated cancer from controls (AUC = 0.822) and identified TC (AUC = 0.866), while 1,4-Phthalazinedione,2,3-dihydro-6-nitro- detected BC (AUC = 0.783). Combinations of metabolites yielded AUCs > 0.7 for both cancers. However, limited discriminatory power was observed between TC and BC (maximum AUC = 0.663), indicating significant metabolic similarity. Furthermore, specific metabolite abundances correlated with conventional serum biomarkers, thyroid hormone levels, and lymphatic metastasis.

CONCLUSION: Our findings establish EBC metabolomics as a powerful, non-invasive tool for early cancer detection and monitoring. The identification of shared metabolic alterations between TC and BC suggests common metabolic features that warrant further investigation and paves the way for developing breath-based diagnostic assays.

PMID:42151663 | DOI:10.1007/s12672-026-05150-6

Environ Monit Assess. 2026 May 19;198(6):607. doi: 10.1007/s10661-026-15457-0.

ABSTRACT

The COVID-19 pandemic provided a unique opportunity to evaluate the impact of reduced anthropogenic activities on air quality. This study assesses variations in atmospheric concentrations of carbon monoxide (CO), nitrogen dioxide (NO₂), and sulphur dioxide (SO₂) across selected regions of South India during three phases: pre-COVID (2019), during lockdown (2020), and post-COVID (2021). Satellite observations from Sentinel-5P and NASA Giovanni datasets were used to analyse spatial and temporal trends. The results indicate a clear reduction in pollutant concentrations during the lockdown period, particularly for NO₂, followed by a noticeable rebound as restrictions were relaxed. These trends highlight the strong influence of transportation, industrial activity, and energy consumption on regional air quality. Although variations exist between datasets due to differences in retrieval approaches and resolution, the overall patterns consistently demonstrate improved air quality during reduced human activity. The findings emphasise the potential for achieving significant air quality improvements through effective emission control strategies. This study provides insights for sustainable urban planning and air pollution management, underscoring the need for long-term policies that balance economic development with environmental protection.

PMID:42151662 | DOI:10.1007/s10661-026-15457-0

Behav Res Methods. 2026 May 18;58(6):168. doi: 10.3758/s13428-026-03029-6.

ABSTRACT

With the advent of wearable recorders, scientists are increasingly turning to automated methods of analysis of audio and video data in order to measure children’s experience, behavior, and outcomes, with a sizable literature employing long-form audio-recordings to study language acquisition. While numerous articles report on the accuracy and reliability of the most popular automated classifiers, less has been written on the downstream effects of classification errors on measurements and statistical inferences (e.g., the estimate of correlations and effect sizes in regressions). This paper’s main contributions are drawing attention to downstream effects of confusion errors, and providing an approach to measure and potentially recover from these errors. Specifically, we use a Bayesian approach to study the effects of algorithmic errors on key scientific questions, including the effect of siblings on children’s language experience and the association between children’s production and their input. By fitting a joint model of speech behavior and algorithm behavior on real and simulated data, we show that classification errors can significantly distort estimates for both the most commonly used Language ENvironment Analysis (LENA™), and a slightly more accurate open-source alternative (the Voice Type Classifier from the ACLEW system). We further show that a Bayesian calibration approach for recovering unbiased estimates of effect sizes can be effective and insightful, but does not provide a foolproof solution.

PMID:42151656 | DOI:10.3758/s13428-026-03029-6