Tag: nevin manimala

JACC Adv. 2026 Apr 4;5(5):102708. doi: 10.1016/j.jacadv.2026.102708. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiac resynchronization therapy (CRT) failure leads to adverse remodeling and poor outcomes.

OBJECTIVES: The purpose of this study was to evaluate vericiguat effects on outcomes, mitochondrial function, and inflammation/oxidative stress in CRT nonresponders at 1 year.

METHODS: In this multicenter, observational prospective study, CRT nonresponders treated with vericiguat (n = 156) were compared with non-treated (n = 415). Mitochondrial function was assessed by technetium-99m-methoxyisobutylisonitrile uptake and metabolic profiling of peripheral blood mononuclear cells. Primary endpoint was the CRT responder rate at 1 year; secondary endpoints included heart failure (HF) hospitalizations, mitochondrial function, and inflammatory/oxidative stress markers. CRT responders showed ≥10% reduction in left ventricle end-systolic volume with improved functional status at follow-up. Statistical analysis included Student’s t-tests, chi-square tests, Fisher’s tests, linear mixed models, and Cox regression (significance P < 0.05).

RESULTS: At 1 year, vericiguat users vs those untreated had higher CRT responders’ rate [67/156 (42.9%) vs 51/415 (12.3%)] and lower HF hospitalizations [17/156 (11.1%) vs 114/415 (27.5%)], (P < 0.05). They had better NYHA functional class, higher left ventricular ejection fraction, and lower inflammatory/oxidative stress levels (P < 0.05). Reduced methoxyisobutylisonitrile washout, enhanced adenosine triphosphate (ATP) synthesis, and increased sirtuins3-6 expression were observed (P < 0.05). CRT-responders outcome was predicted by vericiguat (2.165; 95% CI: 1.512-4.623), sacubitril/valsartan (1.432; 95% CI: 1.020-2.885), and low-baseline ATP (0.265; 95% CI: 0.072-0.369); HF hospitalizations outcome was reduced by vericiguat (0.312; 95% CI: 0.195-0.497) and sacubitril/valsartan (0.672; 95% CI: 0.308-0.865) and increased by lower baseline ATP production (4.881; 95% CI: 1.945-8.507) and left ventricular ejection fraction (1.864; 95% CI: 1.209-2.871) at follow-up end.

CONCLUSIONS: In this small cohort of CRT nonresponders, vericiguat increased CRT response at 1 year, likely through improved mitochondrial function and reduced inflammatory/oxidative stress. Larger studies are needed to confirm these findings.

PMID:41936180 | DOI:10.1016/j.jacadv.2026.102708

Int J Pediatr Otorhinolaryngol. 2026 Apr 3;204:112816. doi: 10.1016/j.ijporl.2026.112816. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the clinical characteristics, causes of readmission, postoperative complications, and auditory outcomes of pediatric patients in whom otitis media with effusion (OME) was detected during cochlear implant (CI) surgery.

MATERIALS AND METHODS: This retrospective study reviewed medical records and audiological follow-up data of 461 ears from 243 patients who underwent CI surgery. Postoperative complications were analyzed in the entire cohort. For audiological outcome analysis, 25 ears with intraoperatively detected OME were compared with 25 randomly selected ears without OME and with similar clinical characteristics to ensure balanced group sizes and reduce potential confounding. Appropriate parametric tests were applied, and effect sizes were calculated using Cohen’s d and Cramér’s V.

RESULTS: There were no significant differences between the OME and control groups regarding age or gender distribution (p > 0.05). Pure-tone average and most audiological parameters did not differ significantly between groups. However, the Speech Recognition Threshold (SRT) was significantly lower in the OME group compared with the control group (p = 0.012, d = -0.741). Postoperative infection occurred more frequently in ears with OME than in those without (12.0% vs. 2.5%), and this difference was statistically significant (p = 0.035).

CONCLUSION: Although the presence of OME during CI surgery is associated with an increased risk of postoperative infection, the clinical effect size is limited. OME does not appear to adversely affect overall auditory performance. With appropriate perioperative management and follow-up, OME should not be considered an absolute contraindication for cochlear implantation in pediatric patients.

PMID:41936177 | DOI:10.1016/j.ijporl.2026.112816

J Epidemiol Popul Health. 2026 Apr 4;74(4):203366. doi: 10.1016/j.jeph.2026.203366. Online ahead of print.

ABSTRACT

INTRODUCTION: Firearm-related mortality remains a public health concern in the United States (US). This study examines firearm-related mortality trends in Pennsylvania from 2012 to 2023, with an emphasis on demographic disparities.

METHODS: Firearm-related mortality data was obtained from the Pennsylvania Enterprise Data Dissemination Informatics Exchange, categorizing deaths as intentional (suicide, homicide) or unintentional based on ICD-10 codes. Crude mortality rates were analyzed by sex, age, race/ethnicity, and county. Annual percentage changes were computed to assess trends, and statistical significance was determined using chi-square tests and linear regression models.

RESULTS: From 2012 to 2023 in Pennsylvania, there were 19,470 firearm-related deaths, including 11,520 suicides and 7446 homicides. Firearms accounted for 51.4% of all suicides (11,520 of 22,395) and 76.8% of all homicides (7446 of 9691). The proportion of firearm-related suicide was significantly higher among males compared to females (57.2% [10,151/17,740] vs 29.4% [1369/4654]; p < 0.001) and among Whites compared to Blacks (52.7% [10,514/19,939] vs 47.4% [655/1381]; p < 0.001). Among racial subgroups, the firearm-related suicide rate increased among Whites, Blacks, and Hispanics, however, the statistically significant increase over time occurred among Whites (p = 0.011) and Blacks (p < 0.001). The proportion of firearm-related homicide rate mortality was significantly higher among males compared to females (81.3% [6439/7924] vs 57.0% [1007/1766]; p < 0.001) and among Blacks compared to Whites (87.3% [5126/5875] vs 54.5% [1505/2760]). Subgroup analysis showed the highest rate increase was among Black males aged 40-59 years (122.7%).

CONCLUSIONS: Firearm-related mortality rates increased substantially in Pennsylvania in the past decade, with disparities observed in subgroup populations. Firearm safety policies, mental health support, and violence prevention programs are needed to reduce firearm-related mortality in Pennsylvania.

PMID:41936170 | DOI:10.1016/j.jeph.2026.203366

J Surg Res. 2026 Apr 4;321:523-530. doi: 10.1016/j.jss.2026.03.034. Online ahead of print.

ABSTRACT

INTRODUCTION: Reconstruction of complex incisional hernias can be technically challenging. Enterotomy (ENT) is infrequent in most abdominal wall reconstruction (AWR) cases, yet in complex, reoperative fields, bowel injury can be difficult to avoid. Data describing the incidence and outcomes of ENT in these operations remain limited.

METHODS: A prospective, tertiary hernia center database was queried for elective AWR. Outcomes following an operative ENT (small bowel) were compared with no ENT (non-ENT). Standard statistical analyses were performed. Kaplan-Meier analysis compared recurrence-free survival between groups.

RESULTS: Of 2687 patients, 41 (1.5%) patients sustained an ENT. ENT and non-ENT were similar in age, body mass index, and smoking status (all P > 0.05). Diabetes was more prevalent in non-ENT (9.8% versus 23.8%; P = 0.027). Though similar defect sizes (189.0 (133.0, 308.0) versus 160.0 (63.0, 286.0); P = 0.093), ENT had more recurrent hernias (68.3% versus 51.5%; P = 0.033). Most operations were performed open (95.1% versus 93.3%) with all mesh placed preperitoneal. Biologic mesh was used more frequently in ENT (68.3% versus 19.2%; P < 0.001). Fascial closure was achieved in most cases (100.0% versus 93.1%; P = 0.401). Delayed primary closure was performed more often in ENT (14.6% versus 5.9%; P = 0.021). ENT had longer operative times (227.0 (193.0, 284.0) versus 181.0 (138.0, 230.0) minutes; P < 0.001), length-of-stay (6.0 (5.0, 8.0) versus 5.0 (3.0, 6.0) days; P < 0.001), wound complications (36.6% versus 19.5%; P = 0.006) and hernia recurrence (12.2% versus 3.7%; P = 0.005). Mesh infection was not different (4.9% versus 1.3%; P = 0.108). ENT wound complications were significantly lower in biologic versus synthetic mesh (25.0% versus 61.5%; P = 0.024), but recurrence (7.1% versus 23.1%; P = 0.304) was similar. Both ENT mesh infections were in synthetic mesh. Average follow-up was similar (15.1 (2.7, 49.9) versus 11.3 (1.3, 51.3) months; P = 0.311).

CONCLUSIONS: ENT during AWR is rare but is associated with wound morbidity and hernia recurrence. Prevention of bowel injury and aggressive mitigation of wound morbidity are important to preserving long-term durability of AWR.

PMID:41936147 | DOI:10.1016/j.jss.2026.03.034

J Plast Reconstr Aesthet Surg. 2026 Mar 18;116:118-130. doi: 10.1016/j.bjps.2026.03.029. Online ahead of print.

ABSTRACT

BACKGROUND: Facelifts are commonly associated with postoperative complications. The hemostatic net has emerged as a promising approach to reduce these events. The aim of this meta-analysis was to evaluate the efficacy and safety of the hemostatic net in facelift.

METHODS: The PubMed, Embase, and Cochrane databases were systematically searched up to May 2025 for studies evaluating the hemostatic net in facelift and rejuvenation surgeries (browlift and necklift). Statistical analysis was performed using R version 4.4.1 with a random-effects model for single-arm meta-analysis, reporting outcomes per 100 observations. The primary outcome was hematoma incidence. Secondary outcomes included seroma, necrosis, ischemia, infection, hyperemic marks, persistent hyperpigmentation, and sensory deficits.

RESULTS: Eight studies (1617 patients) were included. The outcomes incidences were hematoma: 0.14 per 100 (95% CI: 0.00 to 0.58; I² = 23.8%); seroma: 2.16 per 100 (95% CI: 0.00 to 9.32; I² = 85.4%); necrosis: 0.36 per 100 (95% CI: 0.00 to 1.14; I² = 3.4%); ischemia: 1.10 per 100 (95% CI: 0.00 to 6.56; I² = 94.7%); infection: 0.62 per 100 (95% CI: 0.00 to 4.35; I² = 70.4%); hyperemic marks: 12.70 per 100 (95% CI: 0.74 to 34.96; I² = 97.5%); persistent hyperpigmentation: 0 per 100 (95% CI: 0.00 to 0.14; I² = 0%); and sensory deficits: 0 per 100 (95% CI: 0.00 to 0.33; I² = 0%).

CONCLUSION: Minimal incidence of hematoma, seroma, necrosis, ischemia, and infection was observed. Hyperemic marks associated with the technique resolved completely within 2 to 3 months, with no progression to persistent hyperpigmentation. No sensory deficits were identified.

SYSTEMATIC REVIEW PROTOCOL: CRD420251136208.

PMID:41936137 | DOI:10.1016/j.bjps.2026.03.029

Mol Genet Metab. 2026 Apr 2;148(2):110112. doi: 10.1016/j.ymgme.2026.110112. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVE: Mutations in the GBA1 gene, particularly the severe L444P variant, are among the strongest known genetic risk factors for Parkinson’s disease (PD). Prior meta-analyses published before 2018 included fewer studies and often pooled multiple mutations, prompting this updated, mutation-specific systematic review and meta-analysis.

METHODS: Standard systematic review and meta-analytic methods were used, including predefined eligibility criteria, literature search, and pooled analysis of odds ratios (ORs) for PD in GBA1 L444P carriers versus non-carriers.

RESULTS: We included 51 studies comprising 33,752 PD patients and 34,101 controls across multiple continents. In random-effects meta-analysis, heterozygous GBA1 L444P carriers had markedly higher odds of PD than non-carriers (pooled OR 9.19, 95% CI 6.94-12.16), with similar estimates across sensitivity and leave-one-out analyses. Cumulative meta-analysis showed early variability but stable pooled ORs around 7-9 from 2008 to 2010 onward. Ancestry-specific pooled ORs were consistently elevated across populations, with overlapping confidence intervals and no significant subgroup differences. Funnel and Galbraith plots and Egger’s test showed no evidence of substantial small-study effects or publication bias.

CONCLUSIONS: This updated synthesis demonstrates that heterozygous GBA1 L444P carriage confers a consistently large increase in PD risk across populations, with robust pooled estimates across multiple sensitivity analyses. Although overall statistical heterogeneity was negligible, wide confidence intervals in several ancestry subgroups highlight imprecision due to sparse data and internal heterogeneity, underscoring the need for broader and more equitable genetic testing, improved risk estimation in underrepresented populations, and targeted research on severe GBA1 variants to inform genetic counseling and PD risk discussions.

REGISTRATION: PROSPERO Registration Number: CRD420251182022. Registration details available at the PROSPERO database.

PMID:41936135 | DOI:10.1016/j.ymgme.2026.110112

GM Crops Food. 2026 Dec 31;17(1):2653897. doi: 10.1080/21645698.2026.2653897. Epub 2026 Apr 5.

ABSTRACT

GMO testing laboratories operating within the current European Union (EU) regulatory framework governing the presence of genetically modified organisms (GMOs) in food and feed (EC Reg. 1829/2003 and EC Reg. 1830/2003) perform a stepwise workflow from DNA extraction to quantification of genetically modified events. A very valuable intermediate step in guiding and optimizing this workflow is the screening phase, where any positives require the laboratory to proceed to the subsequent identification and quantification steps. Very often, however, samples with low GM content result positive at screening but then the GM component is not quantifiable, wasting time and resources. In order to overcome this issue, in this study a statistical framework was developed to predict the presence of soybean GM events based on the difference between the quantification cycle (Cq, also known as threshold cycle (Ct) of the Real time PCR technique) values observed from screening elements as cauliflower mosaic virus 35S promoter (P35S), the nopaline synthase terminator (T-nos), the 5-enolpyruvylshikimate -3-phosphate synthase gene (CP4 epsps) and lectin reference gene (Lec) (ΔCq values). The feasibility of this approach was successfully in-house verified on real life and spiked samples. This approach can be seen as a proof of concept to suggest how to optimize, on a statistical basis, the workflow of GMO testing laboratories that need to evaluate sample compliance with quantitative tests.

PMID:41936134 | DOI:10.1080/21645698.2026.2653897

Nurs Open. 2026 Apr;13(4):e70516. doi: 10.1002/nop2.70516.

ABSTRACT

AIM: To assess the nursing and midwifery students’ knowledge and practice regarding fluid resuscitation during the acute phase of burn management.

DESIGN: A cross-sectional, descriptive design was employed.

METHODS: The data were collected using an online-administered questionnaire at a governmental university among nursing and midwifery students, who were selected purposively. The instrument consisted of three sections. The first section covered participants’ characteristics, including age, sex, marital status, academic program, level of study, grade point average (GPA) and residency. The second section is self-reported and composed of 10 questions to assess the students’ knowledge domains, and the third section is also self-reported and composed of 11 questions to assess participants’ practice regarding practice; each question received a binary response based on whether or not students completed a specific practice.

RESULTS: The study of midwifery and nursing students reported that they had an average knowledge (73.58%) of fluid monitoring, with 96% comprehending fluid balance, but only 28.4% being able to calculate fluids using the Parkland formula. In practice, participants demonstrated a high level of compliance (94.89%) with documentation of fluid administration; however, adherence was notably lower (85.7%) for the application of the rule of nines during assessment.

PATIENT CONTRIBUTION: Midwives and nurses draw clinical judgements based on their academic and professional experience, as well as scientific facts. Theoretical knowledge can help support and improve health practices. A strong intellectual background is essential for providing appropriate care throughout the acute phase of burn management. Future research could incorporate direct observation methods to validate self-reported findings and assess the translation of theoretical knowledge into clinical practice.

PMID:41936122 | DOI:10.1002/nop2.70516

Nurs Open. 2026 Apr;13(4):e70523. doi: 10.1002/nop2.70523.

ABSTRACT

AIM: This study was conducted to examine the effect of nursing practice environment individual and occupational characteristics on nurses’ attitudes towards medical error.

DESIGN: Cross-sectional study.

METHODS: The questionnaire was used for data collection in a tertiary university hospital from 4 March to 30 April 2022. The questionnaire included the “Information Form”, the “Practice Environment Scale-Nursing Work Index (PES-NWI)” and the “Medical Error Attitude Scale”. The population of this study included 1329 nurses. A total of 355 nurses who voluntarily completed the questionnaires constituted the study sample. Convenience sampling was used to select participants. Since the study was conducted at a single hospital, the survey was emailed to all nurses at the institution to ensure broad accessibility. Pearson correlation analysis was used to assess the relationships between continuous variables. Multiple linear regression analysis was employed to examine factors influencing the scores on the Medical Error Attitude Scale. Ethical approval was obtained from the institutional ethics committee, and informed consent was obtained from all participants. The findings were reported following the STROBE guidelines.

RESULTS: The mean score of the PES-NWI was 2.60 ± 0.45 and the mean score of the Medical Error Attitude Scale was (3.50 ± 0.39). Regression analysis was performed to identify factors influencing nurses’ attitudes towards medical errors. According to the results of the multiple regression analysis, age (p < 0.001), duration of experience in the institution (p < 0.001), educational status (p < 0.001), general satisfaction with patient safety in the unit (p < 0.05) and two subdimensions of the PES-NWI-“Nurse manager ability, leadership and support of nurses” (p < 0.05) and “Staffing and resource adequacy” (p < 0.05)-were significant predictors. These six variables collectively explained 12.8% of the total variance in the Medical Error Attitude Scale score (R² = 12.8%, F = 7.454, p < 0.001).

CONCLUSIONS: The study concluded that both the nursing practice environment and certain individual and occupational characteristics of nurses impact their attitudes towards medical errors. In line with this study’s results, we recommend that institutional managers and nurse managers make necessary arrangements to improve nurses’ attitudes towards medical errors, as well as to develop institutional strategies designed to prevent medical errors in their units/institutions, thereby improving patient safety and quality of care.

NO PATIENT OR PUBLIC CONTRIBUTION: The participants of this study were nurses and this contribution has been explained in the data collection section. There was no patient contribution in this study.

PMID:41936116 | DOI:10.1002/nop2.70523

Pharm Nanotechnol. 2026 Mar 25. doi: 10.2174/0122117385394646251111112131. Online ahead of print.

ABSTRACT

Wounds associated with diabetes mellitus are among the most serious complications, with the potential to progress to cell necrosis and, in severe cases, necessitate amputation. Current statistics indicate that diabetic wounds affect approximately 15% of patients with diabetes, and 20% of these cases lead to limb amputation. Conventional therapies often prove ineffective due to molecular and structural alterations in the injured tissue, highlighting the need for innovative delivery methods to enhance treatment efficacy. Recent research has focused on developing advanced materials for wound management, particularly through phyto-nanotechnology. Topical applications of nanoscaffolds and nanofibers have shown promising outcomes in promoting wound healing. Nano-sized particles facilitate smooth progression through the healing phases by enhancing cellular and molecular interactions. Among these, silver nanoparticles (AgNPs) have attracted attention for diabetic wound treatment due to their potent antibacterial and anti-inflammatory properties. AgNPs also stimulate cellular mechanisms that support the repair of chronic wounds; however, potential toxicities remain a concern. This review examines the role and mechanisms of biogenic AgNPs in diabetic wound management, with a focus on their efficacy in wound dressings. Additionally, it examines marketed AgNP formulations for wound care, highlights reported toxicity issues, and discusses clinical trials and future prospects for their application in wound healing.

PMID:41936080 | DOI:10.2174/0122117385394646251111112131