Tag: nevin manimala

Am J Sports Med. 2026 May 30:3635465261443986. doi: 10.1177/03635465261443986. Online ahead of print.

ABSTRACT

BACKGROUND: Because of the difficulty of baseball players with capitellar osteochondritis dissecans (OCD) lesions to return to sport (RTS), multiple operative strategies have been used for these lesions. However, there has yet to be a systematic review of RTS outcomes in specifically baseball players.

PURPOSE/HYPOTHESIS: The purpose of this study was to compare the RTS rates between surgical procedures for capitellar OCD lesions in youth baseball players, with a secondary purpose of comparing improvements in elbow range of motion (ROM) and improvements in Timmerman-Andrews scores between surgical procedures. The authors hypothesized that RTS rates would not differ based on the surgical procedure for capitellar OCD lesions in youth baseball players.

STUDY DESIGN: Systematic review; Level of evidence, 4.

METHODS: The authors performed a literature search in February 2025 to identify studies evaluating postoperative outcomes for the treatment of capitellar OCD lesions in youth baseball players. Surgical procedures were grouped into debridement/loose-body removal ± microfracture, fixation procedures, bone peg grafting, and autologous osteochondral transplantation. Preoperative and postoperative elbow flexion and extension ROM, Timmerman-Andrews scores, and RTS rate and time were collected. Meta-analysis included pooled effect estimates for improvements in flexion ROM, extension ROM, and Timmerman-Andrews scores, as well as the proportion of RTS, applying a common effect model.

RESULTS: Overall, 462 studies were screened and 16 studies were included. There were 389 total youth baseball players and 89% of lesions were unstable. RTS after autologous osteochondral transplantation (175/182; 96%) was more likely than after fixation (68/76; 89%), bone peg grafting (27/31; 87%), or debridement/loose-body removal ± microfracture (59/70; 84%) (P = .022). Overall, 31 of 60 (52%) pitchers were able to return to pitching. Fixation procedures were associated with greater improvements in elbow extension ROM (8° vs 3°; P = .013) than autologous osteochondral transplantation. Fixation procedures (score, 71) and autologous osteochondral transplantation (score, 58) also had greater improvements in Timmerman-Andrews scores than bone peg grafting (score, 26; P < .001); however, there was significant heterogeneity across studies and large differences in preoperative Timmerman-Andrews scores across groups.

CONCLUSION: Overall, 92% of youth baseball players RTS after operative management of capitellar OCD lesions, with the highest RTS rates after autologous osteochondral transplantation; however, almost half of pitchers are unable to return to pitching. Clinicians can counsel injured youth baseball players that capitellar OCD lesions indicated for autologous osteochondral transplantation can have similar or better RTS outcomes than OCD lesions indicated for fixation or debridement ± microfracture.

PMID:42216683 | DOI:10.1177/03635465261443986

J Clin Nurs. 2026 May 30. doi: 10.1111/jocn.70381. Online ahead of print.

ABSTRACT

AIMS: To examine the association between compassion fatigue and spiritual care competence amongst palliative care nurses, investigate the mediating role of palliative care quality and determine the moderating effect of job satisfaction.

BACKGROUND: Palliative care nurses face intense emotional demands and end-of-life stressors, increasing their risk of compassion fatigue and potentially affecting care delivery. Spiritual care competence is central to holistic palliative nursing; however, its association with compassion fatigue and the organisational factors shaping this relationship remain unclear.

DESIGN: A cross-sectional, correlational study.

METHODS: Using a convenience sampling approach, 141 nurses working in palliative care units across hospitals in different regions of Türkiye were recruited. Data were collected between April and August 2024 via an online questionnaire including demographic variables and validated instruments measuring compassion fatigue, palliative care quality, spiritual care competence and job satisfaction. Data were analysed using SPSS and PROCESS macro.

RESULTS: The mean spiritual care competence score was 107.9 ± 14.7. Compassion fatigue was negatively associated with palliative care quality and spiritual care competence, whereas palliative care quality was positively associated with spiritual care competence. Mediation analysis indicated a significant indirect association between compassion fatigue and spiritual care competence through palliative care quality. Moderated mediation analysis indicated that this indirect effect was significant only amongst nurses reporting higher job satisfaction.

CONCLUSIONS: Compassion fatigue was negatively associated with palliative care nurses’ spiritual care competence. Mediation analysis suggested that this association was statistically explained by palliative care quality, whilst job satisfaction moderated the relationship between compassion fatigue and care quality.

RELEVANCE TO CLINICAL PRACTISE: Addressing compassion fatigue as a critical occupational risk in palliative care nursing is essential. Organisational strategies that enhance job satisfaction and support high-quality care delivery may help sustain nurses’ spiritual care competence and promote high-quality palliative nursing practise.

PATIENT OR PUBLIC CONTRIBUTION: No patients or members of the public were involved in this study. Palliative care nurses participated by completing online questionnaires.

REPORTING METHOD: This cross-sectional study was reported in accordance with the STROBE Statement.

PMID:42216662 | DOI:10.1111/jocn.70381

J Integr Neurosci. 2026 May 9;25(5):47320. doi: 10.31083/JIN47320.

ABSTRACT

BACKGROUND: Temporal lobe epilepsy (TLE) is increasingly recognized as a dysfunction of the brain network. However, the topological alterations of the metabolic brain network underlying impaired awareness seizures (IAS) remain unclear. In this study, we aimed to characterize metabolic network reorganization in patients with TLE and IAS (TLE-IAS) and to preliminarily investigate the specificity of these alterations by comparing the results with those of patients with TLE and aware seizures (AS).

METHODS: This retrospective study included a total of 193 TLE-IAS patients, 30 patients with TLE-AS, and 193 controls. Metabolic brain networks were constructed for all groups, and nonparametric permutation testing was applied to compare group differences in graph-theoretical metrics and hub node distribution.

RESULTS: Compared with controls, both TLE patient groups exhibited globally weakened metabolic connectivity. Graph-theoretical analysis revealed that both groups demonstrated significant increases in characteristic path length and significant decreases in clustering coefficient (Cp). Furthermore, the TLE-AS group showed a significant decrease in local efficiency compared with controls. No statistically significant differences were found between the two patient groups across the four graph-theoretical parameters. Hub analysis revealed a convergent reorganization in both groups involving loss of default mode network hubs and a limbic/paralimbic shift, with the TLE-IAS group showing more limbic hubs, while the TLE-AS group exhibited more primary auditory hubs.

CONCLUSIONS: This study revealed alterations in graph-theoretical parameters and hub distribution in patients with TLE-IAS and TLE-AS. These findings provide preliminary metabolic imaging evidence for the neural substrates underlying impaired awareness in TLE.

PMID:42216648 | DOI:10.31083/JIN47320

J Integr Neurosci. 2026 May 25;25(5):48076. doi: 10.31083/JIN48076.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a recognized treatment for advanced PD, yet its impact on gait parameters remains variable. The aim of this prospective study was to evaluate changes in spatiotemporal gait parameters following DBS-STN in patients with advanced PD.

METHODS: Thirty patients with advanced PD underwent bilateral DBS-STN. Gait assessments were performed preoperatively and three months postoperatively using a pressure-sensitive treadmill under three walking speed conditions (slow, optimal and fast). Spatiotemporal gait parameters (as walking speed, double-stance phase, cadence, step length, stance phase duration) and derived values, such as asymmetry of both step length and stance phase, were analyzed with respect to the clinically better and worse limbs defined in accordance with Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS).

RESULTS: No significant changes in walking speed, cadence, or double stance phase duration comparing gait characteristics pre- and postoperatively were found. Significant improvements were found in step length for the clinically worse limb at slow and optimal walking speeds and in stance phase duration for the clinically better limb at fast walking speed. Additionally, asymmetry in both step length and stance phase duration decreased at the fast walking speed after stimulation. For all other parameters evaluated in other walking speeds, the differences were not statistically significant.

CONCLUSIONS: DBS-STN combined with medication had limited overall effects on spatiotemporal gait parameters in patients with advanced PD. However, when the clinically worse and better lower limbs were analyzed separately, selective improvements in step length and stance phase duration, along with reduced gait asymmetry at higher walking speeds were observed. These findings suggest that DBS may modulate specific components of gait control rather than global gait performance, highlighting the importance of individualized assessment in postoperative gait evaluation.

PMID:42216637 | DOI:10.31083/JIN48076

Birth Defects Res. 2026 Jun;118(6):e70056. doi: 10.1002/bdr2.70056.

ABSTRACT

BACKGROUND: This study examined the association between maternal immigrant status and survival of children with congenital heart diseases (CHD) in Ontario, Canada.

METHODS: A retrospective population-based cohort study of hospital live births between April 2002 to September 2020 in Ontario, Canada was conducted at the Institute for Clinical Evaluative Sciences. Multilevel Cox hazard regression models generated hazard ratios (HR) for the association between maternal immigrant status and child death while accounting for hospitals as a cluster factor and adjusting for maternal age at birth, neighborhood income and education quintiles, comorbidities, a composite of severe maternal morbidity, gestational age at birth, birth weight, infant sex and residential rurality among all CHD, severe CHD or single ventricle patients.

RESULTS: Among children with any CHD, relative to children born to nonimmigrants, the adjusted HR was 1.17 (95% CI: 1.06-1.30) in children born to nonrefugee immigrants, and 1.33 (95% CI: 1.07-1.65) in those born to refugees. Similar patterns were observed in children with severe CHD, particularly within the single ventricle CHD subcohort, where the adjusted HR for children born to refugees was 2.01 (95% CI: 1.5-2.7) relative to those born to nonimmigrants.

CONCLUSION: Health policy decision-makers should prioritize understanding the underlying causes of mortality in these populations to reduce health inequities.

PMID:42216616 | DOI:10.1002/bdr2.70056

Br J Hosp Med (Lond). 2026 May 20;87(5):49922. doi: 10.31083/BJHM49922.

ABSTRACT

AIMS/BACKGROUND: Psychological distress is highly prevalent among patients undergoing maintenance hemodialysis and may adversely affect treatment adherence and overall quality of life. Evidence-based nursing (EBN) practices and cognitive behavioral theory (CBT)-based approaches have each shown potential value in dialysis care. However, evidence regarding their integration into routine nursing practice in real-world clinical settings remains limited. This study aims to examine the impact of exposure to a structured nursing care pathway incorporating EBN and CBT-informed supportive nursing on psychological, quality-of-life, and selected clinical stability outcomes in patients receiving maintenance hemodialysis.

METHODS: This single-center retrospective cohort study included 236 adult patients with chronic renal failure undergoing maintenance hemodialysis between March 2023 and February 2024. Patients were classified according to the nursing care pathway received during routine clinical practice: standard care or a structured nursing care pathway integrating EBN and CBT-informed supportive communication. Propensity score matching (1:1) was applied to balance baseline demographic, clinical, laboratory, and psychological characteristics. Outcomes assessed over a 12-week observation period included nutritional markers (hemoglobin and serum albumin), the Kt/V, psychological status (Self-Rating Anxiety Scale and Self-Rating Depression Scale), quality of life (Generic Quality of Life Inventory-74), and dialysis-related complications.

RESULTS: After propensity score matching, 186 patients (93 per group) were included in the final analysis. Renal function indicators, electrolyte levels, and inflammatory markers remained stable in both groups throughout follow-up, with no significant between-group differences. Anxiety and depression scores were lower at follow-up in the structured nursing care pathway group than in the standard nursing care group (both p < 0.001), and both groups showed reductions in these scores from baseline (both p < 0.001). At follow-up, the structured nursing care pathway group had higher quality-of-life scores in the physical, psychosocial, and social domains (all p < 0.05), whereas no significant between-group difference was observed in the material well-being domain (p > 0.05). Dialysis adequacy and nutritional indicators were maintained within clinically acceptable ranges in both groups. The incidence of dialysis-related complications was lower in the structured care group, although statistical significance was not observed.

CONCLUSION: In a real-world clinical setting, exposure to a structured nursing care pathway incorporating EBN and CBT-informed supportive communication was associated with more favorable psychological outcomes and selected quality-of-life domains among patients undergoing maintenance hemodialysis, without compromising clinical stability. These findings suggest the potential value of optimizing nursing care pathways to address psychosocial needs in hemodialysis care.

PMID:42216599 | DOI:10.31083/BJHM49922

Br J Hosp Med (Lond). 2026 May 22;87(5):54139. doi: 10.31083/BJHM54139.

ABSTRACT

AIMS/BACKGROUND: Malnutrition represents a major clinical concern in geriatric populations and is strongly associated with adverse outcomes and increased mortality, particularly among patients admitted to the intensive care unit (ICU). This study aimed to compare the predictive performance of the modified Nutrition Risk in the Critically Ill (mNUTRIC) score and the Prognostic Nutritional Index (PNI) for 30-day mortality in geriatric ICU patients.

METHODS: This retrospective study included 704 geriatric patients admitted to the ICU between December 2023 and June 2025 with a length of stay exceeding 24 hours. The mNUTRIC score and PNI were calculated using data obtained within the first 24 hours following ICU admission. Demographic and clinical characteristics were also evaluated and compared between groups according to these nutritional scoring systems. The primary outcome was 30-day mortality.

RESULTS: Of the 704 patients, 301 (42.76%) died during ICU follow-up, and 257 patients (36.51%) died within 30 days. Both the mNUTRIC score and PNI differed significantly between survivors and non-survivors (p < 0.001 for both). Patients with high mNUTRIC scores demonstrated significantly higher rates of both 30-day mortality and ICU mortality compared with those with low scores (p < 0.001 for all comparisons). Receiver operating characteristic (ROC) curve analysis showed that the mNUTRIC score had an area under the curve (AUC) of 0.753, with a cut-off value of 5.5, sensitivity of 0.743, and specificity of 0.638. In contrast, PNI demonstrated the lowest predictive performance among the evaluated scores, with an AUC of 0.624 and a cut-off value of 36.175.

CONCLUSION: Both the mNUTRIC score and PNI are useful for predicting 30-day mortality and clinical outcomes in geriatric ICU patients; however, the mNUTRIC score demonstrates superior predictive performance. Future research should further investigate their integration with established scoring systems and their utility in longitudinal trend monitoring.

PMID:42216593 | DOI:10.31083/BJHM54139

Br J Hosp Med (Lond). 2026 May 22;87(5):54137. doi: 10.31083/BJHM54137.

ABSTRACT

AIMS/BACKGROUND: Hemodialysis is the primary form of treatment for patients with chronic renal failure. The lengthy dialysis process and rigid treatment schedule often lead to poor patient adherence. This study aims to explore the effects of interdisciplinary collaborative nursing and routine nursing on hemodialysis compliance in patients with chronic renal failure.

METHODS: This retrospective analysis included clinical data of 136 patients with chronic renal failure who underwent hemodialysis in Zibo Central Hospital from April 2021 to January 2022. The patients were divided into a control group and an observation group according to the type of nursing care given. The control group received routine nursing, whereas the observation group received nursing intervention based on an interdisciplinary collaborative nursing model. Hemodialysis compliance, anxiety, awareness of disease, and health-related quality of life among the patients were evaluated.

RESULTS: Compared to the control group, the observation group exhibited significantly higher levels of hemodialysis compliance and disease knowledge (p < 0.05). The anxiety level of the observation group was significantly lower than that of the control group (8.04 ± 5.06 vs. 12.49 ± 4.87; p < 0.001). In terms of quality of life, the observation group scored higher than the control group in physical, psychological, social, and environmental domains (p < 0.05).

CONCLUSION: The interdisciplinary collaborative nursing enhances hemodialysis compliance in patients with chronic renal failure, ameliorates their anxiety, and improves their health-related quality of life. This research provides a theoretical basis for the design and selection of clinical management plans in the future.

PMID:42216592 | DOI:10.31083/BJHM54137

Hum Vaccin Immunother. 2026 Dec;22(1):2497205. doi: 10.1080/21645515.2025.2497205. Epub 2026 May 30.

ABSTRACT

Vaccination against tetanus, diphtheria, and pertussis (Tdap) is essential to protecting mothers and infants against these severe diseases. In the Kingdom of Saudi Arabia, vaccination coverage among pregnant women remains suboptimal, with only 25-30% of pregnant females. The analysis of their knowledge, attitudes, and behaviors concerning the vaccine will, in turn, help formulate strategies to increase the vaccination rate. A cross-sectional study was carried out on 398 pregnant Saudi women aged 18-40 y using a validated questionnaire examining their knowledge of the vaccine. The study demonstrated that there were significant gaps in knowledge in that 36% of the participants correctly identified pertussis as a highly contagious disease yet preventable by vaccination, while 22% identified its severity in newborns. Better knowledge was associated with higher education attainment, and prior knowledge of vaccination against pertussis in adults was associated with more positive attitudes. A more significant majority of participants reported positive attitudes about vaccination overall, but 71% of them expressed concerns about side effects and safety. The findings indicate a need for targeted educational interventions as far as safety and knowledge gaps are concerned. Improving communication by health providers can increase vaccination uptake among pregnant women to ensure an increase in the protection of mothers and infants against whooping cough.

PMID:42216579 | DOI:10.1080/21645515.2025.2497205

Proteomics. 2026 May 30:e70151. doi: 10.1002/pmic.70151. Online ahead of print.

ABSTRACT

Saffron (Crocus sativus L.) is one of the world’s most valuable spices, renowned for its distinctive aroma, flavor, and pharmacological properties derived from apocarotenoids such as crocin, picrocrocin, and safranal, which accumulate in the stigmas during flower development. Despite their economic and medicinal importance, the molecular regulation of apocarotenoid biosynthesis across floral developmental stages remains poorly understood, particularly at the proteomic level. To address this gap, we applied an LC-MS/MS-based proteomic approach combined with bioinformatic and structural analyses to characterize stage-specific protein expression across five developmental stages: corm with floral shoot buds (A1), flower inside the sheath (S1), just outside the sheath (S2), flower at unopened state (S3), and flower at opened state (S4). Differential abundance analysis, gene ontology enrichment, STRING-based protein-protein interaction networks, KEGG pathway mapping, and structural modeling identified 57 developmentally regulated proteins linked to stigma differentiation and apocarotenoid metabolism. Stage-specific protein sets comprising 128 (A1), 44 (S1), 38 (S2), 29 (S3), and 29 (S4) proteins were selected using stringent statistical thresholds and validated through Limma-based differential expression analysis. Key enzymes, including PSY2, CCD2, ALDH2B4, and UGT707B1, emerged as central regulators of apocarotenoid biosynthesis during floral maturation. Overall, this study provides a comprehensive proteomic framework underlying stigma development and apocarotenoid accumulation in saffron, offering valuable molecular targets for improving metabolite yield and quality. The data supporting this study have been deposited in the ProteomeXchange repository under the identifier PXD076029.

PMID:42216577 | DOI:10.1002/pmic.70151