Tag: nevin manimala

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

Phys Occup Ther Pediatr. 2026 May 30:1-14. doi: 10.1080/01942638.2026.2678397. Online ahead of print.

ABSTRACT

AIMS: Family-centered services (FCS) are essential in pediatric rehabilitation to improve outcomes for children with disabilities. Despite global recognition, parents’ perceptions of FCS in Saudi Arabia remain underexplored. This study aimed to examine parents’ perceptions of FCS in pediatric rehabilitation and the relationships between parental perceptions and demographic and clinical factors.

METHODS: A descriptive cross-sectional study was conducted among parents of children with disabilities receiving pediatric rehabilitation services in Saudi Arabia. Data were collected using the Arabic version of the Measure of Processes of Care-20. Descriptive statistics and Spearman correlation analyses were used to explore associations between FCS domains and demographic and clinical factors.

RESULTS: Parents reported moderate to high levels of FCS, with the highest scores in Respectful and Supportive Care (m = 6.34), Coordinated and Comprehensive Care (m = 6.13), and Enabling and Partnership (m = 6.11). Lower scores were observed in Providing General Information (m = 4.93) and Providing Specific Information about the Child (m = 4.84). Significant correlations were found between child diagnosis and information provision and between the number of services and parents’ perceptions of care.

CONCLUSION: Parents’ perceptions FCS to be practiced at a moderate to high level; however, gaps in information sharing remain.

PMID:42216569 | DOI:10.1080/01942638.2026.2678397

J Hum Lact. 2026 May 30:8903344261446162. doi: 10.1177/08903344261446162. Online ahead of print.

ABSTRACT

BACKGROUND: The prescription of infant formula during postpartum hospitalization is one of several factors that influence breastfeeding.

RESEARCH AIMS: To analyze the prevalence of non-exclusive breastfeeding at hospital discharge in Uruguay, a Latin American country, and to identify the predictors of non-exclusive breastfeeding at hospital discharge.

METHOD: This cross-sectional study draws on data from all births between 2008 and 2020 registered in the Uruguayan perinatal information system. XGBoost, a machine-learning algorithm, was used to identify the predictors of infant formula at hospital discharge. A binary variable indicating non-exclusive breastfeeding (1 = yes, 0 = no) was used as dependent variable, and another 35 variables were used as predictors, including mother, child, and hospital characteristics.

RESULTS: The prevalence of non-exclusive breastfeeding at hospital discharge descriptively increased in the period, from 7.0% in 2008 to 27.9% in 2020. The model had a moderately adequate prediction performance (ROC AUC = .781, 95% CI [.778, .785], Brier score = .188, 95% CI [.187, .189], PR AUC = .424, 95% CI [.187, .431]). Hospital type was the most important variable in predicting non-exclusive breastfeeding, followed by birth weight and type of birth. Predicted probability of non-exclusive breastfeeding was highest in public hospitals in the capital (Montevideo), for infants with birth weight lower than 3000 g and higher than 3900 g and born through Cesarean delivery.

CONCLUSION: Results suggest the need to address the structural and procedural factors that may contribute to the prescription of infant formula to improve breastfeeding practices in the country. Additional studies are needed to identify the specific maternity practices that promote the prescription of infant formula at hospital discharge.

PMID:42216514 | DOI:10.1177/08903344261446162

Br J Haematol. 2026 May 29. doi: 10.1111/bjh.70571. Online ahead of print.

NO ABSTRACT

PMID:42216510 | DOI:10.1111/bjh.70571

Clin Implant Dent Relat Res. 2026 Jun;28(3):e70161. doi: 10.1111/cid.70161.

ABSTRACT

OBJECTIVE: To compare the effect of deproteinized bovine bone matrix (DBBM) and horizontal platelet rich fibrin bone block (H-PRF-BB) in transcrestal sinus floor elevation (TSFE).

MATERIALS AND METHODS: This retrospective study included 65 patients receiving 73 implants placed simultaneously with TSFE. Patients were divided into two groups: (1) the H-PRF-BB group (23 patients, 24 implants) and (2) the DBBM group (42 patients, 49 implants). Cone beam computed tomography (CBCT) was obtained pre-, immediate post-surgery and at the follow-up time. Residual bone height (RBH), height of the augmented bone above the apex of the implant (AH), and height of the elevated sinus floor (EH) were measured. The differences between the groups were analyzed using Welch’s t-test or Mann-Whitney U test. The correlations between RBH0 and whether the implant apex was covered with bone were evaluated through Fisher’s exact probability test.

RESULTS: RBH preoperative (RBH0) and immediate postoperative (RBH1) exhibited no statistically significant difference between the two groups. The RBH at the follow up time (RBH2) in the H-PRF-BB group (11.46 ± 0.32 mm) was higher than that of the DBBM group (10.31 ± 0.30 mm), but without statistical significance. The bone height gained immediately after TSFE (EH1) was 6.39 ± 0.43 mm in the H-PRF-BB group and 5.65 ± 0.28 mm in the DBBM group (no statistical difference). Nevertheless, the bone height gained at the follow up time (EH2) was higher in the H-PRF-BB (5.39 ± 0.41 mm) group when compared to the DBBM group (4.04 ± 0.24 mm). The bone height change (ΔH) was minimal in the H-PRF-BB group (-1.02 ± 0.18 mm) compared to that in the DBBM group (-1.80 ± 0.23 mm). The mean AH immediately after surgery (AH1) was comparable in both groups, but was higher above the implant apex in the H-PRF-BB group (2.18 ± 0.28 mm) at the follow up time (AH2) when compared to the DBBM group (1.36 ± 0.16 mm). Lastly, the apex exposure rate was also lower in the H-PRF-BB group (12.5%) compared to the DBBM group (29.8%).

CONCLUSION: H-PRF-BB showed better radiographic outcomes in TSFE compared to DBBM, with an elevated EH2 and AH2. The use of H-PRF-BB was found to reduce the height decrease over time and lessen implant exposure at the apex.

PMID:42216507 | DOI:10.1111/cid.70161