Tag: nevin manimala

Scand J Caring Sci. 2026 Mar;40(1):e70190. doi: 10.1111/scs.70190.

ABSTRACT

AIMS AND OBJECTIVES: Patients’ perspectives on quality of care are vital, and cross-country comparisons of inpatient settings can provide valuable insights. This study aims to describe and compare Norwegian and Swedish patients’ perceptions of the quality of their inpatient mental healthcare. It also explores how admission status (voluntary vs. involuntary), demographics and clinical characteristics are associated with these perceptions.

ETHICAL ISSUES AND APPROVAL: The study adhered to the Declaration of Helsinki and received approval from the Regional Ethical Committees in both countries.

RESEARCH METHODS: A cross-sectional, descriptive-comparative design was applied. Adult inpatients meeting inclusion criteria were recruited from 21 mental health hospital wards in Norway and Sweden using convenience sampling. Data were collected using the validated Quality in Psychiatric Care-Inpatient (QPC-IP) instrument. Of 354 returned questionnaires, 40 were excluded due to missing data, leaving 155 Norwegian and 159 Swedish for analysis. Descriptive statistics and inferential analyses were conducted to examine differences (p ≤ 0.05).

OUTCOME MEASURES: Perceived quality of mental healthcare, measured with the QPC-IP.

RESULTS: Norwegian patients reported significantly higher perceived quality of care than Swedish patients across all QPC-IP dimensions: Encounter, Participation, Discharge, Support, Secluded Environment and Secure Environment. Significant interactions between country and admission status were observed on the Support and Discharge dimensions, with involuntarily admitted Swedish patients reporting the lowest quality of care.

STUDY LIMITATIONS: Although the study included multiple hospitals in both countries, the sample size was relatively small. While not designed to yield generalisable results, the limited sample may still restrict transferability. Data was collected during different time periods, which may have introduced time-related variation.

CONCLUSIONS: The findings reveal significant differences in perceived quality of mental healthcare between the two settings, underscoring the need to explore factors contributing to these disparities.

PMID:41578152 | DOI:10.1111/scs.70190

Nat Commun. 2026 Jan 23. doi: 10.1038/s41467-026-68707-7. Online ahead of print.

ABSTRACT

Brain age prediction has been widely utilized to assess functional connectivity (FC) development, but conventional global brain age indices are limited in capturing spatial heterogeneity across the cortex. This study introduces a regional brain development index to characterize fine-grained FC maturation across cortical regions. We examined its spatial variability and stratified individuals into subtypes with distinct region-wise FC developmental patterns. Using data from the Philadelphia Neurodevelopmental Cohort (ages 8-23 years), we identified three distinct subtypes and found that individuals with advanced FC developmental pattern aligning with the sensorimotor-association axis exhibited superior cognitive performance. Robustness was confirmed through replication in the Human Connectome Project Development cohort. Further analyses revealed associations between FC development and gene expression linked to neural differentiation, synaptogenesis, and myelination. These findings suggest that spatial heterogeneity in FC development reflects cortical microstructure and hierarchical organization, underscoring its critical role in neurocognitive maturation during youth.

PMID:41578132 | DOI:10.1038/s41467-026-68707-7

Nat Commun. 2026 Jan 23. doi: 10.1038/s41467-026-68714-8. Online ahead of print.

ABSTRACT

Despite decades of neuroimaging research, how white matter develops along the length of major tracts in humans remains unknown. Here, we identify fundamental patterns of white matter maturation by examining developmental variation along major, long-range cortico-cortical tracts in youth ages 5-23 years using diffusion MRI from three large-scale, cross-sectional datasets (total N = 2716). Across datasets, we delineate two replicable axes of human white matter development. First, we find a deep-to-superficial axis, in which superficial tract regions near the cortical surface exhibit greater age-related change than deep tract regions. Second, we demonstrate that the development of superficial tract regions aligns with the cortical hierarchy defined by the sensorimotor-association axis, with tract ends adjacent to sensorimotor cortices maturing earlier than those adjacent to association cortices. These results reveal developmental variation along tracts that conventional tract-average analyses have previously obscured, challenging the implicit assumption that white matter tracts mature uniformly along their length. Such developmental variation along tracts may have functional implications, including mitigating ephaptic coupling in densely packed deep tract regions and tuning neural synchrony through hierarchical development in superficial tract regions – ultimately refining neural transmission in youth.

PMID:41578121 | DOI:10.1038/s41467-026-68714-8

J Gen Intern Med. 2026 Jan 23. doi: 10.1007/s11606-026-10172-5. Online ahead of print.

ABSTRACT

BACKGROUND: Opioid use disorder (OUD) is responsible for significant morbidity and mortality in the USA. Hospitalization rates for patients with OUD have increased over the recent decades. Those with OUD have a substantially higher rate of patient-directed discharge (PDD) than those without OUD. There have been mixed results when examining the association between inpatient MOUD and PDD.

OBJECTIVE: To determine the association between inpatient MOUD and the rate of PDD among patients without evidence of MOUD treatment prior to hospitalization.

DESIGN: Retrospective study comparing admissions receiving inpatient MOUD and propensity score-matched control admissions who did not receive MOUD.

SUBJECTS: Two thousand seven hundred seventy-one admissions with a diagnosis of OUD and without evidence of prior MOUD treatment were compared to 2771 propensity-matched admissions.

INTERVENTION: Provision of inpatient MOUD, either buprenorphine or methadone during admission.

MAIN MEASURES: Primary outcome was patient-directed discharge. Secondary outcomes were buprenorphine prescription at discharge, buprenorphine prescription within 60 days of discharge, admission into an outpatient methadone program within 30 days of discharge, 30-day readmission, and 30-day post-discharge ED visit.

KEY RESULTS: Among 5542 admissions with OUD and no evidence of MOUD prior to admission, those that received inpatient MOUD were significantly less likely to have a PDD (11.9% vs 14.4%; OR 0.80 [CI 0.67-0.96]) and significantly more likely to receive a discharge prescription for buprenorphine (8.6% vs 1.2%; OR 8.04 [CI 5.52-11.71]) and another buprenorphine prescription within 60 days of discharge (5.5% vs 1.1%; OR 5.09 [CI 3.35-7.74]), compared with control admissions who did not receive MOUD. Inpatient MOUD was not significantly associated with admission into an outpatient methadone program within 30 days, 30-day readmission, and 30-day post-discharge ED visit.

CONCLUSIONS: Receipt of inpatient MOUD was associated with a statistically significant reduction in PDD among those with OUD and without evidence of MOUD before admission when compared with propensity-matched admissions which did not receive inpatient MOUD.

PMID:41578099 | DOI:10.1007/s11606-026-10172-5

Pharm Res. 2026 Jan 23. doi: 10.1007/s11095-026-04017-3. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Studies have documented that continuous infusion is superior to bolus infusion in providing longer time with drug concentration above the minimal inhibitory concentration (T > MIC). This porcine study compared steady-state penicillin concentrations in oropharyngeal and frontal sinus tissues following intravenous bolus and continuous administration. EXPERIMENTAL APPROACH: Twelve pigs were randomized to receive either intravenous bolus (Group BI) or continuous (Group CI) infusion of penicillin (1.2 g). Doses were administered at 0, 6, and 12 h, with sampling from 12 to 18 h. Microdialysis was used for sampling in oropharyngeal and frontal sinus tissues, with simultaneous plasma sampling. The primary endpoints were T > MIC for two MIC targets (0.125 (low target) and 0.5 (high target) μg/mL) and attainment of ≥ 50%T > MIC treatment target.

KEY RESULTS: No statistically significant differences were found between Group BI and CI for either MIC target. The ≥ 50%T > MIC target was achieved in all compartments except for the high MIC target in oropharyngeal tissue in Group CI (46%). although no statistical significance, T > MIC in oropharyngeal tissue tended to be longer in Group BI (low target: 98%; high target: 74%) compared with Group CI (low target: 68%; high target: 46%) (p = 0.07 and p = 0.19, respectively).

CONCLUSION AND IMPLICATION: Penicillin bolus and continuous infusion resulted in comparable T > MIC in oropharyngeal and frontal sinus tissues. However, bolus infusion showed a higher likelihood of attaining ≥ 50%T > MIC in oropharyngeal tissue. These findings are specific to the porcine model and dosing regimens used and cannot be directly extrapolated to humans.

PMID:41578093 | DOI:10.1007/s11095-026-04017-3

Aging Clin Exp Res. 2026 Jan 23. doi: 10.1007/s40520-025-03302-2. Online ahead of print.

ABSTRACT

BACKGROUND: Celecoxib is widely used for the management of different chronic musculoskeletal conditions including osteoarthritis (OA), but the comparative effectiveness of 200 mg once daily (OD) versus 100 mg twice daily (BID) in patients with varying baseline pain severity is not fully established.

AIMS: To compare the efficacy of celecoxib 200 mg OD and 100 mg BID in reducing pain among OA patients with moderate or severe baseline pain, using pooled post hoc analyses of two similar randomized controlled trials.

MATERIALS AND METHODS: Data from two 6-week, double-blind, placebo-controlled trials in knee OA (n = 1,360) were pooled. Patients were stratified into moderate (VAS 40-69 mm, n = 675) or severe (VAS ≥ 70 mm, n = 685) pain subgroups. Interventions included celecoxib 100 mg BID, celecoxib 200 mg OD, or placebo. Primary endpoint was change from baseline in VAS pain at weeks 2 and 6, analyzed via mixed-effects model for repeated measures (MMRM) and ANCOVA with last observation carried forward. WOMAC pain score was a secondary endpoint.

RESULTS: Both celecoxib regimens significantly reduced VAS pain scores versus placebo at weeks 2 and 6 in the overall and moderate pain groups (p < 0.05). In severe pain patients, both regimens were superior to placebo at week 2; however, at week 6, only the 200 mg OD regimen retained statistical significance (LS mean difference vs. placebo – 7.45, p = 0.0135), while 100 mg BID did not. WOMAC pain score results mirrored VAS findings, with 200 mg OD showing the greatest improvement in severe baseline pain.

CONCLUSION: Celecoxib 100 mg BID and 200 mg OD are both effective for OA pain relief, in moderate and severe pain. Findings suggest 200 mg OD may confer an advantage in patients with severe baseline pain in the long-term treatment (week 6).

PMID:41578085 | DOI:10.1007/s40520-025-03302-2

Eur Radiol. 2026 Jan 24. doi: 10.1007/s00330-026-12344-7. Online ahead of print.

NO ABSTRACT

PMID:41578081 | DOI:10.1007/s00330-026-12344-7

Eur Radiol. 2026 Jan 24. doi: 10.1007/s00330-025-12303-8. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the performance of model-based dynamic contrast-enhanced (DCE)-MRI and diffusion-weighted imaging (DWI) in determining the disease activity of thyroid-associated ophthalmopathy (TAO), and to establish their additional value to fat-suppressed T2-weighted imaging (FS-T2WI) for staging TAO.

MATERIALS AND METHODS: Seventy-two patients with TAO (48 active, 96 eyes; 24 inactive, 48 eyes) were prospectively enrolled. DCE-MRI, DWI and FS-T2WI were scanned for pre-treatment evaluation. Simplified histogram parameters (min, mean, max) of DCE-MRI-derived K^trans, K_ep and V_e, apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) on FS-T2WI of extraocular muscles were calculated for each orbit and compared between active and inactive groups. Multivariate analyses were used to identify independent indicators for disease activity. Receiver operating characteristic (ROC) curves analyses and DeLong tests were performed to evaluate and compare the performances of the identified significant imaging parameters and their combinations.

RESULTS: Active TAO patients showed significantly higher mean and maximum V_e, higher minimum, mean and maximum ADC, higher minimum, mean and maximum SIR than inactive patients (p < 0.05). Mean SIR (odds ratio (OR) = 3.449, p = 0.002), mean ADC (OR = 1.008, p < 0.001), and mean V_e (OR = 14.138, p = 0.022) were found to be independent predictors of active TAO. Combination of mean V_e, mean ADC and mean SIR outperformed mean SIR alone in staging TAO (area under ROC curves, 0.839 vs 0.769, p = 0.016).

CONCLUSION: DCE-MRI and DWI could determine the disease activity of TAO and provide additional value to FS-T2WI in staging TAO.

KEY POINTS: Question Fat-suppressed T2-weighted imaging was the most commonly used imaging technique for determining the disease activity of thyroid-associated ophthalmopathy; however, its performance needs to be improved. Findings Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted imaging could provide added value to fat-suppressed T2-weighted imaging for determining the clinical activity of thyroid-associated ophthalmopathy. Clinical relevance Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted imaging can provide information about tissue permeability and water molecule diffusion of extraocular muscles in patients with thyroid-associated ophthalmopathy (TAO), and therefore provide additional value to fat-suppressed T2-weighted imaging in staging TAO.

PMID:41578080 | DOI:10.1007/s00330-025-12303-8

Behav Res Methods. 2026 Jan 23;58(2):50. doi: 10.3758/s13428-025-02940-8.

ABSTRACT

Categorization studies, in which stimuli vary along a category continuum, are becoming increasingly popular in psychological science. These studies demonstrate the effect of category ambiguity on various behavioral and neural measures. In such studies, researchers manipulate objective category levels by varying the physical properties of the stimuli, and then use these levels as predictors of behavior-assuming they map directly onto participants’ perceived locations along the category continuum. This approach might not be optimal, considering the variability in participants’ category boundary locations (their point of subjective equality, or PSE). In this tutorial, we propose addressing this issue by estimating participants’ individual points of subjective equality, adjusting category levels relative to these points, and conducting statistical analyses on the subjective category levels. Implementing this method significantly improves the statistical power of the analysis in both experimental and simulated data. Adjusting stimulus levels by the points of subjective equality is highly suited for social categorization studies, in which points of subjective equality vary significantly. On a broader scale, it can be applied to a variety of categorization, discrimination, and decision-making studies.

PMID:41578073 | DOI:10.3758/s13428-025-02940-8

Neurosurg Rev. 2026 Jan 24;49(1):154. doi: 10.1007/s10143-025-04075-y.

ABSTRACT

Trigeminal neuralgia (TN) is a neuropathic pain disorder characterized by severe orofacial pain. The underlying pathophysiological nuances remain under study, and their understanding is key to developing new and more effective therapies for this debilitating disease. The field of cellular therapies for neurological diseases is continuously evolving. This systematic review was performed after the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We sought studies on the preclinical and clinical uses of cellular therapies for trigeminal neuralgia. We included 8 studies encompassing 1 clinical and 7 preclinical applications. Of the preclinical studies, four used Stem Cells from Human Exfoliated Deciduous Teeth (SHED), two used Olfactory Ensheathing Cells (OECs), and one used Bone Marrow Mesenchymal Stem Cells (BMSCs). All preclinical studies showed a statistically significant behavioral improvement in groups receiving cellular therapies compared to controls (p < 0.05), with either local or systemic delivery. In addition, cellular therapies have the potential to mitigate TN by promoting myelin repair, reducing neuroinflammation, and modulating pain-related pathways. The only clinical report in the literature described the incidental use of Adipose-Derived Stem Cells (ADSCs) during a facial cosmetic procedure in a 60-year-old female with a long history of TN, who remained pain-free at 2-year follow-up. These findings highlight the promising role of cellular therapies in the treatment of TN, demonstrating significant behavioral and molecular benefits in preclinical models and a compelling clinical case. Further rigorous clinical studies are necessary to establish their safety, efficacy, and long-term therapeutic impact.

PMID:41578017 | DOI:10.1007/s10143-025-04075-y