Tag: nevin manimala

J Intensive Care Med. 2026 Apr 4:8850666261424210. doi: 10.1177/08850666261424210. Online ahead of print.

ABSTRACT

PurposeSerratia marcescens is a well-recognized hospital-acquired pathogen frequently implicated in outbreaks in neonatal and pediatric intensive care units. We compared clinical characteristics of infants with Serratia bloodstream infections (BSI) to those with non-Serratia gram-negative BSI.MethodsA retrospective case-control study comparing infants (0-2 y/o) hospitalized at our referral pediatric cardiac intensive care unit (PCICU), who acquired gram-negative blood cultures, during 2012-2022. Patients were categorized into two groups: S. marcescens BSI versus non-Serratia gram-negative BSI. Demographic and clinical data were extracted from our medical databases.ResultsOf 112 patients meeting inclusion criteria, 40 (36%) had Serratia BSI and 72 (64%) non-Serratia gram-negative BSI. Blood stream infection with Serratia occurred later postoperatively (median 15 vs 7 days, p < .01), were associated with less pre-infection inotropic support (median VIS 0 vs 5, p < .01) and higher rates of multisite involvement (35% vs 18%, p = .04). Duration of indwelling vascular catheters at time of infection was longer in the Serratia group (median 10 vs 7 days, p = .03). No associated mortality was attributed to Serratia BSI, as compared to a 5.6% mortality rate in the non-Serratia group.ConclusionsSerratia BSI in the PCICU tends to develop later during hospitalization, involves more multiple infection sites, and is associated with longer vascular catheters dwell durations at the time of infection. Serratia infections appeared sporadically throughout the year without seasonal clustering. This supports the importance of stringent infection control practices and warrants prospective studies on prevention strategies.

PMID:41934153 | DOI:10.1177/08850666261424210

Breast J. 2026;2026(1):e8459253. doi: 10.1155/tbj/8459253.

ABSTRACT

BACKGROUND: Breast conservation surgery (BCS) is considered to be a low-morbidity procedure; however, postoperative complications may adversely affect the quality of life of breast cancer survivors. Social determinants of health have previously been shown to impact postoperative outcomes in various other medical conditions. However, there is a paucity of literature that comprehensively examines the social determinants that impact BCS complications or how race influences specific surgical outcomes. This study thus seeks to address this gap by analyzing the impact of these factors within our diverse patient population in the Bronx.

METHODS: A retrospective chart review was conducted that examined patients who underwent BCS between January 2016 and December 2022 at a single institution. Patient information, such as comorbidities, Distressed Communities Index (DCI), BMI, race, insurance status, age, pathology, surgery details, adjuvant therapy, and complications, was collected. Univariate and multivariate analyses were utilized to determine the relationship between these variables and postoperative complications.

RESULTS: A total of 627 patients were included in the study. Of these patients, 512 (81.5%) were either Hispanic or African American, 46 patients (7.3%) were White, and 69 (11%) belonged to other races. There was a delay in 37 (6.2%) patients receiving adjuvant therapy. Our study found that higher DCI quintile and higher BMI were associated with a statistically significant increase in overall complication rate (p = 0.044, p = 0.05, respectively). Race had an association with persistent pain (p = 0.003). Former smokers (OR = 3.44, 95% CI [1.419, 8.34], p = 0.0062), hypertensive patients (OR = 3.846, 95% CI [1.13, 13.12], p = 0.0314), and patients who received adjuvant chemotherapy (OR = 2.756, 95% CI [1.117, 6.801], p = 0.0278) had higher odds of developing any complication. Patients who developed any complication were more likely to have a delay in adjuvant therapy than patients who did not have complications (OR = 6.452, CI [2.696, 15.44], p < 0.001).

CONCLUSION: BCS is generally a safe procedure with minimal complications; however, patient-specific factors are associated with increased complication rates which can lead to delays in adjuvant therapy. Future studies with larger sample sizes are needed to adequately compare outcomes among minority racial groups to a larger reference population.

PMID:41934150 | DOI:10.1155/tbj/8459253

Int J Gynaecol Obstet. 2026 Apr 4. doi: 10.1002/ijgo.70946. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to investigate familial transmission patterns in women with endometriosis by generating a customized single-nucleotide polymorphism (SNP) array.

METHODS: Patients aged 18-45 who were diagnosed histopathologically with endometriosis were included in the study. Daughters and mothers of these patients were also included, regardless of whether they were diagnosed with endometriosis or not. The control group consisted of female patients of similar ages who were not diagnosed with endometriosis. The first stage of this investigation was the determination of the genes associated with the SNPs through meta-analyses in the field of endometriosis in the literature. The second stage was the creation of a unique SNP array by determining the SNPs in the selected target genes. We specifically evaluated whether SNPs in the WNT4 gene at locus 1p36.12 (rs7521902), the GREB1 gene at locus 2p25.1 (rs13391619), and the FN1 gene at locus 2q35 (rs1250248) were associated with endometriosis risk in the Turkish population.

RESULTS: The study included 91 participants, comprising 66 women diagnosed with endometriosis and 25 healthy controls. The analysis revealed statistically significant associations for the FN1 (rs1250248, G>A) and the GREB1 (rs13391619, T>C) variants among endometriosis patients and their mothers and daughters, indicating a possible familial genetic link.

CONCLUSION: These findings strengthen the evidence for a hereditary component in endometriosis and suggest that SNP-based genetic profiling may support earlier identification of at-risk individuals, enabling more timely surveillance and clinical intervention.

PMID:41934140 | DOI:10.1002/ijgo.70946

Nurs Open. 2026 Apr;13(4):e70520. doi: 10.1002/nop2.70520.

ABSTRACT

AIM: This study aimed to develop and evaluate a hypothetical model based on Lazarus and Folkman’s stress and coping framework to identify the factors and pathways influencing Generation Z new graduate nurses’ intention to stay in the job.

DESIGN: This model validation study employed a cross-sectional path analysis approach using structural equation modelling.

METHODS: The participants were 215 nurses born after 1995 who had < 1 year of nursing experience and were working at three general hospitals located in Seoul, Korea. Structural equation modelling was used to analyse the collected data, and the model was validated through confirmatory factor analysis. Key variables included character strengths and job resources (exogenous) and reality shock, work-life balance and intention to stay (endogenous). Path analysis with phantom variables was conducted to explore mediating effects.

RESULTS: The model showed proper fit indices: χ²/df = 2.34, TLI = 0.90, CFI = 0.91, RMSEA = 0.08, SRMR = 0.06. Character strengths (ß = 0.41, p < 0.001) and reality shock (ß = -0.75, p = 0.002) had significant direct effects, explaining 53.5% of the variance in intention to stay. Reality shock also mediated the relationships between character strengths, job resources and intention to stay, emphasising its pivotal role in retention strategies for Generation-Z nurses. The findings indicate that character strengths and reality shock are important factors in the intention to stay of new graduate nurses in Generation-Z.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:41934133 | DOI:10.1002/nop2.70520

West J Nurs Res. 2026 Apr 3:1939459261431011. doi: 10.1177/01939459261431011. Online ahead of print.

ABSTRACT

BACKGROUND: The U.S. nursing workforce faces persistent challenges, worsened by a 3.3% decline of nurses and high rates of emotional exhaustion, job dissatisfaction, and moral injury. An aging population drives rising demand for acute and long-term care, requiring proactive pathways for a healthy, competent workforce. This demands precise national and local insights, yet federal and state data sources complicate addressing current and future issues.

OBJECTIVE: We examined registered nurse (RN) workforce data from common federal and state sources, highlighting data set strengths, discrepancies, implications, and use cases.

METHODS: Using Minnesota as an example and California as a contrast, we compared workforce data sources, quantified projected shortages or surpluses, and drew actionable conclusions for nurse leaders and policymakers.

RESULTS: Substantial differences exist in nursing workforce data sets’ completeness and utility. State licensure and survey data provide complete nurse lists and voluntary samples on elements like intent to leave, focusing on supply and characteristics but not growth, demand, or shortages. Bureau of Labor Statistics and similar national data sets support modeling growth and demand but offer little on supply, characteristics, or maldistribution. For example, one source projects 5.6% national RN job growth by 2032, while another forecasts 10% supply and 11% demand growth. These projections are difficult to model due to assumption limitations, capturing long-term trends well but often missing short-term ones.

CONCLUSION: Accurate, complete historical data sets form the foundation for workforce planning and analyzing future trends. We must urgently document and study nursing’s endemic challenges and pursue sustainable solutions, requiring reliable, locally relevant data.

PMID:41934117 | DOI:10.1177/01939459261431011

Interdiscip Cardiovasc Thorac Surg. 2026 Apr 3:ivag066. doi: 10.1093/icvts/ivag066. Online ahead of print.

ABSTRACT

Herein, we reported a new technique as the simultaneous ligation of vessels after bronchus section that could facilitate the achievement of Robotic-Assisted Thoracic Surgery (RATS) Right Upper Lobectomy (RUL). The clinical data of all consecutive patients undergoing RATS RUL for management of early-stage Non-Small Cell Lung Cancer (NSCLC) was included in the study. Patients were divided in two groups based on whether RUL was performed by simultaneous ligation of vessels (Simultaneous Ligation Group) or by traditional single isolation-ligation technique (Control group). The inter-group differences regarding operative and peri-operative outcomes were statistically compared to assess the feasibility and safety of the procedure. Simultaneous ligation (n = 7) compared to control group (n = 37) was associated with a significant reduction of operative time (127 ± 56 min vs 178 ± 78.5 min; p = 0.01) and with a lower number of staplers used (3.4 ± 1.1 vs 7.5 ± 2.4; p = 0.001) while no significant differences were found regarding the number of resected LN station (p = 0.76) and of resected LN (p = 0.75); blood loss (p = 0.69); daily chest drainage output (p = 0.73); and length of chest drainage (p = 0.81) and of hospital stay (p = 0.86). The median follow-up was 11 months (ranged from 2 to 18 months); no recurrence was observed. Simultaneous ligation of vessels represented a viable option for surgeons in challenging cases, when standard technique was difficult to perform.

PMID:41934113 | DOI:10.1093/icvts/ivag066

Interdiscip Cardiovasc Thorac Surg. 2026 Apr 3:ivag093. doi: 10.1093/icvts/ivag093. Online ahead of print.

ABSTRACT

OBJECTIVES: Most ascending aortic replacements for acute type A aortic dissection (ATAAD) are performed utilizing hypothermic circulatory arrest with an ‘open’ distal anastomosis (‘hemiarch’), whereas some are completed without ever removing the aortic cross-clamp. We sought to determine the impact of distal anastomotic technique in ascending aortic replacement for ATAAD repair.

METHODS: All patients in the IRAD Interventional Cohort database who underwent ATAAD repair between 2010 and 2020 were identified (n = 2559). Data for distal anastomotic technique was available in 2031 patients who underwent ascending aortic replacement, divided into 2 groups, based on whether they underwent hypothermic circulatory arrest (Clamp Off, n = 1900 {93.5%}) or not (Clamp On, n = 131, 6.5%}). We then propensity-matched 101 pairs of patients and analyzed operative data and short- and mid-term outcomes.

RESULTS: In-hospital mortality for the unmatched population was 13.1% (266 deaths), not statistically different between matched groups (Clamp Off, 11.0% vs Clamp On, 5.1% p = 0.22). There were no statistically significant differences observed in three-year post-discharge survival curves between matched cohorts (Clamp Off, 89.5% vs Clamp On, 90.4%; stratified log-rank p value = 0.46). Major perioperative complications (renal failure requiring dialysis, reoperation for bleeding, respiratory insufficiency) were not significantly different between groups, notably including stroke (Clamp Off, 10.2% vs Clamp On, 5.8%, p = 0.32).

CONCLUSIONS: In this propensity-matched cohort, postoperative mortality, major morbidity, and mid-term survival were comparable between open distal anastomosis and clamp-on strategies in selected patients undergoing ascending aortic replacement for ATAAD.

PMID:41934110 | DOI:10.1093/icvts/ivag093

Rheumatology (Oxford). 2026 Apr 3:keag161. doi: 10.1093/rheumatology/keag161. Online ahead of print.

ABSTRACT

OBJECTIVES: Previously, tumour necrosis factor inhibitors (TNFi)-exposed infants were recommended to withhold rotavirus vaccination until 6 months due to infection risk. Guidelines have recently supported earlier vaccination, although safety data remain limited. We aimed to compare diarrhea risk (during early [1.5-6 months] and later [6-24 months] infancy) in TNFi-exposed infants who received rotavirus vaccination before 6 months vs those unvaccinated by 6 months.

METHODS: We identified 3,167 TNFi-exposed offspring in MarketScan commercial claims born to mothers with chronic inflammatory diseases between 2011-2021. Early vaccination was defined as ≥ 1 rotavirus dose between 1.5-6 months and modelled as time-varying. Diarrhea events were identified using ICD-9/10 codes from hospitalizations, outpatient visits, or emergency department visits. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for diarrhea events in vaccinated vs unvaccinated infants.

RESULTS: Among TNFi-exposed offspring, no statistically significant association was found between early vaccination and diarrhea risk during early (101 events; HR 1.04; 95% CI 0.65, 1.68) or later infancy (283 events; HR 1.16; 95% CI 0.87, 1.55). Patterns remained consistent among infants exposed to TNFi in the third trimester (1.5-6 months: HR 1.07; 95% CI 0.62, 1.85; 6-24 months: HR 1.10; 95% CI 0.79, 1.52) and those exposed to high-placental transfer TNFi in the third trimester (1.5-6 months: HR 0.93; 95% CI 0.51, 1.70; 6-24 months: HR 1.09; 95% CI 0.77, 1.56).

CONCLUSION: Eaxsrly rotavirus vaccination in TNFi-exposed infants did not increase diarrhea risk, even for those exposed late in pregnancy. Findings support early vaccination and reinforce updated recommendations.

PMID:41934107 | DOI:10.1093/rheumatology/keag161

J AOAC Int. 2026 Apr 3:qsag015. doi: 10.1093/jaoacint/qsag015. Online ahead of print.

ABSTRACT

BACKGROUND: The SureFast® Listeria 3plex ONE Kit uses the real-time polymerase chain reaction (PCR) technique for multiplex detection of Listeria species and Listeria monocytogenes in foods and environmental samples. The SureFast® Listeria 3plex ONE Kit can also be used with the SureFast® PREP Bacteria Kit to provide a second DNA extraction option and can be analyzed on multiple thermocyclers.

OBJECTIVE: The kit was evaluated using 25 g test portions in an unpaired study design for a single matrix, ready-to-eat smoked deli turkey as part of a harmonized validation protocol with MicroVal Certification.

METHODS: The matrix was compared to the International Organization for Standardization Technical (ISO) 11290-1:21017 reference standard. 17 participants from 16 laboratories, located within Austria, Germany, Italy, Spain, and the United States were solicited for the multi-laboratory validation (MLV), with only 10 participants submitting data. Three levels of contamination were evaluated: an uninoculated control level (0 colony forming units (CFU)/test portion), a low inoculum level (0.2-2 CFU/test portion) and a high inoculum level (2-10 CFU/test portion). Statistical analysis was conducted according to the Probability of Detection (POD) statistical model.

RESULTS: Results obtained for the low inoculum level test portions produced a dLPOD value with 95% confidence interval of -0.01 (-0.04, 0.02). The dLPOD results indicate equivalence between the candidate method and reference method for the matrix evaluated and the method demonstrated acceptable multi-laboratory reproducibility as determined in the MLV. False positive and false negative rates were determined for the matrix and produced values of 0.0% and 0.8% respectively.

CONCLUSIONS: Based on the data generated, the method demonstrated equivalence to the ISO reference method in a MLV study.

HIGHLIGHTS: The SureFast ONE 3plex method is a rapid and reliable alternative for the multiplex detection of Listeria species and Listeria monocytogenes in a broad range of foods and environmental surfaces.

PMID:41934106 | DOI:10.1093/jaoacint/qsag015

Nurs Open. 2026 Apr;13(4):e70490. doi: 10.1002/nop2.70490.

ABSTRACT

AIM: To assess the incidence of delayed chemotherapy-induced nausea and vomiting (CINV) and identify key risk factors among adult patients.

DESIGN: A descriptive cross-sectional design.

METHODS: A total of 326 adult patients undergoing chemotherapy were recruited using consecutive sampling from a nearly 4000-bed tertiary general hospital in Shanghai, China, between July 2023 and April 2024. Demographic and health status data were collected within 24 h of patient admission. Clinicopathologic information was retrieved from nursing documents and electronic medical records. Delayed CINV was measured on the third day post-chemotherapy via telephone interviews using the Common Terminology Criteria for Adverse Events (CTCAE 5.0). Statistical analyses included univariate analysis, random forest modelling, least absolute shrinkage and selection operator (LASSO) analysis and binary logistic regression.

RESULTS: Among 326 participants, 113 (34.7%) reported delayed nausea and/or vomiting, with 32.2% (n = 105) experiencing delayed nausea and 13.2% (n = 43) experiencing delayed vomiting. The step-by-step analysis identified anxiety, motion sickness and high emetogenicity of chemotherapy agents as key risk factors for delayed CINV. Post hoc analysis showed that body mass index (BMI) and history of delayed nausea or vomiting during previous chemotherapy cycles emerged as important predictors that should be considered when assessing the risk of delayed CINV.

CONCLUSIONS: Health care providers should be vigilant in recognising patients at high risk for delayed CINV. Early and targeted prophylactic interventions are recommended to mitigate the risk of delayed CINV.

REPORTING METHOD: The study followed the STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:41934104 | DOI:10.1002/nop2.70490