Tag: nevin manimala

Rev Med Virol. 2026 Jan;36(1):e70102. doi: 10.1002/rmv.70102.

ABSTRACT

Persistent high-risk Human Papillomavirus (HPV) infection causes anogenital and oropharyngeal cancers across all genders. The primary cancer associated with HPV is cervical cancer and the HPV vaccination before sexual exposure is recommended for cervical cancer elimination globally. This scoping review aims to map the preliminary evidence regarding the determinants of adolescent HPV vaccine acceptance and hesitancy during the COVID-19 pandemic in high income countries. A scoping review was conducted as per the updated Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Using the PCC (Population, Concept, and Context) framework, search keywords and search strategies were developed. Electronic databases were searched using specific search terms and the last search date noted as February 8, 2025. A thematic content analysis was carried out to identify the themes and subthemes by a deductive approach. Fourteen studies were included as the potential sources of evidence in this review. The study population included 493,819 adolescents from Australia, Hong Kong, Italy, Poland, Saudi Arabia, and the USA. The themes identified were inequity, attitude and behaviour, knowledge and communication, and engagement and influence. The COVID-19 pandemic generated a negative parental attitude towards HPV vaccines for a brief period. The adolescent HPV vaccine acceptance mainly depended on strong parental support and appropriate access to healthcare professionals and vaccination services. Travel restrictions, lockdowns, school closures, and social distancing contributed to significant HPV vaccine hesitancy in high income countries.

PMID:41482705 | DOI:10.1002/rmv.70102

Med Sci Monit. 2026 Jan 3;32:e950481. doi: 10.12659/MSM.950481.

ABSTRACT

BACKGROUND With the global rise in geriatric populations, femoral fractures in elderly individuals have become a major health burden. This study aimed to evaluate the prognostic value of 3 readily available laboratory-based indices – HALP (hemoglobin, albumin, lymphocyte, platelet), Prognostic Nutritional Index (PNI), and Systemic Immune-Inflammation Index (SII) – in predicting 1-year mortality among elderly patients with femoral fractures. MATERIAL AND METHODS This retrospective cohort study included 309 patients aged ≥65 years who presented to the emergency department of a tertiary university hospital between 2018 and 2023 with low-energy femoral fractures and who underwent surgery. Demographic, clinical, and laboratory data were collected. HALP, PNI, and SII were calculated preoperatively. In-hospital, 30-day, and 1-year mortality were recorded. ROC analysis was used to assess the predictive accuracy of each index. RESULTS One-year mortality was 32.4%, while in-hospital and 30-day mortality were 5.5% and 11%, respectively. Lower albumin and PNI scores were significantly associated with higher mortality at all time points (P<0.001). PNI demonstrated moderate predictive accuracy (AUC=0.659), while HALP had limited but statistically significant predictive value (AUC=0.577, P=0.030). SII did not show statistically significant prognostic value (AUC=0.549, P=0.166). Multivariate analysis showed PNI and HALP are independent predictors of long-term mortality. CONCLUSIONS PNI and HALP are practical, cost-effective tools with prognostic utility in elderly patients with femoral fractures. Early identification of high-risk individuals using these biomarkers may facilitate targeted interventions and improved outcomes. Future multicenter prospective studies are warranted for external validation.

PMID:41482700 | DOI:10.12659/MSM.950481

Aging Cell. 2026 Jan;25(1):e70362. doi: 10.1111/acel.70362.

ABSTRACT

Age-varying DNA methylation sites reflect increasing interindividual epigenetic divergence during aging, offering insights into health heterogeneity and potential for personalized interventions. Leveraging longitudinal DNA methylation data (3 waves over 5 years) from 135 relatively healthy Chinese older adults in the Rugao Longitudinal Ageing Study, we systematically characterized dynamic DNA methylation changes with age via mixed-effects modeling, identifying 125,353 age-associated (i.e., sites showing significant shifts in average methylation levels with age) and 3145 age-varying CpG sites (i.e., sites showing significant interindividual variability in methylation trajectories with age). Functional analysis revealed distinct enrichment profiles: age-associated CpG sites were enriched in nervous system development, cell signaling, and disease-related pathways, whereas age-varying CpG sites were enriched in cell adhesion, synaptic organization, and organ morphogenesis pathways. Notably, both categories showed significant enrichment in nervous system-related pathways, such as regulation of nervous system development and neuronal cell body. Established epigenetic clocks (e.g., HannumAge) were significantly enriched for age-associated CpG sites but not for age-varying sites. Furthermore, we quantified the pace of aging across eight major organ systems and identified 925 significant associations between organ-specific pace of aging and longitudinal methylation change rates at age-varying CpG sites. Pathway enrichment analysis revealed organ system-relevant biological functions-CpG sites associated with a given organ system were often enriched in pathways relevant to that system’s function-with additional evidence of cross-system enrichment. Together, our findings elucidate the role of methylation variability in multi-organ systems aging and its potential for revealing mechanisms of aging heterogeneity and guiding precision monitoring and interventions.

PMID:41482678 | DOI:10.1111/acel.70362

Nurs Health Sci. 2026 Mar;28(1):e70283. doi: 10.1111/nhs.70283.

ABSTRACT

This study aimed to evaluate the validity and reliability of the Turkish version of the Health Protection Behavior Scale (HPBS). The study was conducted using a two-stage cross-cultural research design in accordance with STROBE guidelines. Data were analyzed using descriptive statistics and exploratory factor analysis (EFA), without performing confirmatory factor analysis (CFA) to avoid the use of the same dataset for model derivation and validation. The overall Cronbach’s alpha for the scale was 0.851, indicating high internal consistency. In terms of construct validity, the Healthy Lifestyle Behaviors Scale II and the WHOQOL-BREF showed strong and moderate positive correlations, respectively (p < 0.05). The psychometric properties of the Turkish version of the HPBS are generally good and acceptable.

PMID:41482673 | DOI:10.1111/nhs.70283

Int J Tuberc Lung Dis. 2026 Jan 2;30(1):11-15. doi: 10.5588/ijtld.25.0260.

ABSTRACT

<sec><title>SETTING</title>TB remains a global challenge, requiring diagnostic innovations, especially for TB infection (TBI) cases.</sec><sec><title>OBJECTIVE</title>This study aimed to analyse patent registers related to TB diagnosis in a Brazilian database, promoting reflections on knowledge translation into clinical practice.</sec><sec><title>DESIGN</title>This research on digital documents was carried out in March 2025 in the National Institute of Industrial Property database. Data were assessed descriptively and analysed by using absolute and relative frequencies.</sec><sec><title>RESULTS</title>Of the 62 patents found, 71% were published by 2015, with an average time of 1,274 days between filing and publication. Half of the filers were companies or large corporations. Most patents refer to pharmaceutical compositions also intended for treatment and vaccines. Only six complete kits aimed at detecting TB disease and TBI, based on adenosine deaminase, sputum culture, MPB64 protein, fusion proteins, or synthetic peptide antigens. Some include assays for strains resistant to isoniazid and rifampicin.</sec><sec><title>CONCLUSION</title>The scarcity of registered innovative products reveals gaps in the early diagnosis of TB, especially in TBI. Investments in biotechnology and artificial intelligence may represent promising strategies to strengthen the fight against TB.</sec>.

PMID:41482618 | DOI:10.5588/ijtld.25.0260

Int J Tuberc Lung Dis. 2026 Jan 2;30(1):21-26. doi: 10.5588/ijtld.25.0338.

ABSTRACT

<sec><title>OBJECTIVES</title>Primary objective of the study was to identify TB-associated factors in admitted malnourished children at malnutrition treatment centres, Rajasthan, India.</sec><sec><title>DESIGN</title>A nested case-control study was conducted. Clinical and demographic data were analysed. Crude and adjusted odds ratios were calculated.</sec><sec><title>RESULTS</title>The study included 39 confirmed TB cases and 512 controls. A total of 20 clinical factors were analysed. Bivariate analysis identified three statistically significantly associated factors. These were 1) cough duration of ≥2 weeks (odds ratio [OR] = 5.4; 95% confidence interval [CI]: 2.5-11.6), 2) fever duration of ≥2 weeks (OR = 3.3; 95% CI: 1.4-7.7), and 3) Mantoux test ≥ 5 mm (OR = 4.4; 95% CI: 1.4-14.2). Multivariate regression analysis revealed that 1) cough duration of ≥2 weeks (adjusted odds ratio [AOR] = 4.2; 95% CI: 1.5-11.7) and 2) hepatomegaly (AOR = 2.4; 95% CI: 1.01-5.5) were independently and significantly associated with TB.</sec><sec><title>CONCLUSION</title>Study findings align with paediatric TB diagnostic criteria, which emphasise persistent cough ≥2 weeks as an important criterion of presumptive TB. However, hepatomegaly came out as a new, independently significant associated factor. A study with large number of cases may be undertaken to validate the association of hepatomegaly.</sec>.

PMID:41482617 | DOI:10.5588/ijtld.25.0338

Int Endod J. 2026 Jan 2. doi: 10.1111/iej.70087. Online ahead of print.

ABSTRACT

INTRODUCTION: Diagnosing cemental tears remains challenging, and treatment outcomes can be unpredictable; recommendations for their diagnosis and management are primarily based on case reports and anecdotal experience. Although a classification has been developed for cemental tears, its clinical applicability and importance have yet to be investigated and validated.

AIMS AND OBJECTIVES: This study aims to deepen our understanding of cemental tears through a comprehensive examination of a patient cohort, focusing on: (i) evaluating the cases based on the classification for cemental tears; (ii) assessing clinical presentations, radiographic features, and histopathological characteristics; and (iii) identifying factors that influence diagnosis, treatment approaches, and clinical outcomes.

MATERIALS AND METHODS: This retrospective cohort study evaluated teeth diagnosed with cemental tears at the university’s endodontic clinic from September 2019 to June 2024. The review included case histories, clinical, radiographic and histopathological findings, as well as the treatments performed and their outcomes. Descriptive statistics were used.

RESULTS: Thirty-seven patients with 45 teeth diagnosed with cemental tears were included. Majority of affected teeth (68.9%) had received previous treatment or undergone previously initiated therapy. Among those root treated, most (84.6%) exhibited adequate obturation. Pain, swelling and/or sinus tracts, as well as significant crestal bone loss, were detected in approximately half of the cases. Cone-beam computed tomography (CBCT) scans and direct inspection successfully identified all affected teeth, whereas periapical radiographs (PR) only detected 60.0%. Histopathological analysis revealed cementum in all 37 cases comprising 45 teeth, bone in 11 cases, and cystic lesions in 5 cases. Unfavourable treatment outcomes were observed in 78.9% of teeth classified as Class 4-6. Across all classes, regenerative approaches using enamel matrix derivatives (EMD) achieved favourable outcomes in 44.4% of teeth treated, xenografts in 38.1%, and collagen membranes in 55.6%. Notably, none of the teeth in Classes 4-6 treated with EMD or xenografts demonstrated favourable outcomes.

CONCLUSION: CBCT scans, direct inspection, and histopathological examination demonstrated a higher detection rate compared to PR. Classification is a critical prognostic factor, with Classes 4-6 exhibiting poorer outcomes than others. The impacts of regenerative approaches on periradicular healing appear questionable.

PMID:41482607 | DOI:10.1111/iej.70087

Spec Care Dentist. 2026 Jan-Feb;46(1):e70135. doi: 10.1111/scd.70135.

ABSTRACT

AIMS: Malnutrition is common among individuals with intellectual disabilities, and behavioral resistance may limit access to routine oral care. This study examined the association between refusal of oral care and poor nutritional status.

METHODS: In this cross-sectional study, conducted between February and March 2025, we assessed 55 adults with intellectual disabilities living in two designated residential support facilities for persons with disabilities in Fukuoka, Japan. Nutritional status was evaluated using the Mini Nutritional Assessment-Short Form. Oral care refusal was identified from staff records. Functional and body composition data were obtained using the Functional Independence Measure, Barthel Index, and bioelectrical impedance analysis.

RESULTS: The at-risk/malnourished group had significantly lower BMI, fat mass, and functional scores, and a higher rate of oral care refusal (p = 0.007). Logistic regression showed that oral care refusal [OR = 9.23 (95% confidence interval (CI): 1.10-77.33], lower fat mass [OR = 0.78 (0.66-0.92)] were independently associated with poor nutritional status (FIM-Eating [OR = 0.86 (0.53-1.39)], gender [OR = 0.44 (0.08-2.27)], age [OR = 0.96 (0.90-1.02)]). AUC was 0.90 (0.81-0.98).

CONCLUSION: Oral care refusal may indicate increased risk of malnutrition among adults with intellectual disabilities. Larger, longitudinal studies are needed to confirm these findings.

PMID:41482509 | DOI:10.1111/scd.70135

J Appl Clin Med Phys. 2026 Jan;27(1):e70447. doi: 10.1002/acm2.70447.

ABSTRACT

BACKGROUND: Progress in mitigating plan degradation due to intrafraction patient motion may involve the identification and management of specific control points that are sensitive to motion. Robust planning in this manner could improve deliverable dosimetry and support advancements toward reducing planning target volume (PTV) margins.

PURPOSE: To improve radiotherapy plan quality robustness in the presence of intrafraction motion by identifying the control-point-specific dosimetric sensitivities. This work explores control-point-specific plan characteristics that impact dosimetry by retrospectively assessing the consequence of simulated patient scenarios for cranial radiotherapy.

METHODS: Single target cranial volumetric modulated arc therapy (VMAT) treatment plans (n = 30) were converted into static field plans and reconstructed by applying 3D control-point-specific motion traces (n = 100) using our in-house MATLAB application. PTV coverage (volume covered by 100% of the prescription isodose, VRx) and the differences in minimum dose delivered to 99% (D_99%) of the gross tumor volume (GTV) were examined across the patient cohort as these are pertinent metrics for each structure. To identify the individual control points where motion led to target coverage loss, three patient plans (5 and 14 were randomly chosen, and 19 with the greatest range in prescription dose coverage) were selected for an area under the curve (AUC) analysis of control point dose volume histograms (DVHs). The mean dose difference in the area under the curve of control point DVHs (mAUC), and the standard deviation of differences (sAUC) were the metrics used in the investigation. Multileaf collimator (MLC) aperture areas were also explored as a function of these metrics.

RESULTS: Under conditions of simulated intrafraction motion, PTV coverage spanned from -2.8% to +0.73% of target volume with 78.6% of the three thousand motion traces resulting in coverage loss. There were no changes in GTV D_99% that exceeded ± 1.5%. For the in-depth control point analysis, MLC aperture areas formed weak to moderately weak correlations with sAUC (r = -0.19, r = -0.42, and r = -0.32, p < 0.01 for patient plans 5, 14, and 19 respectively). In addition, two statistically distinct sub-populations of MLC aperture areas were confirmed by Welch corrected t-tests (p < 0.0001, p = 0.02, p = 0.005 for cases 5, 14 and 19) across a threshold of ± 0.05 mGy in mAUC.

CONCLUSION: This work has demonstrated that the dosimetric impact of intrafractional motion reflects the inherent motion sensitivity of specific control points. Our findings suggest that motion sensitive control points could be selectively targeted for gating to enhance robustness against intrafraction motion and improve dosimetry in support of a PTV margin reduction strategy. Single target cranial plans serve as ideal cases to characterize the consequences of motion at the control point level with the aim of expanding the analysis to other anatomical regions.

PMID:41482505 | DOI:10.1002/acm2.70447

BJU Int. 2026 Jan 2. doi: 10.1111/bju.70130. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the cost-effectiveness of proficiency-based progression (PBP) training compared to conventional surgical training approaches, and to determine whether PBP training implementation is economically justified when scaled to large numbers of trainees.

METHODS: Economic analysis was performed using data from the prospective, randomised, and blinded Orsi Surgical Skills E-learning Trial (OSSET; ClinicalTrials.gov identifier: NCT04541615) at ORSI Academy (Belgium), where 47 medical trainees without prior robotic surgery experience were randomised into four groups, each with progressively reduced adherence to the PBP methodology. All trainees completed simulation-based training on a validated bladder-urethra anastomosis model, ranging from full PBP training with metric-based assessment and proficiency benchmarks (Group 1) to a traditional apprenticeship model (Group 4). The primary outcome was training cost, evaluated per trainee and based on programme scalability (12-500 trainees), including expenses for accommodation, laboratory time, and metric development. Cost equivalence points and scalability thresholds were identified to compare the financial impact of the four training strategies.

RESULTS: The PBP training was more expensive than conventional methods for small cohorts (e.g. €14 139 vs €7067 per trainee for 12 trainees), but became significantly more cost-effective beyond 25 trainees (equivalence point). At 500 trainees, total PBP training cost was €1.69 million compared to €3.53 million for conventional training, a 110% cost advantage. All differences were statistically significant (P < 0.001).

CONCLUSIONS: We conclude that PBP training is significantly more effective and becomes increasingly cost-efficient as the number of trainees increases. These findings support its integration into high-volume national training programmes, offering a scalable and economically sustainable alternative to apprenticeship-based surgical education.

PMID:41482504 | DOI:10.1111/bju.70130