Tag: nevin manimala

J Vis Exp. 2026 Aug 28;(234). doi: 10.3791/72116.

ABSTRACT

Compound acid chemical peeling is widely used to treat acne vulgaris (AV), but the biological mechanisms underlying its clinical effects remain incompletely understood. We hypothesized that compound acid chemical peeling would improve acne severity and would be associated with changes in the skin microbiome and a reduction in local inflammatory responses in patients with moderate AV. This study aimed to investigate the clinical, microbiological, and inflammatory effects of compound acid peeling in this population. We carried out a prospective, split‑face, randomized trial enrolling 30 patients with moderate AV. One hemiface received compound acid peeling twice weekly for 3 weeks (6 total sessions), followed by a 9‑week observation period. The contralateral hemiface received no treatment for the first 3 weeks and then underwent the same peeling protocol for 3 weeks, with a 6‑week follow‑up. Outcome measures included the Global Acne Grading System (GAGS), patient self‑assessment, standardized facial imaging, skin biopsy with immunohistochemistry, bacterial DNA extraction, PCR amplification, and 16S rRNA gene sequencing. Patients showed a statistically significant improvement in GAGS scores (P < 0.001). Facial imaging analysis revealed reductions in redness and porphyrin readings. Immunohistochemical staining for interleukin (IL)-1α, IL-6, IL-17, transforming growth factor-β (TGF-β), and toll-like receptor 2 (TLR2) was reduced. Skin microbiome alpha diversity decreased, with a notable decrease in the relative abundance of Staphylococcus (P < 0.05). Throughout the study, no adverse events were reported. Compound acid peeling was effective and well-tolerated during the observation period and was associated with changes in the skin microbiome and local inflammatory marker staining.

PMID:42667203 | DOI:10.3791/72116

J Vis Exp. 2026 Aug 28;(234). doi: 10.3791/71894.

ABSTRACT

Short-term associations of omega-3 polyunsaturated fatty acids (PUFA)-enriched oral nutritional supplementation (ONS) with hematological, nutritional, and immune-inflammatory outcomes were evaluated in a retrospective cohort of 87 malnourished or nutritionally at-risk patients with gastrointestinal (GI) cancer. During a 3-week observation period, 46 patients received omega-3 PUFA-enriched ONS plus dietary counseling, whereas 41 received dietary counseling alone. The groups differed at baseline in tumor site, body-weight status, and recent weight loss, whereas oncological treatment category and supportive treatment did not differ statistically. Unadjusted change analyses showed a smaller decline in neutrophil (NE) count in the ONS group (P for Δ = 0.007), whereas between-group differences in white blood cell (WBC) and platelet (PLT) changes were not statistically significant. The larger reductions in the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) in the control group coincided with greater declines in NE and PLT and were therefore not interpreted as evidence of an anti-inflammatory benefit. In linear regression models adjusted for the corresponding baseline value, tumor site, and weight-loss status, ONS receipt was associated with higher week-3 body weight (adjusted difference, 1.49 kg; 95% CI, 0.58-2.39; P = 0.002), body mass index (BMI) (0.51 kg/m²; 95% CI, 0.19-1.02; P = 0.002), WBC (1.08 × 10⁹/L; 95% CI, 0.24-1.92; P = 0.012), and NE count (0.97 × 10⁹/L; 95% CI, 0.30-1.64; P = 0.005). Adjusted NLR was also higher in the ONS group (adjusted difference, 0.60; 95% CI, 0.07-1.13; P = 0.028), whereas PLT, C-reactive protein (CRP), PLR, SII, albumin (ALB), and prognostic nutritional index (PNI) did not differ significantly. Thus, receipt of omega-3 PUFA-enriched ONS was associated with a potential myeloprotective effect and more favorable short-term weight outcomes, but not with a consistent reduction in systemic inflammation.

PMID:42667193 | DOI:10.3791/71894

Eur J Oral Sci. 2026 Aug 29:e70136. doi: 10.1111/eos.70136. Online ahead of print.

ABSTRACT

This systematic review investigated the osteogenic effects of platelet concentrate (PRF/PRP) when combined with non-autogenous graft materials in sinus lift procedures. Key characteristics assessed included platelet concentration, total platelet dose, leukocyte content, and fibrin-network structure. A comprehensive search of EMBASE OvidSP, PubMed, and the Cochrane Library was conducted in April 2026, resulting in the inclusion of 25 articles. Studies were broadly categorized according to whether they reported enhanced osteogenic outcomes or not: positive studies (n = 15) and negative studies (n = 10). A key finding is that positive studies used a higher total platelet dose than negative studies (8.02 × 10⁹ vs. 3.67 × 10⁹). A subgroup meta-analysis of eight randomized controlled trials (RCTs) found that the five high-dose studies, using approx. ≥10 × 10⁹ platelets, demonstrated a significant increase in new bone formation (effect size: 1.04; p < 0.01). In contrast, the three low-dose studies showed a modest but nonsignificant effect (effect size: 0.49; p = 0.355). However, the difference between the two subgroups was not statistically significant. Available evidence suggests that higher platelet doses, particularly around ≥10 × 10⁹ platelets, may be associated with more favorable osteogenic outcomes. However, this dose should not be interpreted as a clinically validated threshold.

PMID:42667174 | DOI:10.1111/eos.70136

J Rural Health. 2026 Jun;42(3):e70218. doi: 10.1111/jrh.70218.

ABSTRACT

PURPOSE: Increasing population longevity has led to greater demand for home and community-based services (HCBS) to assist older adults as an alternative to institutional care. Despite the recognized benefits of HCBS, there are significant differences in their availability and utilization between rural and urban communities. This study aimed to (1) compare rural and urban caregivers of older veterans in terms of searching for and receiving services and (2) examine differences in expressed interest in various service types.

METHODS: Five hundred and eleven older veterans’ caregivers completed an online survey on various HCBS. Rural-Urban Commuting Area codes (RUCA) were utilized to determine rurality, and data were analyzed using chi-squares, t-tests, and logistic regressions.

FINDINGS: There were no differences in service interest between urban and rural caregivers. However, there were differences between the services searched for and those received. Urban caregivers were less likely than rural caregivers to seek respite. Urban caregivers also reported receiving more services than rural caregivers.

CONCLUSION: This study indicates that rural and urban caregivers’ interest in services is similar; however, rural veterans receive fewer HCBS than their urban counterparts. This study highlights potential gaps in the service pathway for rural caregivers. It provides insights into which specific services might benefit from targeted interventions to improve access and utilization for veterans in rural areas. The findings directly inform evidence-based resource allocation, targeted program development, and policy interventions designed to mitigate rural-urban disparities in caregiver support.

PMID:42667160 | DOI:10.1111/jrh.70218

Womens Health (Lond). 2026 Jan-Dec;22:17455057261485000. doi: 10.1177/17455057261485000. Epub 2026 Aug 29.

ABSTRACT

BackgroundGlobally, intimate partner violence and sexual violence (IPV/SV) are prevalent among women and can lead to numerous and overlapping service needs. Co-located service models for IPV/SV aim to reduce burden on survivors and increase timely engagement in services by streamlining access to immediate and longer-term support. These models involve multiple cross-disciplinary partners and require a high level of tailoring and adaptation to the local and agency context. Consequently, fidelity measurement approaches need to be adaptive.ObjectivesThis study redefines co-located IPV/SV centers (e.g., Family Justice Centers) as complex health interventions and applies the form and function matrix advanced within the field of implementation science.DesignThe current study uses cross-sectional data collected as part of a larger formative evaluation testing protocols for an implementation study and outcome evaluation.MethodsA researcher-developed adaptive fidelity survey was administered to agency leaders from six co-located IPV/SV centers to determine the core functions and adaptable forms of co-located service models along with the necessary infrastructural support. Univariate statistics and a descriptive content analysis approach were used to analyze the survey data.ResultsSurvey findings showed that there are core services, partners, infrastructure, and processes that many or most respondents believed to be essential to the functioning of the co-located center. However, respondents also believed that implementation of these elements could vary without diminishing the effectiveness of the model.ConclusionsFindings highlight that there are many ways to accomplish the same function, which underscores the need for a flexible and adaptive measurement approach to capturing fidelity in function and variation in form. This study adds to the research on limitations of fidelity assessment for complex health interventions and suggests focusing on the hypothesized relationships between structural elements of the model and intermediary outcomes.

PMID:42667157 | DOI:10.1177/17455057261485000

J Nurs Manag. 2026;2026(1):e8900636. doi: 10.1155/jonm/8900636.

ABSTRACT

AIM: To examine the associations of interpersonal justice with work engagement and burnout among hospital nurses in Japan, and to test whether job satisfaction moderates these relationships.

DESIGN: A cross-sectional study using structural equation modeling (SEM), grounded in job demands-resources framework.

METHODS: Survey data were collected between 2016 and 2017 from 2773 nurses across 10 Japanese hospitals. Interpersonal justice was operationalized using workplace fairness and gender equality indicators. Work engagement and burnout were measured using study-specific indicators. SEM was used to test direct and moderated pathways, with theoretically justified modifications to the measurement model resulting in acceptable fit (RMSEA = 0.052; CFI = 0.987; TLI = 0.976; SRMR = 0.023).

RESULTS: Interpersonal justice was independently associated with higher work engagement (β = 0.28, p < 0.001) and lower burnout (β = -0.28, p < 0.001). Job satisfaction also predicted both outcomes but did not moderate the effects of interpersonal justice. These findings suggest that fair and equal work environments support nurse well-being regardless of overall job satisfaction.

CONCLUSION: Interpersonal justice represents an important component of healthy work environments that may inform management interventions aimed at strengthening the nursing workforce in Japan and similar contexts.

IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers and healthcare leaders can help promote nurse well-being by fostering fair and equal workplace interactions through transparent decision-making, equitable workload allocation and promotion practices, inclusive leadership, and mechanisms for addressing discrimination and unfair treatment. Such efforts may support higher work engagement, lower burnout, and a more sustainable nursing workforce.

PMID:42667141 | DOI:10.1155/jonm/8900636

Inquiry. 2026 Jan-Dec;63:469580261483969. doi: 10.1177/00469580261483969. Epub 2026 Aug 29.

ABSTRACT

Administration of comprehensive geriatric assessment is time-consuming and labor intensive. A new instrument, the Integrated Self-Screening Instrument for Geriatric Health Testing (INSIGHT), was developed to quickly identify common geriatric problems. The present study evaluated the clinimetric properties of the INSIGHT. Content Validity Index (CVI) was measured via expert review. Older adults (≥65 years) attending geriatric outpatient visits for the first time (N=224) completed the INSIGHT. Internal consistency was calculated using McDonald’s ω, greatest lower bound, and Cronbach’s α. Factor structure was evaluated using parallel analysis and exploratory factor analysis (EFA) based on domain scores. After two rounds of expert review, scale-level CVI/universal agreement was 0.95, and all scale-level CVIs/average were 1.00. Using the INSIGHT, 15.2% of the 224 participants had no potential health problems identified, while 14.3% had one, and over 70% had ≥ two. Internal consistency was good (> 0.8), and EFA confirmed unidimensionality with all domain factor loadings >0.3. The INSIGHT demonstrates good content validity, internal consistency, and unidimensional structure, supporting its reliability for rapid geriatric health screening.

PMID:42667136 | DOI:10.1177/00469580261483969

FASEB J. 2026 Sep 15;40(17):e72238. doi: 10.1096/fj.202602915R.

ABSTRACT

Gastric cardia adenocarcinoma is biologically distinct from distal disease, but deployable molecular markers remain scarce. We investigated whether explainable deep learning applied to public transcriptomes could nominate diagnostic and survival-associated candidates. We developed and externally evaluated an explainable transcriptome-based classifier. The Asian Cancer Research Group SuperSeries GSE66229 (300 tumors and 100 patient-matched non-tumor tissues) underwent robust multi-array average preprocessing and quality control. An attention-based deep neural network was evaluated by stratified fivefold cross-validation for tumor-versus-non-tumor classification. Inputs were restricted before training to genes available in all cohorts and ordered identically; no missing model inputs were imputed. Shapley additive explanations nominated 20 genes, and univariable Cox models evaluated overall survival associations. External testing without refitting used GSE29272 and The Cancer Genome Atlas stomach adenocarcinoma cohort. Pathway analyses provided biological context. Cross-validated receiver operating characteristic and precision-recall areas under the curve were both 1.00. External values were 0.85/0.93 for cardia and 0.50/0.67 for non-cardia in GSE29272, and 0.78/0.80 and 0.71/0.50, respectively, in The Cancer Genome Atlas cohort. Six genes showed nominal survival associations in GSE66229. None replicated statistically in the strict external cardia subset; LVRN and WISP2 were nominally concordant in the full stomach adenocarcinoma cohort, but neither survived six-test correction. Enrichment implicated immune and lipid-related processes. Explainable deep learning prioritized candidates with stronger external performance in cardia-versus-non-tumor contrasts. These exploratory diagnostic and survival findings require clinically adjusted, prospective validation before clinical use.

PMID:42667125 | DOI:10.1096/fj.202602915R

JAMA Netw Open. 2026 Aug 3;9(8):e2634516. doi: 10.1001/jamanetworkopen.2026.34516.

ABSTRACT

IMPORTANCE: Evidence on the safety of atrial fibrillation ablation during rapid growth in both procedural volume and the number of hospitals performing it remains inconsistent. Although clinical registries and randomized trial meta-analyses report extremely low mortality, administrative databases have suggested rates up to 10-fold higher, with concerning temporal increases.

OBJECTIVE: To define the periprocedural mortality risk following elective atrial fibrillation ablation using a validated nationwide database and to determine whether this expansion was associated with diffusion-related safety penalties (ie, transient erosion of safety driven by a widening efficacy-effectiveness gap).

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, nationwide, population-based cohort study used data from a nationwide administrative database of participating cardiovascular hospitals in Japan from April 1, 2012, to March 31, 2023. Analyses were conducted in 2025 to 2026, with follow-up through discharge from the index hospitalization for the primary outcome. Patients with atrial fibrillation who underwent scheduled elective catheter ablation with transseptal puncture were included.

EXPOSURES: Elective atrial fibrillation ablation.

MAIN OUTCOMES AND MEASURES: The primary outcome was in-hospital mortality during the index hospitalization. In-hospital mortality and other event rates are presented as proportions with exact (Clopper-Pearson) binomial 95% CIs. Multivariable analyses used Firth penalized logistic regression.

RESULTS: Among 618 024 catheter ablation procedures, 412 947 were elective atrial fibrillation ablations (median [IQR] patient age, 68 [60-74] years; 288 825 male patients [69.9%]) performed between 2012 and 2022. Annual procedural volume increased from 10 969 procedures in 2012 to 63 014 procedures in 2022. In-hospital mortality occurred in 119 patients (0.029%; 95% CI, 0.024%-0.034%), with a modest but statistically significant decline (P for trend = .04). Within 30 days of the procedure, deaths occurred during the index hospitalization in 91 patients (0.022%; 95% CI, 0.018%-0.027%) and during readmission in 72 patients (0.017%; 95% CI, 0.014%-0.022%). The most frequent concurrent complication among index-hospitalization deaths was cardiac tamponade (26 patients [21.8%]). In Firth penalized multivariable analysis, factors independently associated with in-hospital mortality included older age (odds ratio [OR], 1.04; 95% CI, 1.01-1.07), lower body mass index (OR, 0.94; 95% CI, 0.89-1.00), Charlson Comorbidity Index score of 3 or higher (OR, 4.59; 95% CI, 2.59-8.12), low institutional volume (OR, 2.52; 95% CI, 1.45-4.38), and preserved functional status (Barthel Index >90; OR, 0.11; 95% CI, 0.07-0.19).

CONCLUSIONS AND RELEVANCE: In this Japanese nationwide registry study of 412 947 elective atrial fibrillation ablation procedures, in-hospital mortality was 0.029%, comparable to contemporary registry benchmarks. No evidence of a diffusion-related safety penalty was observed during rapid expansion.

PMID:42667122 | DOI:10.1001/jamanetworkopen.2026.34516

J Nurs Manag. 2026;2026(1):e1251723. doi: 10.1155/jonm/1251723.

ABSTRACT

INTRODUCTION: The ward atmosphere in closed psychiatric wards significantly influences nurses’ well-being and quality of care. However, the formation mechanisms of ward atmosphere perceptions remain underexplored, and previous research has largely overlooked individual heterogeneity in how nurses perceive different dimensions of the ward environment. This study aims to identify distinct profiles of ward atmosphere among psychiatric nurses in closed wards and examine the predictive effects of physical environmental factors and workplace violence on profile membership.

MATERIALS AND METHODS: This quantitative, cross-sectional study adopted mixed nonprobability sampling combining purposive and convenience sampling and collected data via online questionnaires. A total of 1037 psychiatric nurses from 34 hospitals in China completed self-report questionnaires between July and August 2024. Ward atmosphere was measured using the Chinese-version Essen Climate Evaluation Schema. Physical environment characteristics were collected using a self-developed questionnaire. Workplace violence was measured using the Workplace Violence Scale. Latent profile analysis was conducted using Mplus 8.3 to identify distinct ward atmosphere profiles. Multinomial logistic regression (R3STEP) was used to examine predictors of profile membership. All respondents provided electronic informed consent, and the study was approved by the institutional ethics committee.

RESULTS: Three distinct profiles of ward atmosphere were identified: “Triple-High group” (10.8%), “Safety-Deficient group” (77.1%), and “Support-Depleted group” (12.1%). Compared with nurses in the Triple-High group, those in the Safety-Deficient and Support-Depleted groups reported poorer ventilation, smaller ward size, less adequate safety measures, more frequent workplace violence, and higher rates of permission for smartphone use. Greenery, video surveillance, tidiness, and larger ward size differentiated the Safety-Deficient group from the Support-Depleted group.

CONCLUSION: Psychiatric nurses’ perceptions of ward atmosphere are heterogeneous, with the majority experiencing safety deficits. Both physical environmental features and exposure to workplace violence are important predictors of these perceptions. Hospital administrators should implement targeted modifications to the physical environment of the wards and reduce workplace violence to enhance the ward atmosphere.

IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should acknowledge the heterogeneity in nurses’ perceptions of ward atmosphere. Targeted improvements to ward physical environments-such as enlarging ward space, enhancing ventilation, and upgrading safety facilities-are recommended. Effective strategies should also be developed to mitigate workplace violence in closed psychiatric wards. Simple, low-cost environmental adjustments may improve ward atmosphere, potentially alleviate psychological stress, and further contribute to nurse well-being and retention.

PMID:42667118 | DOI:10.1155/jonm/1251723