Tag: nevin manimala

J Racial Ethn Health Disparities. 2026 Jun 4. doi: 10.1007/s40615-026-03058-z. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to assess the prevalence and impact of food insecurity (FI) among medical students at Howard University College of Medicine (HUCM), a historically Black institution, where data on FI in Black-majority medical student populations remain scarce.

METHODS: In Spring 2025, a cross-sectional survey incorporating the USDA Six-Item Short Form Food Security Scale was distributed to all HUCM medical students. Additional questions assessed demographics, financial concerns, nutrition, and the perceived academic impact of FI. Responses were anonymized and analyzed using descriptive statistics.

RESULTS: Of 120 respondents, 79% identified as Black, 85% relied on loans, and 49% met USDA criteria for food insecurity, with 23% experiencing very low food security. 31% reported unreliable access to healthy foods, and 71% skipped or downgraded meals due to financial or time constraints. More than four in five students expressed concern about basic living expenses, and 35% reported that FI negatively impacted academic performance in the last month. A majority (92%) endorsed the need for on-campus food resources, and 83% indicated willingness to contribute to a student-run garden.

CONCLUSIONS: These findings provide the first institution-level data on FI in a majority Black medical student population and highlight the urgent need to reform financial support models in medical education.

PMID:42240822 | DOI:10.1007/s40615-026-03058-z

Int J Clin Pharm. 2026 Jun 4. doi: 10.1007/s11096-026-02167-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Medication-related hospital admission is a major contributor to preventable patient harm and healthcare burden worldwide. The relationship between age and medication-related hospital admission has not been comprehensively synthesised.

AIM: To evaluate the association between age and medication-related admission in adults and to provide research recommendations.

METHOD: MEDLINE (Ovid), EMBASE, Scopus, Web of Science, PsycINFO, CINAHL, Cochrane Library, and Global Health databases were searched from January 2000 to March 2025. Studies of adults reporting medication-related admission, providing data on participant age for an exposed and comparator group, published in English were included. Studies restricted to children were excluded. Selection through dual, independent title/abstract screening and full-text assessment using predefined eligibility criteria. Disagreements resolved by third reviewer or consensus. Study quality assessed using Joanna Briggs Institute tool for systematic reviews addressing questions of prevalence. Findings were reported descriptively and two meta-analyses were performed. Risk ratios of experiencing medication-related admission by age group (16-64 years-old, 65+years-old) were pooled. Mean ages of those experiencing medication-related admission compared to another cause of admission were pooled. Prediction intervals and sub-group analyses were used to explain heterogeneity.

RESULTS: Fifty studies, recruiting 210,514 participants, were included, with the majority judged as good quality. Thirteen studies exclusively recruited an older cohort, 30 studies were undertaken in Europe. Age data were variably described. The pooled risk ratio 1.64, (95% CI 1.15-2.35, K = 12, I² = 96%, n = 56,101) suggested adults ≥ 65 years had a higher risk of experiencing medication-related admission than younger adults (16-64 years). Studies undertaken in Africa had a higher effect size. The pooled mean difference (2.86 years, 95% CI – 1.63-7.36; p = 0.21, K = 10, I² = 93%, n = 12,440) indicated no statistically significant difference in age between groups. Risk of bias judgement was a statistically significant contributor to heterogeneity. Prediction intervals for both meta-analyses were wide, suggesting that findings of future studies could differ significantly. The certainty of evidence, GRADE approach, was very low.

CONCLUSION: Age is an unreliable predictor for medication-related admission without accounting for confounding and context. Future research should consistently define age categories and better explore other risk factors for medication-related admission.

PMID:42240819 | DOI:10.1007/s11096-026-02167-3

Behav Res Methods. 2026 Jun 4;58(7):187. doi: 10.3758/s13428-026-03057-2.

ABSTRACT

Eye tracking during visual search generates spatiotemporally rich but complex data. Traditional analyses often utilize simplified metrics (saccade landings, dwell time, etc.) that necessarily exclude a substantial fraction of the variance in the raw eye data. Here, we asked if deep learning might aid scientists in objectively incorporating such discarded data into analyses. Convolutional neural networks (CNNs) are supervised machine learning tools that excel at classifying biological data. We built several CNNs that learn from raw eye-position time-course data to classify the location of relevant stimuli (e.g., search targets/distractors). We train each CNN on two-thirds of the data and cross-validate on the rest, comparing classification accuracy to chance via traditional frequentist testing and hierarchical Bayesian modeling. Using data from two of our previous visual search studies (Massa et al., Atten Percept Psychophys 86(4):1108-1119, 2024; Grubb & Li, Atten Percept Psychophys 80:822-828, 2018), CNNs successfully classified the location of distractors with a “history as a sought target,” finding evidence for reflexive, experience-driven overt attention within each oculomotor dataset. Successful prediction of distractor location generalized to a third dataset without additional training (Doyle et al., Atten Percept Psychophys 87:721-727, 2025) and outperformed a traditional saccade-landing metric. Feature visualization illustrated how the CNNs learn from eye-position samples near distractors early in trials and opposite distractors later in trials, suggestive of reflexive attentional allocations towards distractors followed by corrective shifts in gaze. We thus validate our CNN-based approach and highlight its utility in analyzing the spatiotemporally rich data gathered from eye tracking during visual search.

PMID:42240817 | DOI:10.3758/s13428-026-03057-2

Lancet Reg Health West Pac. 2026 May 25;71:101887. doi: 10.1016/j.lanwpc.2026.101887. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: Lung cancer in Taiwan is never-smoking and adenocarcinoma (LUAD) predominant. This study evaluated national LUAD stage-shifts and their association with opportunistic, self-initiated low-dose computed tomography (LDCT) screening.

METHODS: A retrospective study was conducted using Taiwan Cancer Registry (TCR) data (2011-2023), and self-initiated LDCT screening records from five medical centers (2011-2021). Patients were classified as early-stage (stage I) and late-stage (stage II-IV). Outcomes included age-standardized incidence rate (ASIR), age-standardized incidence-based mortality (ASIBM), and average annual percentage change (AAPC) of national LUAD, and screening volume of self-initiated LDCT.

FINDINGS: Among 126,753 LUAD cases 71,159 (56.1%) were females and 87,830 (69.3%) never smoked. The opportunistic self-initiated LDCT screening revealed 70,803 individuals, most never smoked (83.7%) and were male (56.6%). ASIRs of stage 0 (AAPC, 49.6%; 95% confidence interval [CI], 43.3-71.0) and early-stage (AAPC, 13.0%; 95% CI, 12.3-13.7) increased significantly. Conversely, late-stage ASIRs declined in selected subgroups, including never-smoking females aged <55 years (AAPC, -1.9%; 95% CI, -0.3 to -0.9) and in smoking patients aged ≥75 years (males AAPC, -2.3%; 95% CI, -3.1 to -1.5; females AAPC, -3.9%; 95% CI, -6.3 to -1.3). Rising LDCT screening volume descriptively paralleled this stage-shift in never-smoking females. ASIBM declined significantly over time, particularly in advanced-stage disease.

INTERPRETATION: The coexistence of increasing early-stage incidence, largely stable late-stage disease, and declining incidence-based mortality suggests a transition phase characterized by both detection expansion and emerging clinical benefit. The increase in self-initiated LDCT screenings paralleled the stage-shift among never-smoking females, and further research is needed to assess long-term outcomes and cost-effectiveness.

FUNDING: Health Promotion Administration, Ministry of Health and Welfare; the Ministry of Health and Welfare and Formatting the Risk Prediction Models for Never-Smoking Lung Cancer (FORMOSA).

PMID:42239973 | PMC:PMC13227239 | DOI:10.1016/j.lanwpc.2026.101887

Front Med (Lausanne). 2026 May 19;13:1825410. doi: 10.3389/fmed.2026.1825410. eCollection 2026.

ABSTRACT

OBJECTIVES: Alpha-thalassemia is caused by deletional and/or mutational genetic abnormalities. Limited information exists in Saudi Arabia about the genotype-phenotype correlation. We asked if certain changes in laboratory parameters can predict the underlying genetic subgroup.

METHODS: All patients diagnosed with genetically defined alpha-thalassemia at King Saud University Medical City between 2017 and 2024 were included. Data were collected retrospectively. We hypothesized that there is no difference between the mutation and deletion groups in terms of complete blood count, hemoglobin electrophoresis parameters, or ferritin. Mann-Whitney U and independent samples t-tests were used for between-group comparisons. Fisher’s exact or chi-square tests were used for categorical variables. Two-sided p-values of <0.05 were considered statistically significant. A descriptive summary was conducted for all the other variables.

RESULTS: A total of 378 patients were identified with alpha-thalassemia, of whom 276 had deletion, 64 had mutation, and 38 had both mutation and deletion. Of the 340 patients included in the final comparative analysis, the median age was 27 years, and 216 were female. Higher indirect bilirubin (12.3% versus 4%, p-value 0.013), mean red cell distribution width (RDW) (18.8 versus 17.1, p-value of 0.005), and heterozygous genotype status (71.9% versus 57.5%, p-value 0.036) were seen in the mutation group. Hemoglobin H (HbH) detectability was higher in the mutation group than in the deletion group (1.63 versus 0.02, p-value <0.001). These differences in RDW % and HbH detectability held true even after adjusting for sickle hemoglobin (HbS) level, with p-values of 0.006 and <0.001, respectively. No statistical difference was found between the two groups in ferritin level.

CONCLUSION: Alpha-thalassemia mutations create a distinct hematologic phenotype characterized by increased red cell size variability, indirect bilirubin, and HbH compared to deletions, supporting different pathophysiological mechanisms. These could serve as simple laboratory markers to help distinguish between alpha-thalassemia subtypes, supporting the hypothesis that mutations create a more severe hemolytic phenotype than deletions.

PMID:42239965 | PMC:PMC13226189 | DOI:10.3389/fmed.2026.1825410

Front Med (Lausanne). 2026 May 11;13:1829629. doi: 10.3389/fmed.2026.1829629. eCollection 2026.

ABSTRACT

Rosacea is a chronic inflammatory skin disorder characterized by persistent facial erythema. Its clinical assessment relies on the Clinician’s Erythema Assessment (CEA), a subjective scale prone to inter-observer variability. To address the need for diagnostic consistency, this study developed a multimodal artificial intelligence framework for objective CEA grading using standardized VISIA® imaging. We analyzed a retrospective cohort of 1,001 patients. To establish a robust reference standard, three expert dermatologists conducted a multi-step collective audit to reach a unanimous consensus for each case. The framework integrated handcrafted image-derived tabular features with deep learning representations. During training, spatial data augmentations and Focal Loss were implemented to address dataset imbalance and mitigate overfitting. Our results demonstrated that the multimodal fusion model achieved statistically significant improvements over the strong image-only baseline (McNemar’s $p=0.031$ ; DeLong’s $p=0.024$ ), yielding a Macro-AUC of 0.902 (95% CI: 0.862-0.937). Furthermore, to address the ordinal nature of the disease severity, the fusion model achieved a Quadratic Weighted Kappa (QWK) of 0.800 and an Intraclass Correlation Coefficient (ICC) of 0.801 (95% CI: 0.720-0.860), indicating excellent alignment with expert consensus. Error analysis revealed that over 95% of misclassifications in intermediate grades (CEA3) were restricted to adjacent categories, reflecting strong clinical safety. Interpretability analysis via layer-wise relevance propagation confirmed the model’s focus on clinically recognized erythema-prone regions. This study establishes a robust proof-of-concept tool that transforms rosacea assessment from subjective inspection into an objective digital measurement, offering significant translational potential for clinical trials and teledermatology.

PMID:42239947 | PMC:PMC13227112 | DOI:10.3389/fmed.2026.1829629

Front Med (Lausanne). 2026 May 19;13:1819360. doi: 10.3389/fmed.2026.1819360. eCollection 2026.

ABSTRACT

INTRODUCTION: Pediatric medical device development remains limited, particularly for rare and complex conditions such as cyanotic congenital heart disease (CCHD). Although advances in surgery and diagnostics have improved survival, continuous and non-invasive monitoring of metabolic and physiological deterioration is not available outside hospital settings. Wearable devices could address this gap, but their clinical adoption requires alignment with real-world needs, usability, and healthcare workflows. This study aimed to capture clinician perspectives to inform the early development of a wearable multiparametric biosensor for pediatric CCHD within the European OrphaDev4Kids project (EU4H-2023-PJ).

METHODS: A structured, web-based anonymous survey was distributed through EPTRI channels to reach pediatric cardiology experts across Europe, including members of the OrphaDev4Kids Clinical Expert Committee. The questionnaire addressed current monitoring practices in CCHD, unmet clinical needs, usability and compliance, data integration, training requirements, and data governance. Quantitative responses were analyzed using descriptive statistics, and qualitative feedback was descriptively reviewed.

RESULTS: Clinicians reported that current CCHD monitoring relies mainly on imaging and basic physiological parameters, with minimal assessment of metabolic markers and no availability of non-invasive metabolic monitoring. Infancy, both before and after heart surgery, was identified as the most critical phase for remote monitoring. Respondents strongly supported non-invasive, multiparametric wearable devices providing threshold-based alerts and longitudinal summaries rather than continuous data streams. Comfort, intuitive design, and minimal disruption to daily activities were key determinants of patient compliance, while integration with clinical workflows, training, and technical support were essential for adoption. Clinicians also emphasized the importance of secure, regulation-compliant data handling. Despite limited familiarity with advanced wearable devices, clear and consistent expectations regarding functionality and usability emerged.

CONCLUSION: This expert consultation identifies a clear unmet need and strong clinical support for the development of wearable, multiparametric biosensors tailored to pediatric patients with CCHD. The findings provide actionable guidance for device design and highlight the importance of combining technological innovation with human-centered design, workflow integration, and robust data governance to enable future clinical adoption.

PMID:42239944 | PMC:PMC13226199 | DOI:10.3389/fmed.2026.1819360

J Hand Microsurg. 2026 May 21;18(4):100475. doi: 10.1016/j.jham.2026.100475. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Pyogenic flexor tenosynovitis (PFT) is a common hand infection associated with significant morbidity. Management varies due to lack of evidence-based guidelines, typically involving surgery and antibiotics. We conducted a cohort study, comparing outcomes between different surgical methods to see if one is optimal.

METHODS: Retrospective data collection of patients who underwent surgery for PFT in a single tertiary plastic surgery unit between 21 August 2013 and 4 October 2023 was undertaken. Demographics, injury mechanism, operative details and antibiotic use were recorded. Cases involving cellulitis or osteomyelitis were excluded. Outcomes included length of stay, length of follow-up and post-operative complications. Multivariable regression analyses were performed, adjusting for age, diabetes and smoking status.

RESULTS: A total of 174 patients (mean age 47.2 years [SD 18.7]) were included. PFT most commonly resulted from animal bites (23.7% of cases). There was wide variation in antibiotic prescribing practice. Open surgery was performed in 121 cases, whilst 53 underwent minimally invasive procedures. No statistically significant differences in outcomes were observed between techniques in unadjusted or adjusted analyses. Diabetes was associated with an increased likelihood of requiring further procedures on multivariable analysis.

CONCLUSION: There is no evidence of differing outcomes for open or minimally invasive techniques. Diabetes may be associated with a requirement for further procedures. However, these results should be interpreted in the context of the retrospective design, missing data and potential for confounding by indication. Standardised, evidence-based management guidelines are required, with prospective multi-centre studies needed to better define optimal treatment strategies.

PMID:42239939 | PMC:PMC13227196 | DOI:10.1016/j.jham.2026.100475

Med Devices (Auckl). 2026 May 29;19:595863. doi: 10.2147/MDER.S595863. eCollection 2026.

ABSTRACT

PURPOSE: Uncontrolled bleeding remains a major surgical challenge, increasing morbidity, operative time, and costs, highlighting the need for effective adjunctive hemostats. Veriset is a synthetic, absorbable patch that promotes clotting and provides mechanical hemostasis. While early studies show efficacy, real-world evidence across diverse settings is needed. This post-market, multicenter study evaluated the safety and effectiveness of Veriset in various surgical procedures.

METHODS: This observational, single-arm, prospective study was nested within Medtronic’s product surveillance registry. Sites were selected for procedural diversity (cardiovascular, soft-tissue, solid-organ), high Veriset use, and clinical study experience. Patients treated with Veriset as part of usual care were followed for 30 days post-procedure to monitor adverse events (AEs). The primary safety and effectiveness endpoints were device-related AEs within 30 days and hemostasis within 5 minutes, respectively. Secondary outcomes included time to hemostasis, length of hospital stay, and bleeding-site severity. Results were summarized using descriptive statistics and exact (Clopper-Pearson) confidence intervals.

RESULTS: Veriset was used on-label in 100 patients in cardiovascular (56), soft-tissue (18), solid-organ (18), and other (8) procedures. Most were performed via open surgery (90.0%), with 34% involving anastomoses. Median blood loss was 600 mL (interquartile range 200-1500), with transfusions in 24 patients. Of the 120 bleeding sites treated, pre-Veriset methods included sutures (55.8%, 67/120) and pressure (29.2%, 35/120). Bleeding was mostly mild/moderate (82.5%, 99/120). Device-related AEs occurred in 1 patient, with no deaths. Hemostasis within 5 minutes was achieved at 91.7% (110/120) of sites and in 96.0% (96/100) of patients. Median time to hemostasis was 2.0 minutes; median hospital stay was 7 days.

CONCLUSION: This study provides real-world evidence that Veriset is safe and suggests that it may be an efficacious and rapid adjunct for surgical hemostasis, including in high-risk cardiovascular and solid-organ procedures, supporting and extending prior trial data for routine clinical use.

CLINICALTRIALSGOV IDENTIFIER: NCT01524276, Dec 24, 2025.

PMID:42239929 | PMC:PMC13228841 | DOI:10.2147/MDER.S595863

Saudi Med J. 2026 Feb;47(2):283-290. doi: 10.15537/1658-3175.1009. Epub 2026 Feb 7.

ABSTRACT

OBJECTIVE: To investigate the risk factors, clinical manifestations, and treatment outcomes in patients with Primary Bone Sarcomas (PBS).

METHODS: This retrospective study included all patients with PBS treated between June 2016 and December 2023 at King Abdulaziz Medical City, excluding patients with incomplete data, presence of other malignancies, diagnosis at autopsy, or unknown metastasis. Data were analyzed using SPSS software version 27. A p-value of less than 0.05 was considered statistically significant. Log Rank test was used for survival analysis.

RESULTS: The study included 127 patients. Common past medical history included diabetes (7%), hypertension (5.5%), and metastasis at presentation (15%). Joint pain (76%) and bone swelling (75%) were common clinical presentations. The median overall survival was 5 years, with a 42% mortality rate. The presence of diabetes, hypertension, high Charlson score, high histological grading, and metastasis were more common among patients with osteosarcoma than other types (p < 0.05). Significant predictors of mortality included older age (HR: 1.03, p = 0.009), metastasis at presentation (HR: 8.19, p = 0.042), and metastasis (HR: 2.92, p = 0.010). Male gender (HR: 0.47, p = 0.020) had a lower risk of mortality.

CONCLUSION: This study highlights the significant burden of PBS in Saudi Arabia. Key risk factors such as age and metastasis at diagnosis significantly impact survival, underscoring the necessity for improved surveillance and follow-up strategies. Further research is needed to develop effective, risk-stratified treatment to improve outcomes for patients.

PMID:42239909 | PMC:PMC13227453 | DOI:10.15537/1658-3175.1009