Tag: nevin manimala

J Neurooncol. 2026 Aug 6;179(1):31. doi: 10.1007/s11060-026-05741-x.

ABSTRACT

PURPOSE: This study aimed to determine where along the surgical care pathway race- and ethnicity-associated differences emerge after primary transsphenoidal surgery (TSS) for Cushing’s disease (CD).

METHODS: Single-center retrospective cohort of 104 adults undergoing primary TSS for pathologically confirmed CD (2013-2024): 44 White non-Hispanic (WnH), 44 Hispanic, and 16 Black. Preoperative phenotype, perioperative complications, biochemical remission, radiographic persistence, and reintervention were compared across groups using unweighted statistics (Kruskal-Wallis, chi-square or Fisher’s exact tests). Sensitivity analysis used inverse probability of treatment weighting (IPTW) with a multinomial propensity model; Black subgroup comparisons were considered exploratory.

RESULTS: Hispanic patients lived closer to the center (p = 0.003) and presented with milder disease. Black patients were younger (p = 0.003), with higher BMI (p = 0.033) and near-uniformly solid tumors (94%; p = 0.040). Postoperative arginine vasopressin deficiency was less frequent in Hispanic than WnH patients (25% vs. 55%; p = 0.005). Durable remission rates were comparable (WnH 79%, Hispanic 81%, Black 88%), though Black patients had higher day-1 cortisol and delayed remission on IPTW sensitivity, higher radiographic persistence (38% vs. 21%), and higher crude reintervention (25% vs. 4.5%; p = 0.036). On exploratory IPTW analysis, Hispanic patients also showed shorter reintervention-free survival despite favorable baseline features (IPTW HR 4.20; p = 0.036), a signal not apparent in unadjusted analysis.

CONCLUSION: Race- and ethnicity-associated differences emerged mainly at baseline presentation and in postoperative trajectory, whereas durable biochemical remission converged across groups; Black subgroup analyses were limited by small sample size and residual imbalance after weighting. These hypothesis-generating findings support postoperative surveillance tailored to where differences emerge rather than to ultimate remission and require validation in larger multicenter cohorts.

PMID:42560567 | DOI:10.1007/s11060-026-05741-x

Environ Monit Assess. 2026 Aug 6;198(9):918. doi: 10.1007/s10661-026-15761-9.

ABSTRACT

Reservoir water quality is critical for drinking water security and sustainable watershed management. Land use and landscape patterns can either enhance or attenuate pollutant transport by altering hydrological connectivity, runoff pathways, and retention capacity. However, these effects remain relatively underexplored across seasons and spatial scales in reservoir watersheds. This study used remote sensing data from 2005, 2010, 2015, and 2020 to assess changes in land use composition, land use intensity, and landscape patterns in the Qiaodian Reservoir watershed, Jinan, China. Furthermore, RDA and PLSR were applied to identify the associations between water quality indicators and variations in land use and landscape patterns based on experimental data. The results showed that from 2005 to 2020, land use change was dominated by grassland loss and landscape pine forest expansion, primarily driven by the conversion of grassland to cultivated land (4.79 km²) and cultivated land to landscape pine forest (3.04 km²). The sub-basin and 100 m buffer scales were identified as key spatial scales affecting water quality. On the sub-basin scale, land use demonstrated its strongest capacity to explain water quality in November. Total Edge (TE), Total Area (TA), Landscape Division Index (DIVISION), and Contagion Index (CONTAG) were identified as important landscape metrics associated with reservoir water-quality variation. These findings provide a scientific basis for targeted land management and reservoir water resource protection.

PMID:42560561 | DOI:10.1007/s10661-026-15761-9

Arch Gynecol Obstet. 2026 Aug 6;313(1):245. doi: 10.1007/s00404-026-08548-3.

NO ABSTRACT

PMID:42560555 | DOI:10.1007/s00404-026-08548-3

J Neurooncol. 2026 Aug 6;179(1):32. doi: 10.1007/s11060-026-05748-4.

ABSTRACT

PURPOSE: Central nervous system solitary fibrous tumors (CNS SFTs) are rare mesenchymal neoplasms. The 2021 World Health Organization (WHO) classification recognizes a single SFT entity characterized by NAB2::STAT6-associated biology. This study evaluated clinicopathologic and immunohistochemical features, with particular emphasis on STAT6, CD34, and p16 expression.

METHODS: We retrospectively reviewed 25 CNS SFTs identified between 2004 and 2024. Clinical, radiologic, histologic, immunohistochemical, treatment, and outcome data were collected. Histologic slides were reviewed by two neuropathologists. Immunohistochemistry for STAT6, CD34, and p16 was performed; molecular testing was unavailable.

RESULTS: The cohort included 13 men and 12 women, with a mean age of 51 years. Among tumors with available site data, most were intracranial. WHO grades were grade 1 in 40%, grade 2 in 24%, and grade 3 in 36%. Nuclear STAT6 expression was present in all cases. CD34 expression was greatest in grade 1 tumors, whereas p16 expression was numerically highest in grade 3 tumors; neither marker showed a statistically significant association with recurrence. Tumor size increased across WHO grades. Outcome analyses were limited by few events and heterogeneous follow-up.

CONCLUSION: CNS SFTs are clinicopathologically heterogeneous. STAT6 was a consistent diagnostic marker in this cohort. CD34 and p16 showed grade-related numerical patterns, but their prognostic value was not established. Larger, molecularly confirmed cohorts with standardized long-term follow-up are required.

PMID:42560553 | DOI:10.1007/s11060-026-05748-4

Environ Monit Assess. 2026 Aug 6;198(9):922. doi: 10.1007/s10661-026-15770-8.

ABSTRACT

Missing values are common in air-quality monitoring records and can distort downstream analyses when reconstruction methods do not match the temporal structure of the data. This study examines whether a lightweight seasonal refinement can improve shape-preserving Stineman interpolation for hourly air-quality series and when that refinement is reliable in practice. To address this question, we propose similarity-weighted seasonal anchor Stineman interpolation (SW-SAST), which preserves a local Stineman anchor while selectively borrowing cross-day information when nearby daily analogues are compatible with the local estimate. The method was evaluated on the UCI Air Quality and Beijing PM 2.5 datasets under MCAR, MAR, and MNAR mechanisms, with missing rates from 10% to 50% across 30 repeated runs per condition. The evaluation includes a univariate LSTM reference baseline, RMSE, MAPE, Pearson’s R, confidence intervals, and contiguous gap-length experiments. SW-SAST slightly improved performance on the UCI dataset, especially under MCAR and MAR, but it did not outperform the original Stineman interpolator on the Beijing dataset. The contribution is therefore not a universal replacement for local interpolation, but a clearer account of when similarity-weighted seasonal borrowing can strengthen or weaken imputation in air-quality monitoring records.

PMID:42560544 | DOI:10.1007/s10661-026-15770-8

Cytokine. 2026 Aug 5;206:157196. doi: 10.1016/j.cyto.2026.157196. Online ahead of print.

ABSTRACT

BACKGROUND: Cutaneous verrucae (warts) are benign epidermal proliferations caused by human papillomavirus (HPV) infection. The host immune response particularly T helper 17 (Th17) related cytokines such as interleukin-17A (IL-17A) and interleukin-23 (IL-23) plays a critical role in the regulation of viral control and inflammatory responses. However, the systemic levels of these cytokines in patients with verrucae have not been sufficiently characterized.

OBJECTIVE: To investigate serum IL-17A and IL-23 levels in patients with cutaneous verrucae, to compare them with those of healthy controls, and to evaluate their associations with age, sex, number of lesions, disease duration, and lesion localization.

METHODS: In this case-control study, 49 patients with palmoplantar or anogenital verrucae and 41 age- and sex-matched healthy controls were included. Serum IL-17A and IL-23 levels were measured using enzyme-linked immunosorbent assay (ELISA). Continuous variables were analyzed using the Mann-Whitney U test, and categorical variables using the chi-square test. Correlations between variables were assessed using Spearman correlation analysis.

RESULTS: The median serum IL-23 level was 11.8 pg/mL (interquartile range, IQR: 7.8-21.3) in patients with cutaneous verrucae and 8.8 pg/mL (IQR: 7.2-12.0) in controls, with a statistically significant difference (p = 0.018). The median serum IL-17A level was 16.6 pg/mL (IQR: 8.7-37.9) in patients and 16.4 pg/mL (IQR: 10.9-24.5) in controls, with no significant difference between the groups (p = 0.755). A strong positive correlation was observed between IL-17A and IL-23 levels in patients (rs = 0.880, p < 0.001). No significant associations were found between cytokine levels and age, sex, number of lesions, disease duration, or localization.

CONCLUSION: Elevated IL-23 levels and its strong positive correlation with IL-17A suggest that the IL-23/IL-17Axis may play a role in immune activation associated with HPV-related cutaneous verrucae. IL-23 may represent a potential indicator of immune activation associated with cutaneous verrucae; however, its standalone diagnostic utility appears limited. Future studies with larger cohorts and tissue-level analyses are needed to further elucidate the role of Th17-related cytokines in the pathogenesis of verrucae.

PMID:42556008 | DOI:10.1016/j.cyto.2026.157196

JMIR Form Res. 2026 Aug 5;10:e87124. doi: 10.2196/87124.

ABSTRACT

BACKGROUND: Adolescents and young adults with chronic health conditions often struggle to adhere to their daily oral medications. Transdiagnostic mobile health (mHealth) interventions have the potential to promote medication adherence by reaching youth at a large scale.

OBJECTIVE: This study aimed at designing an adaptive medication adherence mHealth intervention (Adaptive Cell Phone Support), guided by iterative feasibility, usability, and acceptability feedback. A secondary objective was to explore changes in self-reported medication adherence during a field trial.

METHODS: Using human-centered design methods, researchers collaborated with a community advisory board of young adult patients to conduct 3 cycles of iterative design and usability testing. Adolescents and young adults aged 15-20 years (N=22) were recruited from a large pediatric hospital to user-test the intervention. Data collection included self-report questionnaires, think-aloud usability testing, semistructured interviews, and a 3-week field trial. Quantitative measures included the mHealth App Usability Questionnaire Ease of Use and Usefulness subscales, the Theoretical Framework of Acceptability Questionnaire, and visual analogue scales assessing medication adherence, as well as enrollment and engagement metrics. Qualitative data were analyzed using rapid assessment methods to identify actionable design insights, while quantitative data were analyzed using descriptive statistics and paired-samples t tests with a Holm-Bonferroni correction.

RESULTS: Enrollment was 63% and participants completed a mean of 67.2% (SD 23.5) of automated check-ins. Usability and acceptability ratings were relatively high across prototypes (eg, mHealth App Usability Questionnaire Ease of Use was mean 6.40, SD 0.64 for the initial prototype and mean 6.31, SD 0.61 for the third prototype, on a 7-point scale; Theoretical Framework of Acceptability was mean 4.33, SD 0.52 for the initial prototype and mean 4.50, SD 0.53 for the third prototype, on a 5-point scale). Qualitative data emphasized that the intervention was simple, easy to use, convenient, appropriate, and helpful for staying accountable for medication adherence, while also highlighting areas for improvement. Uncontrolled, 2-tailed, pre-post t tests estimated medium-sized improvements in self-reported medication adherence. However, only the percentage of time taking medications over the past month significantly increased (t21=3.26, d=0.70, 95% CI 0.22-1.16; P=.004).

CONCLUSIONS: Integrated qualitative and quantitative results still suggest that more refinement is needed to optimize the intervention. Partnering with community members early in the development of an intervention may improve the ultimate feasibility, usability, and acceptability of digital health tools. Human-centered design offers a rapid, practical, and creative framework for identifying what works and what needs to be improved early in the lifecycle of a new intervention.

PMID:42555969 | DOI:10.2196/87124

JMIR Public Health Surveill. 2026 Aug 5;12:e89958. doi: 10.2196/89958.

ABSTRACT

BACKGROUND: Infectious disease-specific health literacy (IDSHL)-the capacity to obtain, process, and understand basic infectious disease information needed to make appropriate health decisions-is a critical determinant of public health outcomes. The COVID-19 pandemic created an unprecedented global public health education context; yet, its long-term association with population-level IDSHL beyond the pandemic remains unclear. In China, stringent public health measures and digital information campaigns were implemented, yet their lasting impact on IDSHL across different disease domains has not been systematically evaluated over a full pandemic cycle.

OBJECTIVE: This study aimed to evaluate the longitudinal trends in IDSHL among residents of Zhejiang Province, China, from 2019 (prepandemic) to 2024 (postpandemic), and to assess whether the pandemic period was temporally associated with sustained improvements in IDSHL.

METHODS: Six annual cross-sectional surveys were conducted from 2019 to 2024 across 30 counties in Zhejiang Province using consistent multistage stratified random sampling. A validated 12-item IDSHL questionnaire assessed knowledge, behavior, and skills. Annual sample sizes ranged from 17,131 to 19,257 (N=112,917). Data were weighted to the 2020 census population by age and urban or rural residence. Joinpoint regression identified inflection points in the annual proportion of residents with adequate IDSHL (score≥12). Multivariate logistic regression estimated adjusted odds ratios (ORs) for adequate IDSHL by year, with 2021 as the reference (the peak acute pandemic phase), controlling for sociodemographics. All analyses incorporated sampling weights.

RESULTS: Population-weighted overall IDSHL scores increased from 2019 (mean 10.46 SD 3.09) to 2024 (mean 11.40 SD 2.88; P<.001). All subscale scores (knowledge, behavior, and skills) showed upward trends (all P<.001). Joinpoint regression revealed a rapid annual increase in adequate IDSHL during 2019-2021 (annual percent change 9.42%, 95% CI 6.10-13.45; P<.001), which slowed post-2021 (annual percent change 2.28%, 95% CI -0.38 to 3.73; P=.07). Correct response rates surged for pandemic-salient items (eg, respiratory etiquette from 28.44% to 39.67%), while hepatitis B transmission knowledge fluctuated (63.28% in 2019, 60.71% in 2022, 63.84% in 2024), indicating that not all non-COVID-19 content improved monotonically. Adjusted logistic regression showed the lowest odds of adequate IDSHL in 2019 (OR 0.74, 95% CI 0.71-0.78) and highest in 2024 (OR 1.10, 95% CI 1.05-1.15) compared to 2021.

CONCLUSIONS: The COVID-19 pandemic was temporally associated with significant and sustained population-level improvements in IDSHL, particularly for pandemic-relevant knowledge and behaviors. However, gains were time-sensitive and not uniform across all disease domains or demographic groups. These findings underscore the need for postpandemic health strategies that reinforce comprehensive IDSHL through sustained education and address digital divides to bridge persistent equity gaps. Policymakers should prioritize low digital-literacy populations through hybrid (offline+online) educational interventions, and sustain routine surveillance of IDSHL to detect declines in nonpandemic disease knowledge. This study is the first to document six-year population-level IDSHL trends across the full pandemic cycle, providing evidence for future crisis communication and routine health promotion.

PMID:42555965 | DOI:10.2196/89958

JMIR Nurs. 2026 Aug 5;9:e91083. doi: 10.2196/91083.

ABSTRACT

BACKGROUND: Socioemotional competencies (SEC) are essential for nurses to provide quality care and to maintain their own health. Historically underrepresented, nursing programs are changing their curricula to incorporate SEC development more strongly. Although it is recommended to practice SEC during clinical placement, studies on how to support nursing students in developing these competencies are lacking.

OBJECTIVE: Our study explores second-year nursing students’ perceived and actual use of a reflection tool during their first 20-week clinical placement. Designed to support SEC development, the study focuses on how students incorporate the application in their learning process for SEC development.

METHODS: An embedded mixed method study was conducted with 15 students from a nursing program in the Netherlands. Qualitative surveys and semistructured interviews were used to capture students’ experiences with the application both during and at the end of the clinical placement. Log data from the application provided insight into how the app was used. The mixed methods data were analyzed using warranted assertion analysis.

RESULTS: The app helped students relate learning goals to clinical experiences, identify learning opportunities, and experience a sense of growth. Features that removed practical barriers to reflecting were experienced as most beneficial. Although SEC-focused use was limited (n=7), involved students used the app over a longer period of time and reported greater benefits. Nevertheless, 13 students stopped using the app halfway through their clinical placement, as their attitude shifted from learning to working.

CONCLUSIONS: This study gives a rich description of how nursing students used a reflection app to structure their learning process during clinical placement. It reveals that smartphone-based reflection supports students in clinical placement learning. Specifically, the app lowers barriers to engaging in structural reflection and decreases the mental burden of self-regulated learning. However, more guidance and a multimodal intervention approach seem necessary for SEC development. Further research into how to account for students’ shifting attitudes toward learning is needed.

PMID:42555959 | DOI:10.2196/91083

JMIR Form Res. 2026 Aug 5;10:e85102. doi: 10.2196/85102.

ABSTRACT

BACKGROUND: Infant feeding practices, including breastfeeding, are known to benefit maternal and child health outcomes. Therefore, parent access to evidence-based infant feeding advice is critical. In recent years, there has been increased use of digital health technologies to support infant feeding. Despite its potential, using AI to complement existing health care and connect families to timely infant feeding support remains relatively unexplored.

OBJECTIVE: This study aims to explore women’s perceptions of using AI-enabled infant feeding support within mobile health (mHealth) interventions. The study investigates (A) openness to AI-enabled support, (B) experiences with existing AI-enabled support, (C) preferences for SMS text messages generated by AI versus “child and family health” nurses, and (D) opinions on infant feeding topics suitable for AI.

METHODS: Two data collection activities were undertaken with women (primary caregivers) of infants aged 6-14 months, residing in the Hunter New England Local Health District (HNELHD) of New South Wales, Australia. Different women who received antenatal care in HNELHD were recruited for quantitative and qualitative data collection. Quantitative surveys assessed women’s openness to receiving AI-enabled support (objective A). Descriptive and logistic regression analyses were conducted to explore associations between participant characteristics and openness to AI. Qualitative data collection involved focus groups to explore women’s perceptions and preferences on infant feeding topics suitable for AI (objectives B, C, and D). Thematic analysis was used to analyze focus group transcripts.

RESULTS: A total of 164 women completed the quantitative survey. Approximately 53% (87/164) of participants were open to receiving AI recommendations to see a health professional for infant feeding support, 34% (56/164) were open to AI assessing their breastfeeding experiences, and 41% (67/163) were open to AI providing advice to prevent or address breastfeeding challenges. Fewer Aboriginal and Torres Strait Islander participants were open to receiving AI-generated support (adjusted odds ratio 0.41, 95% CI 0.19-0.92) or advice to see a health professional (adjusted odds ratio 0.29, 95% CI 0.13-0.64). Twelve women participated in 3 online focus groups. Thematic analysis resulted in three overarching themes: (1) opportunities to fill gaps in support, (2) variable confidence engaging with AI for information and advice, and (3) potential convenience of AI and mHealth to offer timely support.

CONCLUSIONS: The study highlights the potential of AI and barriers to women’s acceptability and engagement. While women recognized the potential for AI to fill health care gaps in infant feeding support, including after business hours, there was less interest in AI replacing “in-person” support or information easily located via online search. Women’s concerns regarding the credibility and trustworthiness of AI-enabled support should be addressed to maximize their use of emerging AI-enabled tools, embedded within digital technologies and mHealth. There is potential for AI to complement rather than replace usual care.

PMID:42555955 | DOI:10.2196/85102