Tag: nevin manimala

Circ Popul Health Outcomes. 2026 Aug 5:e012988. doi: 10.1161/CIRCOUTCOMES.125.012988. Online ahead of print.

ABSTRACT

BACKGROUND: The American Heart Association Predicting Risk of Cardiovascular Disease EVENT (PREVENT) equations were developed from observational research cohorts and electronic health record data and provide sex-specific risk estimates for cardiovascular disease (CVD), atherosclerotic CVD (ASCVD), and heart failure (HF). External validation in large contemporary samples across multiple health systems in the United States is needed.

METHODS: We assembled a national electronic health record-based cohort of US adults with individual-level patient data pooled from a collective of 30 health systems (Truveta) to externally validate the outcome-specific 10-year PREVENT equations (PREVENT-CVD, PREVENT-ASCVD, and PREVENT-HF). We included patients aged 30 to 79 years without a history of prior CVD and with an ambulatory encounter in the electronic health record between 2013 and 2018. The outcomes were defined as total CVD (composite of ASCVD and HF), ASCVD, and HF through December 2024 using diagnosis codes. Model performance of the outcome-specific PREVENT base equations was assessed with the Harrell C statistic and calibration slope, stratified by sex.

RESULTS: Of the 680 864 adults included, the mean (SD) age was 55 (13) years, and 56% were female. Over a mean (SD) follow-up of 6.8 (2.3) years, there were 29 535 incident CVD events, 19 280 incident ASCVD events, and 16 824 incident HF events. The median (interquartile range) 10-year predicted risk of PREVENT-CVD among women was 3.6% (1.3%-8.8%), and among men was 5.8% (2.5%-11.7%). The C statistic (95% CI) was 0.788 (0.786-0.790), and the calibration slope (95% CI) was 0.98 (0.95-1.01) for PREVENT-CVD. PREVENT-ASCVD and PREVENT-HF demonstrated similar C statistics (0.774 [0.771-0.777] and 0.824 [0.820-0.828]) and calibration slopes (1.07 [1.04-1.10] and 1.01 [0.97-1.04]) for prediction of the 10-year risk of ASCVD and HF, respectively.

CONCLUSIONS: The PREVENT equations accurately and precisely estimate the 10-year risk of CVD, ASCVD, and HF in a large sample of US adults. These findings support the generalizability of the PREVENT equations to inform guideline-recommended risk assessment and preventive efforts.

PMID:42554063 | DOI:10.1161/CIRCOUTCOMES.125.012988

J Clin Nurs. 2026 Aug 5. doi: 10.1111/jocn.70480. Online ahead of print.

ABSTRACT

AIM: To identify the barriers to timely access to palliative care from the perspective of Australian inpatients and their families.

DESIGN: A co-designed mixed methods study with an equal status explanatory design (QUAN ➔ QUAL).

METHODS: Quantitative data were collected in Phase 1 via surveys to assess participants’ knowledge and experience of palliative care. In the second phase, qualitative data were obtained via semi-structured interviews to explore participants’ perceptions of palliative care and to identify barriers to palliative care.

RESULTS: A total of 194 complete patient survey responses and 52 family/visitor responses were received. Mean self-rated knowledge of palliative care was slightly higher than self-rated knowledge of end-of-life care in both groups. Patient respondents scored a mean of 9.3 out of 13 on the Palliative Care Knowledge Scale and family visitor respondents had a mean score of 9.7. Statistically significant differences in the mean Palliative Care Knowledge scores were found when patient and family respondents reported being familiar with palliative care. A total of 11 patients and nine family members participated in an interview in Phase 2. Three main themes and nine subthemes were identified. The three main barriers were Communication, Knowledge and Perceptions, and Accessibility.

CONCLUSION: Patients and family members perceived a range of barriers to palliative care at the individual, health professional, and system level. These findings highlight areas where targeted interventions should be developed to improve timely access to palliative care.

IMPACT: While the perspectives of health professionals are well known, the perceptions of patients and families on the barriers to palliative care are underreported. A wide variety of complex issues that could impede timely access to palliative care were identified at the individual, health professional and system level. Health consumer perspectives are essential to fully understanding the barriers to palliative care access. The findings of this research can be used to inform future interventions to improve access to palliative care.

REPORTING METHOD: Good Reporting of A Mixed Methods Study (GRAMMS) checklist (Data S2) (O’Cathain et al., 2008).

PATIENT OR PUBLIC CONTRIBUTION: The study was guided by a steering group of health consumers and health professionals working in partnership with the research team through all stages of the research process.

PMID:42554039 | DOI:10.1111/jocn.70480

Vet Dermatol. 2026 Aug 5. doi: 10.1111/vde.70115. Online ahead of print.

ABSTRACT

BACKGROUND: Canine epitheliotropic T-cell lymphoma (CETL) is an aggressive and generally incurable disease in dogs. CCNU (lomustine) is commonly used for management, even though it carries a significant risk of adverse effects. Several reports describe oclacitinib producing clinical improvement in affected dogs, yet comparative data between the two treatments are lacking.

OBJECTIVE: To compare the clinical outcomes in dogs with CETL treated with oclacitinib or CCNU, focussing on tumour reduction (response), survival time and time-to-relapse.

MATERIALS AND METHODS: This retrospective review (2008-2024) included 23 client-owned dogs with confirmed CETL treated with either CCNU (n = 11) or oclacitinib (n = 12). Outcomes included response (reduction in measurable tumour burden), survival (time from histopathological diagnosis to death) and time-to-relapse (for dogs with complete or good responses). Clinical presentation and adverse effects also were recorded. Additionally, sex, age and weight were compared between treatment groups to investigate potential confounding factors.

RESULTS: No statistically significant differences were identified between oclacitinib and CCNU for response, survival or time-to-relapse (p > 0.05 for all). Kaplan-Meier survival analysis showed no significant difference in overall survival (log-rank test, p = 0.20). Oclacitinib was associated with fewer adverse effects and reduced monitoring intensity.

CONCLUSIONS AND CLINICAL RELEVANCE: These findings suggest oclacitinib may offer outcomes comparable to CCNU for CETL, with fewer adverse effects and less intensive monitoring. The small, retrospective sample limits firm conclusions, yet these results indicate that oclacitinib could be a reasonable, possibly safer palliative option warranting further prospective study.

PMID:42554028 | DOI:10.1111/vde.70115

Vet Med Sci. 2026 Sep;12(5):e71141. doi: 10.1002/vms3.71141.

ABSTRACT

OBJECTIVE: This study aimed to assess livestock feed resources, feeding systems, feed availability and major feed-related constraints in the Korahey Zone of the Somali Region, Ethiopia.

MATERIALS AND METHODS: A cross-sectional survey was conducted in four purposively selected districts of the Korahey Zone. Three kebeles (the smallest administrative unit in Ethiopia) were selected from each district, and 240 livestock-owning households were purposively sampled. Data on livestock population, landholding size, feed resources, feeding systems and feed-related constraints were collected using a semi-structured questionnaire. The data were analysed using the Statistical Package for the Social Sciences (SPSS) version 20. Feed-related constraints were prioritized using a ranking index, while dry matter (DM) supply and livestock maintenance requirements were estimated to determine the feed balance.

RESULTS: Camels and goats were the dominant livestock species in the study area. Natural pasture was the principal feed resource (75%), and 90% of respondents practised free grazing on natural pasture. The estimated annual feed supply from natural pasture was 2196 tons DM, whereas the annual livestock maintenance requirement was 4023.68 tons DM, indicating that available feed met only 54.6% of the maintenance requirement. The major feed resources included natural pasture, crop residues, improved forages, household food leftovers, maize and sorghum. The main constraints affecting feed availability were drought, grazing land shortages, limited availability of improved forage seeds, feed shortages, invasive plant species, inadequate extension services and land-use conflicts.

CONCLUSION: Livestock production in the Korahey Zone is constrained by insufficient feed resources, resulting in a substantial feed deficit. Improving livestock productivity requires rangeland rehabilitation, expansion of improved forage production, better feed resource management, strengthened extension services and further research to develop sustainable feeding strategies for the area.

PMID:42554023 | DOI:10.1002/vms3.71141

Clin Transplant. 2026 Aug;40(8):e70634. doi: 10.1111/ctr.70634.

ABSTRACT

BACKGROUND: The objective of this study is to evaluate the association between two imaging-derived measures-anteroposterior diameter (APD) and lateral abdominal wall-IVC distance (L-IVC)-and liver transplant (LT) waitlist outcomes.

METHODS: Retrospective cohort study of 520 adult LT candidates listed at a single academic transplant center from January 1, 2015, to December 31, 2023. APD and L-IVC were measured using cross-sectional abdominal imaging and categorized into three groups using interquartile thresholds: APD (<15.0 cm, 15.0-20.0 cm, >20.0 cm) and L-IVC (<10.0 cm, 10.0-12.5 cm, ≥12.5 cm). The primary outcome was time to LT; the competing outcome was waitlist removal due to death or clinical deterioration. Sub-distribution hazard ratios (SHRs) were estimated using competing risks regression. Harrell’s C-statistic and bootstrap comparisons were used to evaluate discrimination versus height, BMI, and body surface area (BSA).

RESULTS: Among 520 candidates (mean [SD] age, 55.7 [10.9] years; 37.5% women), small APD (SHR = 0.51; CI: 0.33-0.72; p = 0.02) and L-IVC (SHR = 0.39; CI: 0.21-0.62: p < 0.001) were associated with lower transplant probability. Candidates with larger APD (>20.0 cm) had the highest risk of waitlist removal (SHR = 1.47; CI:1.02-1.87; p = 0.04). L-IVC was most strongly associated with LT (C-statistic = 0.65) and waitlist removal (C-statistic = 0.67). In sex-stratified models, men with small APD or L-IVC had significantly lower transplant probability, while women with mid-range APD (15.0-20.0 cm) or L-IVC ≥ 12.5 cm had the highest transplant likelihood.

CONCLUSION: Anatomical measurements derived from imaging are more strongly associated with liver transplant waitlist outcomes, outperforming height, BMI, and BSA.

PMID:42553999 | DOI:10.1111/ctr.70634

Niger Med J. 2026 Mar 2;67(2):476-485. eCollection 2026 Mar-Apr.

ABSTRACT

BACKGROUND: Despite increasing e-cigarette use among young adults, data on medical students’ knowledge, attitudes, and practices (KAP) remain limited. This study assessed KAP regarding e-cigarettes and examined the influence of sociodemographic factors on their use.

METHODOLOGY: A cross-sectional study was conducted among 311 MBBS students at RUHS College of Medical Sciences, Jaipur. A validated 37-item questionnaire assessed sociodemographic details and KAP. Responses were recorded on a 5-point Likert scale. Data were analyzed using SPSS version 26 with descriptive statistics, independent t-tests, ANOVA, and chi-square tests. Subgroup analysis compared ever-users and never-users.

RESULTS: Among ever-users, the majority were male (74%) and aged 19-23 years (78%). Knowledge gaps were evident, with 23% unaware of e-cigarette types and 63% perceiving them as less harmful than conventional cigarettes. While most participants recognized nicotine-related harms (91%), awareness of regulatory measures was lower, including the national ban (61.6%) and prior taxation (57.5%). Over half (58.9%) considered e-cigarettes not cost-effective. Ever-users demonstrated relatively more favorable attitudes (43.8%); however, most rejected perceived social benefits (75.3%) and supported regulatory bans (56.2%). Overall use was low, with 76.5% reporting no lifetime use; among ever-users, occasional use predominated (43%).

CONCLUSION: Medical students displayed partial awareness and permissive attitudes, but ever-users showed inconsistent cessation behaviors. These findings underscore the need for targeted education and structured cessation support to address rising e-cigarette use in this vulnerable group.

PMID:42553993 | PMC:PMC13436990

Niger Med J. 2026 Mar 2;67(2):451-462. eCollection 2026 Mar-Apr.

ABSTRACT

An appropriate sample size is essential to determine methodological steps that underpin the scientific validity, ethical integrity, and practical feasibility of biomedical and health research. Inadequate estimation may lead to underpowered studies or unnecessary resource use and participant exposure. This article provides a practical overview of statistical power analysis and sample size determination using the G*Power software (version 3.1.9.7), which is a freely available tool for researchers. The Core statistical concepts, including hypothesis formulation, effect size estimation, significance level (α), statistical power (1-β), and their dynamic interrelationship, are outlined. The article further describes the G*Power software ecosystem, its graphical user interface, supported statistical test families, and the distinct modes of power analysis. Step-by-step methods with realistic research scenarios demonstrate sample size calculation for commonly used statistical tests, including independent and paired t-tests, z-tests for proportions, one-way ANOVA, correlation analysis, and multiple linear regression. The article also highlights common pitfalls, limitations of G*Power, and advanced considerations in sample size estimation. This article aims to provide researchers with a structured framework for accurate sample size estimation, thereby enhancing study quality, reproducibility, and ethical responsibility in biomedical research.

PMID:42553991 | PMC:PMC13436992

Niger Med J. 2026 Mar 2;67(2):791-805. eCollection 2026 Mar-Apr.

ABSTRACT

BACKGROUND: Iron deficiency (ID) is a common comorbidity in patients with heart failure (HF) and is associated with reduced functional capacity, diminished quality of life, and increased mortality. This study aimed to determine the prevalence of ID and its clinical characteristics.

METHODS: This descriptive cross-sectional study involved 136 patients with chronic HF at the University of Port-Harcourt Teaching Hospital. Informed consent was obtained. Blood samples were collected for a full blood count and serum ferritin analysis, while echocardiography was performed for all study participants.

RESULTS: The mean age was 59.2±14.9years, with 51% being males. Notably, 41% of the patients exhibited low ferritin levels (≤100ng/ml), indicating the presence of ID. Among patients with ID, 19.7% had anemia. Although patients aged 65 years and above tended to have lower ferritin levels, this difference was not statistically significant (p=0.141). In contrast, statistically significant associations were observed between ID and gender, with females being more susceptible to iron deficiency (p=0.036). However, normal levels of N-Terminal-prohormone-Brain Natriuretic Peptide (NT-Pro-BNP) and high sensitivity – C Reactive Protein(hs-CRP) were significantly linked to ID (p=0.001 & p=0.004, respectively), and there was no significant correlation between ejection fraction and ferritin levels.

CONCLUSION: Iron deficiency, with or without anemia, is prevalent in chronic heart failure patients, particularly among females and even in persons who have normal levels of markers of HF severity such as hs-CRP and NT-pro-BNP. Regular screening for ID is vital to identify and manage this comorbidity, as iron correction can lead to improved functional capacity and reduced morbidity and mortality associated with heart failure.

PMID:42553980 | PMC:PMC13436994

Saudi J Anaesth. 2026 Jul 2;20(3):519-524. doi: 10.4103/sja.sja_102_26. eCollection 2026 Jul-Sep.

ABSTRACT

CONTEXT: Effective postoperative analgesia after cesarean delivery is essential for early functional recovery. Ultrasound-guided transversus abdominis plane (TAP) block reduces postoperative pain and opioid consumption; however, its effects beyond analgesia remain unclear.

AIMS: To evaluate the effects of TAP block on postoperative pain, maternal self-efficacy, and early recovery after elective cesarean delivery.

SETTINGS AND DESIGN: This prospective randomized study was conducted at a tertiary care center between December 2024 and March 2025.

MATERIALS AND METHODS: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive either bilateral ultrasound-guided TAP block (20 mL of 0.25% bupivacaine per side) or standard analgesia. Maternal self-efficacy was assessed at 48 hours postpartum using the Parent Self-efficacy Scale. Secondary outcomes included postoperative pain scores, time to first breastfeeding and mobilization, rescue analgesic use, neonatal caregiving duration within 24 hours, and length of hospital stay.

STATISTICAL ANALYSIS USED: Appropriate parametric or non-parametric tests were applied, with P < 0.05 considered statistically significant.

RESULTS: A total of 128 patients completed the study. The TAP block group showed significantly lower pain scores, reduced rescue analgesic requirements, earlier breastfeeding and mobilization, longer neonatal caregiving duration, shorter hospital stay, and higher maternal self-efficacy scores (P < 0.05).

CONCLUSION: Ultrasound-guided TAP block provides effective analgesia and supports early functional recovery after cesarean delivery, with additional benefits on maternal self-efficacy.

PMID:42553979 | PMC:PMC13436911 | DOI:10.4103/sja.sja_102_26

Niger Med J. 2026 Mar 2;67(2):669-682. eCollection 2026 Mar-Apr.

ABSTRACT

BACKGROUND: Sickle cell anaemia (SCA) is a hereditary haemoglobin disorder associated with significant cardiovascular complications. Blood pressure abnormalities, including both hypertension and hypotension, are increasingly recognized as important contributors to morbidity in affected children. This study aims to determine the prevalence of hypertension and hypotension among children with SCA in steady state and during vaso-occlusive crisis, and to compare these findings with age- and sex-matched controls with normal haemoglobin genotype (HbAA).

METHODOLOGY: This cross-sectional study included 135 children with SCA aged 2-17 years, evaluated during both steady state and crisis, alongside age- and sex-matched HbAA controls. Blood pressure was measured using a standard mercury sphygmomanometer (Accoson) with appropriately sized cuffs. Data were analysed using appropriate statistical methods, with significance set at p<0.05.

RESULTS: In the steady state, 4.4% of children with SCA were hypertensive, and 11.1% were hypotensive. During the crisis, 6.7% were hypertensive and 6.7% hypotensive. Among controls, 4.4% were hypertensive and 2.2% hypotensive. Mean systolic and diastolic blood pressures were comparable across steady state, crisis, and control groups (p=0.462). In the crisis group, haemoglobin concentration showed a significant negative correlation with diastolic blood pressure (r = -0.37, p = 0.011). Age demonstrated strong positive correlations with both systolic and diastolic blood pressures in the steady state (r = 0.78 and 0.79, respectively; p = 0.001) and during crisis (r = 0.66 and 0.57, respectively; p = 0.001).

CONCLUSION: Blood pressure abnormalities, encompassing both hypertension and hypotension, occur in children with SCA irrespective of clinical status. Despite comparable mean blood pressure values, acute crises are associated with dynamic variations influenced by age and haemoglobin levels. Routine and vigilant blood pressure monitoring is essential for early detection and optimal management.

PMID:42553978 | PMC:PMC13436986