Tag: nevin manimala

Microbiologyopen. 2026 Apr;15(2):e70266. doi: 10.1002/mbo3.70266.

ABSTRACT

Not susceptible to methicillin Staphylococcus aureus (MRSA), is a potentially harmful bacteria that is resistant to the most important antimicrobial agents. Because MRSA is so resistant to many antibiotics, it can cause illnesses by forming biofilms. The aim of this study was to assess the nasal carriage rate of biofilm-producing methicillin-resistant Staphylococcus aureus (MRSA) and its associated factors among HealthCare Workers at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Central Ethiopia. This cross-sectional study, carried out at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Central Ethiopia from August 1 to November 30, 2023. Nasal swab samples from 294 healthcare workers (HCWs) were obtained using sterile cotton swabs. Bacterial isolates were identified using standard culture methods on Mannitol Salt and Blood Agar, while antimicrobial susceptibility testing and biofilm formation assessments followed the CLSI 2023 (M100, 33rd edition) guidelines via the Kirby-Bauer disk diffusion methods. All laboratory analyses were performed in triplicate to ensure consistency. Data were double-entered into Epi Data version 4.6 and cross-checked for accuracy. Missing or inconsistent data were verified against original laboratory records and latterly then, exported to SPSS V25 for analysis. Descriptive statistics and logistic regression were applied for statistical evaluation, with a p-value of ≤ 0.05 regarded as statistically significant. In this study, the occurrence rates of S. aureus, MRSA, and biofilm-producing MRSA were 98 out of 294 isolated strains (33.4%), 41 out of 294 isolated strains (13.9%), and 28 out of 294 isolated strains (9.5%), respectively. The MRSA strains exhibited high sensitivity to linezolid, rifampicin, and vancomycin while showing resistance to cefoxitin, cotrimoxazole, and ciprofloxacin. A history of prior hospitalization (length of stay in the hospital) was statistically significant for the colonization of biofilm-producing MRSA, with an adjusted odds ratio of 10.00 (95% CI: 1.36-73.3; P = 0.024). MRSA and MRSA that produces biofilms were found to be 41.8% and 68.3% prevalent overall in the study area, respectively. Biofilm-producing MRSA is a potential cause of healthcare-associated diseases. Therefore, these findings emphasize the urgent need for improved infection-prevention practices and routine screening of healthcare workers to mitigate the risk of healthcare-associated infections.

PMID:41833560 | DOI:10.1002/mbo3.70266

Int J Stroke. 2026 Mar 15:17474930261435194. doi: 10.1177/17474930261435194. Online ahead of print.

ABSTRACT

BackgroundPregnancy-associated stroke (PAS) is a rare but clinically important complication of pregnancy. Despite its clinical significance, nationwide data on PAS are lacking in South Korea, a representative country with advanced maternal age.AimsThis study aimed to investigate the incidence, temporal trends, and risk factors of PAS in South Korea.MethodsWe retrospectively analyzed nationwide data from the Korean National Health Insurance Service (NHIS) to identify women of reproductive age (15-49 years) who delivered between 2014 and 2021. PAS was defined as an ischemic or hemorrhagic stroke occurring during pregnancy or within 6 weeks postpartum. Multivariable logistic regression analysis was performed to identify independent predictors of PAS.ResultsOf 2,000,110 deliveries between 2014 and 2021, 909 first-ever strokes occurred during pregnancy or within six weeks postpartum, including 500 ischemic (55%) and 409 hemorrhagic (45%) strokes. The overall incidence of PAS was 45.6 per 100,000 deliveries (95% confidence interval [CI], 42.7-48.6) and increased from 41.5 in 2014 to 51.0 in 2021 (P = 0.049), mainly driven by ischemic stroke. PAS occurred predominantly during the postpartum period (P <0.0001) and among older women (P for trend <0.0001). In multivariable analysis, advanced maternal age (odds ratio [OR] per year, 1.02; 95% CI, 1.01-1.05), hypertension (OR, 2.04; 95% CI, 1.37-3.04), migraine (OR, 1.33; 95% CI, 1.02-1.74), gestational hypertension (OR, 1.49; 95% CI, 1.04-2.12), preeclampsia/eclampsia (OR, 5.00; 95% CI, 3.59-6.96), and peripartum cardiomyopathy (OR, 14.26; 95% CI, 4.48-45.42) were identified as independent predictors of PAS.ConclusionsThe incidence of PAS is increasing in South Korea, with advanced maternal age, vascular risk factors, and pregnancy-related complications serving as independent predictors. These findings underscore the clinical importance of heightened awareness of PAS, as well as early identification and proactive management of high-risk women.Data access statementData are available from the NHIS upon reasonable request and with permission of the NHIS.

PMID:41833554 | DOI:10.1177/17474930261435194

Pest Manag Sci. 2026 Mar 15. doi: 10.1002/ps.70731. Online ahead of print.

ABSTRACT

BACKGROUND: Climate change and the spread of herbicide-resistant weeds pose increasing risks to global food security. Eleusine indica (goosegrass) is a globally invasive species characterized by broad geographic distribution, high ecological plasticity, and multiple resistance mechanisms. This study evaluated the current and future climatic suitability of E. indica at a global scale under climate change scenarios.

RESULTS: Ensemble ecological niche models calibrated with georeferenced occurrence records and climatic predictors showed excellent performance (area under the receiver operating characteristic curve (AUC) = 0.999; true skill statistic (TSS)/kappa = 0.980), with low omission rates and high spatial agreement among algorithms (Bioclim, Random Forest, Support Vector Machines, and Maxent). Current projections indicate widespread suitability across tropical and subtropical regions, particularly in South America, Africa, and Southeast Asia. Future projections under SSP245 and SSP585 for 2050 and 2090 suggest a gradual expansion toward higher latitudes, with increased suitability in temperate regions such as the US Corn Belt, the Mediterranean Basin, and East Asia, especially under SSP585 by 2090. Overlap analyses identified substantial vulnerability in major soybean-producing regions, including Brazil, Argentina, the United States, and Southeast Asia.

CONCLUSION: Climate change is expected to facilitate the poleward expansion of E. indica, increasing invasion risk in key agricultural regions while maintaining broad climatic stability across its current range. These findings emphasize the need for early detection, continuous monitoring, and integrated weed management strategies to mitigate long-term agronomic and food security risks posed by this globally invasive species. © 2026 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

PMID:41833552 | DOI:10.1002/ps.70731

J Magn Reson Imaging. 2026 Mar 15. doi: 10.1002/jmri.70297. Online ahead of print.

ABSTRACT

BACKGROUND: Biparametric MRI (bpMRI) was interpreted using Prostate Imaging Reporting and Data System (PI-RADS) version 2.1, a system associated with relatively low specificity. Selective size imaging using filters via diffusion times MRI (SSIFT-MRI) is a novel imaging technique that may improve diagnostic performance.

PURPOSE: To compare the diagnostic performance of bpMRI versus SSIFT-MRI for diagnosing clinically significant prostate cancer (csPCa).

STUDY TYPE: Prospective.

POPULATION: Hundred and eighteen men (age: 70 ± 7 years) with suspected csPCa.

FIELD STRENGTH/SEQUENCE: Pulsed and oscillating gradient spin-echo sequences at 3 T. BpMRI included three-plane T2-weighted imaging and diffusion-weighted imaging.

ASSESSMENT: csPCa status was pathologically determined via ultrasound-guided biopsy or prostatectomy. Three radiologists assessed bpMRI and SSIFT-MRI for identifying csPCa lesions, and we further compared the performance of combining PI-RADS with SSIFT-MRI against that of bpMRI.

STATISTICAL TESTS: Area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for diagnostic performance; bootstrap resampling for comparing AUC; McNemar’s test for comparing sensitivity, specificity, PPV, NPV, and accuracy. A p-value < 0.05 was considered significant.

RESULTS: Per-patient accuracy was significantly higher for SSIFT-MRI (reader 1: 85% vs. 68%; reader 2: 80% vs. 64%; reader 3: 77% vs. 65%). Per-patient specificity (reader 1: 71% vs. 27%; reader 2: 58% vs. 11%; reader 3: 58% vs. 20%) and PPV (reader 1: 84% vs. 67%; reader 2: 78% vs. 64%; reader 3: 77% vs. 65%) were significantly higher for SSIFT-MRI. Combining PI-RADS with SSIFT-MRI yielded significantly higher AUCs and accuracy than bpMRI alone (AUC and accuracy for reader 1: 0.89% and 83%; reader 2: 0.80% and 73%; reader 3: 0.75% and 72%).

DATA CONCLUSION: SSIFT-MRI for csPCa had similar or higher diagnostic performance compared with bpMRI. The combination approach provided significantly higher AUC and accuracy than bpMRI.

EVIDENCE LEVEL: 1.

STAGE OF TECHNICAL EFFICACY: 2.

PMID:41833541 | DOI:10.1002/jmri.70297

Eur J Dent Educ. 2026 Mar 15. doi: 10.1111/eje.70133. Online ahead of print.

ABSTRACT

INTRODUCTION: The “Code Blue” system is a standardised emergency response protocol designed to ensure rapid intervention in critical medical situations, particularly cardiopulmonary arrest. Although mandatory in Türkiye since 2011, inappropriate activations still occur, often due to limited awareness among healthcare staff, including dental students. This pilot project aimed to assess dental students’ knowledge and awareness regarding Code Blue and to examine whether these outcomes differ according to the level of clinical training.

MATERIALS AND METHODS: A cross-sectional survey was conducted among 186 dental students at Akdeniz University, including 3rd-year (preclinical) and 5th-year (clinical) students. A structured 10-item multiple-choice questionnaire was used to evaluate participants’ knowledge of Code Blue indications, activation procedures, and response expectations. Descriptive and comparative statistical analyses were performed.

RESULTS: Of the 186 students analysed, 53.2% were female and 46.8% were male. The most recognised emergency code was Code White (82.26%), followed by Code Blue (70.43%). Code Blue awareness was significantly higher among fifth-year students (77.3%) than third-year students (62.9%) (p < 0.05). Fifth-year students also demonstrated greater knowledge of Code Blue indications and were less likely to choose “don’t know.” However, common misinterpretations were observed: 70.49% incorrectly identified vasovagal syncope as a Code Blue condition, and only 7.38% correctly rejected all non-indicated scenarios. Knowledge of basic life support (BLS) content did not significantly differ between groups (p = 0.8153).

CONCLUSIONS: Code Blue knowledge and awareness were higher among students with greater clinical exposure; however, overall awareness remained limited. These findings support earlier and more structured integration of institutional emergency code training, simulation-based reinforcement, and practical emergency preparedness training within the dental curriculum. Further multi-center studies are recommended to enhance generalizability and guide educational interventions.

PMID:41833538 | DOI:10.1111/eje.70133

Influenza Other Respir Viruses. 2026 Mar;20(3):e70238. doi: 10.1111/irv.70238.

ABSTRACT

BACKGROUND: Quantifying the burden of respiratory syncytial virus (RSV) in adults is challenging compared to influenza, and data among older adults remain scarce in Japan. Country-specific evidence is essential to support RSV vaccination policy.

METHODS: This prospective, multicenter study (APSG-J2) targeted hospitalized adults with community-acquired pneumonia (CAP) and other acute respiratory infections (ARI) in seven community hospitals across four catchment areas in Japan between September 2022 and August 2024. Respiratory samples were analyzed using a multiplex polymerase chain reaction (PCR) kit to detect RSV and influenza. Incidence rates of RSV- and influenza-associated hospitalizations were estimated using study data and national statistics, stratified by age and region.

RESULTS: Among 3047 hospitalized patients with CAP/ARI, 1499 (49.2%) underwent multiplex PCR testing. RSV and influenza were detected in 2.8% and 3.3% of tested patients, respectively. The incidences of RSV-associated CAP/ARI hospitalizations among adults aged ≥ 65 years were 29 and 36 per 100,000 person-years in the first and second years, respectively, with higher incidences among those aged ≥ 85 years (150 and 131 per 100,000 person-years). Influenza incidence increased markedly in the second year (from 11 to 71 per 100,000 person-years for adults age ≥ 65 years), possibly reflecting post-COVID-19 transmission changes.

CONCLUSIONS: In this multicenter study, we estimated the incidence of RSV- and influenza-associated hospitalizations among adults in Japan. The findings indicated that the incidence increased with age, and influenza-associated hospitalizations increased in the second year. Continued surveillance is essential to accurately assess RSV burden in the adult population.

PMID:41833535 | DOI:10.1111/irv.70238

Med Phys. 2026 Mar;53(3):e70385. doi: 10.1002/mp.70385.

ABSTRACT

BACKGROUND: The integration of artificial intelligence into image-guided intraoperative interventions holds considerable promise for deriving 3D geometric information from 2D imaging. 2D/3D registration establishes the spatial relationship between preoperative computed tomography (CT) and intraoperative X-rays. However, existing methods are often limited by the image domain gap and imprecise feature extraction, causing coarse registration to provide inadequate initial poses and subsequent fine registration to fall into local optima, thereby reducing accuracy.

PURPOSE: We aim to develop a robust single-view lumbar spine 2D/3D registration framework that balances high clinical accuracy with intraoperative efficiency requirements by aligning preoperative CT with intraoperative X-rays.

METHODS: We propose utilizing vertebral body edges in X-rays as novel semantic features to guide 2D/3D registration. For robust edge extraction, we develop ESegMamba, an efficient U-shaped Mamba network incorporating Group multi-axis Hadamard Product Attention (GHPA) and Group Aggregation Concatenation (GAC) modules. Experiments for semantic edge extraction were performed on a dataset of 710 images (comprising X-rays and Digitally Reconstructed Radiographs) derived from 10 patients. The dataset was partitioned using a 4:1 patient-specific split, resulting in 568 training and 142 test images. The training set was further utilized via 5-fold cross-validation for network fine-tuning. ESegMamba was benchmarked against SegMamba, SwinUNETR, and UNETR using Dice and mIoU metrics. For 2D/3D registration, experiments were conducted separately on 300 simulated samples and 90 real clinical samples, following the same patient-specific split. The proposed framework was compared with landmark-based, intensity-based, and learning-based methods using mean Target Registration Error (mTRE). Statistical significance was assessed using the Wilcoxon signed-rank test with a significance level of 0.05, applying Bonferroni correction for multiple comparisons.

RESULTS: ESegMamba outperforms representative networks with fewer parameters (99.18 M), achieving 90.36% Dice and 85.49% mIoU on the test set. Compared to the strong baseline SegMamba, ESegMamba demonstrated a large effect size in Dice improvement (Cohen’s $d=2.05$ , ). For 2D/3D registration, the proposed method demonstrated superior performance over representative benchmarks. Specifically, compared to Xreg and PSSS, our method achieved large practical improvements in mTRE ( $d=1.04$ and $d=2.12$ , respectively; ). On real clinical data, the method achieved a mean in-plane translation error of approximately 1.5 mm and an average registration time of approximately 10 s.

CONCLUSIONS: The proposed method, empowered by ESegMamba, yields statistically significant improvements over intensity-based benchmarks ( ). The achieved sub-2mm accuracy and 10 s processing time on clinical data confirm its efficacy for intraoperative spinal navigation. The code for the proposed method is available at github.com/shenao1995/lineReg.

PMID:41833531 | DOI:10.1002/mp.70385

J Am Geriatr Soc. 2026 Mar 15. doi: 10.1111/jgs.70386. Online ahead of print.

ABSTRACT

BACKGROUND: Prescribing cascades occur when cholinesterase inhibitor (ChEI)-induced urinary incontinence is misinterpreted as a new condition, leading to overactive bladder (OAB) antimuscarinic initiation. We evaluated whether the ChEI-OAB antimuscarinic prescribing cascade was associated with delirium or falls compared with mirabegron in older adults living with dementia.

METHODS: We conducted a retrospective cohort study using the Anlitiks All-Payor Claims database (2015-2020). Participants were adults aged ≥ 65 years with dementia newly prescribed a ChEI with no prior ChEI or OAB therapy (180 days). A 60-day window identified OAB treatment initiation after ChEI therapy. Exposures were OAB antimuscarinics or mirabegron. Outcomes were incident delirium and falls identified using diagnosis codes. Propensity score-based weighting balanced baseline characteristics.

RESULTS: Among 2693 patients (mean age 80 years; 66.3% female), 201 (7.5%) initiated antimuscarinics and 2492 (92.5%) started mirabegron. Over 1 year, 8 (4.0%) antimuscarinic users developed delirium versus 95 (3.8%) mirabegron users (adjusted HR 1.35; 95% CI, 0.64-2.86). Falls occurred in 3 (1.5%) antimuscarinic users and 63 (2.5%) mirabegron users (adjusted HR 0.66; 95% CI, 0.20-2.15).

CONCLUSIONS: In older adults living with dementia, the estimated association between initiation of OAB antimuscarinics following ChEIs and the risks of delirium or falls, compared with mirabegron, was statistically compatible with benefit, harm, or no clinically meaningful difference. These findings highlight the need to evaluate whether OAB antimuscarinics are prescribed in response to true clinical need or as part of a prescribing cascade. Given the limited number of outcome events and resulting wide 95% CIs, future studies are needed to more precisely estimate the risk.

PMID:41833520 | DOI:10.1111/jgs.70386

Chin J Traumatol. 2026 Feb 28:S1008-1275(26)00038-6. doi: 10.1016/j.cjtee.2025.11.002. Online ahead of print.

ABSTRACT

PURPOSE: Sarcopenia is a prevalent geriatric syndrome, particularly among the elderly with chronic musculoskeletal diseases, where it exacerbates the risk of functional decline and reduced quality of life. This study aimed to describe the prevalence of muscle weakness and wasting and to investigate some factors related to these 2 syndromes in the elderly with coexisting knee osteoarthritis and chronic spinal pain.

METHODS: A cross-sectional descriptive study enrolled 88 elderly patients (aged ≥60 years) at the musculoskeletal department of Thai Binh General Hospital between May 2024 and October 2024. Muscle weakness was defined according to the Fried criteria, and muscle wasting was diagnosed based on the criteria of the Asian Working Group for Sarcopenia. Data were collected via direct interviews and clinical examinations with measurements, including muscle strength measurement (handgrip strength using the InGrip device), walking speed (by the 15-foot walk test), and body composition analysis using the Inbody 770 machine (using the bioelectrical impedance analysis method). Statistical analysis was performed using SPSS 27.0 software, and multivariate regression was used to investigate a number of related factors, with p < 0.05 being considered statistically significant.

RESULTS: Among the 88 elderly patients, the overall prevalence of sarcopenia was 40.9% (including 23.9% sarcopenia and 17.0% severe sarcopenia), while the prevalence of frailty was 9.1%. Notably, the co-occurrence of both syndromes was significantly higher in men than in women (21.1% vs. 4.3%, p = 0.037), a novel and clinically important finding. After multivariate regression analysis, age was the only significant independent risk factor and those over 70 years old had a 9.0-fold higher risk of developing the condition compared to those aged 60 – 65 years (adjusted odds ratio = 9.0; 95% confidence interval: 2.4 – 33.6).

CONCLUSION: The high prevalence of sarcopenia, with advanced age identified as the most critical independent risk factor, underscores its significant burden in this patient population. These findings highlight the urgent need for early screening and the development of targeted intervention strategies, particularly for high-risk groups such as those aged over 70 years.

PMID:41833494 | DOI:10.1016/j.cjtee.2025.11.002

Eur Urol. 2026 Mar 11:S0302-2838(26)02002-6. doi: 10.1016/j.eururo.2026.02.011. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Studies reported to date indicate that local therapy may improve outcomes in men with de novo metastatic (M1) prostate cancer (PCa). The aim of this study was to evaluate the effect of local therapy to the primary tumor on progression-free survival (PFS) in men with M1 PCa.

METHODS: In a multicenter, randomized phase 2 trial, men with de novo M1 PCa, after receiving 6 mo of best systemic therapy (BST), were randomly assigned (1:1) to continue BST alone (arm 1) or BST with the addition of either radiotherapy or surgery to their primary tumor (arm 2). The primary endpoint was PFS, defined as the time from randomization to progression (Prostate Cancer Working Group 2) by prostate-specific antigen, radiographic or symptomatic progression, or the time to change systemic therapy as per physician discretion and/or clinical decision, or death, whichever occurred first. Immunohistochemistry for the tumor suppressors p53, RB1, and PTEN was performed on available prostate biopsies at baseline and 6 mo. The aggressive variant PCa molecular signature (AVPC-MS) was assigned if two or more of these tumor suppressors were abnormal. In the current intent-to-treat analysis, the Kaplan-Meier product-limit method was used to estimate the median PFS.

KEY FINDINGS AND LIMITATIONS: Between March 2013 and April 2018, 119 patients were randomized (arm 1: 59 and arm 2: 60). The median follow-up for patients who survived was 66 mo (64 mo for BST alone and 67 mo for BST plus local therapy groups). BST included androgen deprivation therapy (n = 119), with docetaxel (n = 37) or with androgen receptor pathway inhibitor agents (n = 9). Local therapy included surgery (n = 45), radiation (n = 13), or none (n = 2). At data analysis, 88 patients met Prostate Cancer Working Group 2 progression, and 53 patients had died. The median PFS was 17.9 mo (95% confidence interval [CI] 11.7-36.4) in arm 1 and 14.8 mo (95% CI 11.4-42.9) in arm 2 (hazard ratio [HR] 0.89, 95% CI 0.59-1.34, p = 0.6). Toxicity was limited in both arms, with grade 3 toxicities in four patients (6.7%) in arm 2 and zero patients in arm 1. Three patients required palliative intervention for symptomatic local progression in arm 1, while an additional six patients crossed over to receive local therapy after meeting castration-resistant PCa progression criteria. Predictors of worse overall survival (OS) for all comers included CHAARTED high-volume (HR 1.84, 95% CI 1.06-3.19) and clinical cT3b/T4 (HR 1.97, 95% CI 0.88-4.41) disease. Having the AVPC molecular profile (AVPC-MS) at baseline or 6 mo was significantly associated with worse PFS (HR 1.74, 95% CI 1.02-2.98, p = 0.04). However, there was no statistically significant association with OS (HR 1.83, 95% CI 0.94-3.56, p = 0.08).

CONCLUSIONS AND CLINICAL IMPLICATIONS: This phase 2 randomized study failed to demonstrate improved PFS in men with de novo M1 PCa treated with BST with the addition of local therapy to their primary tumor. Its effect on OS is being tested in an ongoing phase 3 trial (SWOG 1802). We identified biomarkers of potential prognostic value (CHAARTED volume status, cT3b/cT4 disease, and the AVPC-MS) that may serve to optimize therapy selection and stratification in this population, but these require further evaluation.

PMID:41833492 | DOI:10.1016/j.eururo.2026.02.011