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Nevin Manimala Statistics

Monitoring novel psychoactive substance trends on social media: Analysis of discussions and dashboard implementation

Drug Alcohol Depend. 2026 Jun 26;286:113249. doi: 10.1016/j.drugalcdep.2026.113249. Online ahead of print.

ABSTRACT

INTRODUCTION: Novel psychoactive substances (NPSs), due to rapid emergence and evolving use patterns, pose a significant public health surveillance challenge. Traditional surveillance lags street-level reality, necessitating the exploration of novel strategies and data sources like Reddit for continuous NPS trend monitoring and presenting a public dashboard.

METHODS: We mined data from 60,601 subreddits between January 2015 and June 2025 for seven NPSs (kratom, xylazine, medetomidine, nitazenes, tianeptine, bromazolam, and 2C-B) using keyword-variants. We performed Mann-Kendall trend tests to assess temporal patterns, computed correlations to compare post volumes with National Forensic Laboratory Information System (NFLIS) drug report counts (2015-2024), conducted cross-correlation analyses at ±2-year lags to identify lead-lag relationships, and created a public dashboard for data visualization.

RESULTS: The dataset comprised 328,223 posts from 139,901 accounts. We observed moderate to strong correlations between Reddit volumes and three out of five NPSs with NFLIS reports: bromazolam (ρ = 0.81, p < 0.001), tianeptine (ρ = 0.48, p = 0.04), xylazine (ρ = 0.60, p < 0.001). Cross-correlation analyses indicated Reddit discussions preceded NFLIS reports for medetomidine (ρ = 0.93, lag = -2 years), bromazolam (ρ = 0.86, lag = -1year), tianeptine (ρ = 0.81, lag = -2years), and xylazine (ρ = 0.62, lag = -2years), suggesting Reddit discussions as a potential leading indicator. Co-mention of other substances with NPSs often matched known trends from retrospective data.

CONCLUSION: Reddit-based surveillance provides timely and complementary signals to traditional forensic systems for NPS monitoring. Interactive visualizations and downloadable aggregated statistics are available via our dashboard.

PMID:42378779 | DOI:10.1016/j.drugalcdep.2026.113249

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Dairy farm waste as a source of novel and globally disseminated multidrug-resistant Escherichia coli clones: A genomic and phylogeographic study

J Hazard Mater. 2026 Jun 27;514:142819. doi: 10.1016/j.jhazmat.2026.142819. Online ahead of print.

ABSTRACT

Dairy farm waste may serve as a reservoir for multidrug-resistant (MDR) Escherichia coli clones, but the genomic characteristics and dissemination potential of such clones remain incompletely understood. Here, we performed whole-genome sequencing and comprehensive genomic analysis of 64 MDR E. coli strains isolated from feces and sewage samples collected from two large dairy farms in Gansu Province, China. Genomic analysis revealed that strains carried 16-32 antibiotic resistance genes (ARGs), 1-6 plasmid replicon types, and 26-96 virulence genes (VGs), with numerically higher (though not statistically significant) counts in feces compared to sewage isolates. Multi-locus sequence typing (MLST) identified globally disseminated clones (ST10, ST38, ST58, ST155) and, for the first time in China, documented the presence of ST1508 (the predominant clone, 42% of isolates), as well as ST2520, ST7207, and ST7588 from dairy farm waste. Network analysis showed co-occurrence of these clones with transferable IncF plasmids harboring broad-spectrum resistance genes (e.g., rmtB, blaCTX-M-55) and multidrug efflux systems (e.g., acrAB-tolC). Contig-level analysis suggested that tet(A) and aph(3′)-IIa were located on IncX1 plasmids, blaTEM-1B on IncFIC(FII), and blaCTX-M-55 on IncI1 plasmids, indicating potential for horizontal gene transfer. These findings identify dairy farm waste as a potential environmental reservoir of MDR E. coli clones with genomic features associated with resistance and virulence. While functional validation of transferability and environmental persistence is needed, the presence of these clones – particularly the emerging ST1508 lineage in untreated farm waste suggests that improved waste management, enhanced surveillance, and integrated One Health strategies may help mitigate dissemination risks. Further studies incorporating environmental sampling, persistence assays, and conjugation experiments are required to establish the actual hazard status.

PMID:42378761 | DOI:10.1016/j.jhazmat.2026.142819

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Wearable device-telemonitored Baduanjin for chronic heart failure: A systematic review of effects on exercise tolerance and cardiac function

Complement Ther Med. 2026 Jun 30;100:103402. doi: 10.1016/j.ctim.2026.103402. Online ahead of print.

ABSTRACT

OBJECTIVE: This review evaluates the effects of wearable device-telemonitored Baduanjin on exercise tolerance and cardiac function in patients with chronic heart failure (CHF).

METHODS: A comprehensive literature search was performed in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database and Chinese Biomedical Literature Database (CBM) from their inception to 1 January 2026. The search aimed to identify randomised controlled trials investigating Baduanjin for CHF that explicitly used wearable devices. Study screening, data extraction and Cochrane RoB 2.0 bias assessment were performed independently by two reviewers with discrepancies were resolved by a third. Given significant clinical heterogeneity across the included studies, a narrative synthesis of the findings was conducted, supported by tabulated presentation of outcome data.

RESULTS: Three randomized controlled trials involving 248 participants were included. Individual studies reported that wearable device-telemonitored Baduanjin was associated with improvements in several clinical outcomes in patients with CHF. Reported benefits included increased 6-minute walking distance (568.58 m vs. 367.47 m, P < 0.05), higher peak oxygen uptake (19.00 vs. 17.00 ml/[kg·min], P < 0.001) and improved left ventricular ejection fraction (52.60% vs. 45.28% and 42.79%, P < 0.05). Improvements were also observed in quality of life, depression symptoms, cardiovascular readmission in the intervention group of individual studies. No exercise-related adverse events were reported.

CONCLUSION: Current evidence suggests that wearable device-telemonitored Baduanjin may potentially improve key outcomes in patients with chronic heart failure, However, these findings are based on a narrative synthesis of individual studies and should therefore be interpreted cautiously. Further high-quality, standardised randomised controlled trials are urgently needed.

PMID:42378743 | DOI:10.1016/j.ctim.2026.103402

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Effect of foot orthoses on the biomechanics of stair ascent and descent in chronic metatarsalgia

J Biomech. 2026 Jun 26;205:113437. doi: 10.1016/j.jbiomech.2026.113437. Online ahead of print.

ABSTRACT

In individuals with musculoskeletal disorders such as chronic metatarsalgia, foot orthoses (FOs) are frequently prescribed to reduce plantar pressure, improve foot function and alleviate pain. During walking, medially wedged FOs (MWFO + MPs) with a metatarsal pad are more effective than standard FOs (SFOs) in reducing plantar pressure under the metatarsal heads. As stair ambulation involves higher physical demands than walking and modifies plantar loading, we questioned whether FOs remain effective during more challenging tasks. This study aimed to determine whether MWFO + MPs reduce peak plantar pressure under the metatarsal heads compared to SFOs during stair ambulation in individuals with chronic metatarsalgia. A secondary objective was to examine the effects of these FOs on lower limb 3D joint angles and moments. Twenty-two individuals (16 females and 6 males) with chronic metatarsalgia were recruited to participate in this cross-sectional descriptive study. Participants ascended and descended stairs under three conditions: (1) Shoe-only, (2) SFOs, and (3) MWFO + MPs. Peak plantar pressure, midfoot, ankle, knee, hip angles and moments were compared across conditions using repeated-measures ANOVAs and statistical parametric mapping. Both FOs reduced plantar pressure under the metatarsal heads and heel compared to shoe-only during stair ambulation. MWFO + MPs increased plantar pressure under the medial midfoot, decreased midfoot dorsiflexion, ankle plantarflexion angles compared to shoe-only. MWFO + MPs were more effective than SFOs in reducing peak plantar pressure under the 1st metatarsal head and modifying lower limb joint angles and moments. These findings extend the known biomechanical benefits of FOs in individuals with chronic metatarsalgia during more demanding tasks.

PMID:42378738 | DOI:10.1016/j.jbiomech.2026.113437

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Long-Term Mobile-Based Glycemic Intervention for Secondary Prevention in Patients With Diabetes Undergoing Surgical Revascularization: Multicenter Randomized Controlled Trial

J Med Internet Res. 2026 Jun 30;28:e72226. doi: 10.2196/72226.

ABSTRACT

BACKGROUND: Despite the growing amount of patients who underwent coronary artery bypass grafting (CABG) in low- and middle-income countries like China, their glucose control was suboptimal, likely due to poor adherence to healthy lifestyles and preventive medications. Mobile health tools facilitating secondary prevention seem promising, but evidence focusing on this high-risk population is scarce.

OBJECTIVE: This study aimed to evaluate the significance of mobile health tools in long-term glycemic management for post-CABG patients with comorbid diabetes mellitus.

METHODS: GUIDEME (glycemic control using mini program-based intervention in patients with diabetes undergoing coronary artery bypass to promote self-management) is a multicenter, open-label, closed-user group, randomized controlled trial, in which 1066 patients with diabetes who had recently undergone CABG were enrolled and allocated into 2 groups. Patients in the control group received conventional health education before discharge, whereas those in the intervention group additionally received automatic delivery of bite-sized health education and medication reminders through a smartphone app during the 6 months after discharge. The primary end point was a change in glycosylated hemoglobin (HbA1c) from baseline to 6 months.

RESULTS: Among the 1066 eligible participants enrolled, a total of 1038 (97.4%) had completed the follow-up, while 1000 (93.8%) had 6-month HbA1c results available. Although only 79 (14.9%) patients in the intervention group were defined as active users, a greater reduction of HbA1c in the intervention group was observed (adjusted between-group mean difference -0.13, 95% CI -0.25 to -0.01; P=.04). The intervention group also had a high proportion of good medication adherence (96.1% vs 93.2%, P=.04). There was no difference between the 2 groups regarding the secondary end points.

CONCLUSIONS: Health education and medication reminders based on smartphone app achieved a statistically significant but modest between-group difference in HbA1c, the clinical relevance of which remains uncertain.

PMID:42378688 | DOI:10.2196/72226

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Mpox on Instagram: Content Analytic Study

JMIR Infodemiology. 2026 Jun 30;6:e85379. doi: 10.2196/85379.

ABSTRACT

BACKGROUND: Mpox was declared a public health emergency of international concern in 2022. Instagram is widely used by age groups and communities disproportionately affected by mpox; yet platform-specific evidence on mpox information characteristics and engagement remains limited.

OBJECTIVE: The aim of this study is to characterize sources, content, and engagement features of mpox-related Instagram posts, to describe prevention and treatment framing, and to compare the top 10% most-liked posts with the remaining corpus.

METHODS: We retrieved English-language public Instagram posts via CrowdTangle containing “mpox” or “monkeypox” dated May 5, 2022, to January 17, 2023 (initial N=18,616). Using a pretested, deductive codebook adapted from prior Instagram health studies, 2 coders completed 2 pilot rounds; variables with low agreement were excluded. A randomized analytic sample of 1000 posts was coded for source type, content features, and prevention/treatment framing. Descriptive statistics were computed. For engagement contrasts, we compared the top 10% most-liked posts with the bottom 90% using tests of differences in independent proportions (mean differences [MD] with P values).

RESULTS: Most posts originated from organizations (760/1000, 76%) versus individuals (240/1000, 24%). Organizational sources most commonly included businesses (436/760, 57.4%) and news/media outlets (401/760, 52.8%); government (174/760, 22.9%), nonprofits (131/760, 17.3%), and health care organizations (70/760, 9.2%) were less frequent. About one-third of posts cited a source (344/1000, 34.4%), most often the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC)/other federal entity. Posts predominantly used illustrated images/infographics (827/1000, 82.7%); photos appeared in 47.3% (473/1000) and videos in 12.4% (124/1000) of posts. Prevention content appeared in 38.4% (384/1000) of posts, most commonly vaccination (684/1000, 68.5% of prevention posts), followed by avoiding close contact (145/1000, 14.5%), avoiding contact with objects (83/1000, 8.3%), abstaining from sexual activity (76/1000, 7.6%), and condom use (13/1000, 1.3%); 28.9% (289/1000) of prevention posts noted barriers. Treatment mentions were uncommon (25/1000, 2.5% traditional biomedical; 2/1000, 0.2% alternative). Compared with the bottom 90%, the top 10% most-liked posts (1) were more likely to originate from public figures/celebrities among individuals (MD=-0.591; P<.001) and from businesses (MD=-0.299; P<.001) or news/media (MD=-0.350; P<.001) among organizations; (2) were less likely to be from government (P<.001) , nonprofit (P=.006), or health care organizations (P=.005); and (3) more often included nonmoving images (MD=-0.119; P=.024), visible lesion depictions (MD=-0.081; P=.035), prevalence mentions (MD=-0.180; P<.001), and citations (MD=-0.162; P=.001).

CONCLUSIONS: During the initial outbreak period, the highly engaged mpox content on Instagram skewed toward posts by public figures and news/business accounts and toward static, citation-bearing visuals that included prevalence context and occasionally lesion imagery. Public-health communicators seeking reach on Instagram should prioritize clear static infographics with explicit source citation and epidemiologic context and consider copublishing with trusted creators and news outlets, while addressing access barriers highlighted in prevention posts.

PMID:42378678 | DOI:10.2196/85379

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Deep Learning for Automated Infant Hip Ultrasound: Toward Robust Generalization across Disease Spectrum and Devices

J Ultrasound Med. 2026 Jun 30. doi: 10.1002/jum.70359. Online ahead of print.

NO ABSTRACT

PMID:42378662 | DOI:10.1002/jum.70359

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Nevin Manimala Statistics

Burden in Informal Caregivers of Palliative Care Patients With Pressure Injuries: Perceived Social Support and Influencing Factors Care Burden in Palliative Caregivers

J Eval Clin Pract. 2026 Aug;32(5):e70514. doi: 10.1111/jep.70514.

ABSTRACT

AIMS: This study was designed as a descriptive and correlational study to assess the burden experienced by caregivers of palliative care patients with pressure injuries, to identify the factors influencing this burden and to examine the role of perceived social support.

METHODS: Data were collected from 138 informal caregivers of palliative care patients with pressure injuries in a state hospital. The Burden Interview and the Multidimensional Perceived Social Support Scale were used to collect data. Descriptive statistics, correlation analyses and hierarchical regression were conducted to identify factors associated with caregiver burden.

RESULTS: Caregivers reported a high level of burden. Lower income status, difficulty experienced during caregiving and negative effects on family and social life were associated with greater burden. Higher perceived social support was associated with lower burden, indicating that social support plays a protective role for caregivers of patients with pressure injuries.

CONCLUSION: Caregivers of palliative care patients with pressure injuries experience substantial burden influenced by socioeconomic and caregiving-related factors. Increased perceived social support contributes to reducing this burden and should be considered an essential component of caregiver-focused interventions.

PMID:42378645 | DOI:10.1111/jep.70514

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Integrating nnU-Net Segmentation and Clinical-Radiomics for Multicenter MRI-Based Assessment of Soft Tissue Sarcoma Grade and Ki-67 Expression

J Magn Reson Imaging. 2026 Jun 30. doi: 10.1002/jmri.70424. Online ahead of print.

ABSTRACT

BACKGROUND: Histological grade and Ki-67 expression are prognostic risk factors in patients with soft tissue sarcoma (STS). These assessments require biopsy, which may be affected by tumor heterogeneity and is invasive.

PURPOSE: To develop an automated MRI-based pipeline to assess STS grade and Ki-67 expression.

STUDY TYPE: Retrospective.

POPULATION: 186 patients with pathological confirmation of STS (89 low-grade, 97 high-grade; 87 low Ki-67 expression, 99 high Ki-67 expression) across three hospitals, with 130 and 56 patients in the training and validation cohorts.

FIELD STRENGTH/SEQUENCE: 1.5 T and 3.0 T/Fat-suppressed T2-weighted imaging, fat-suppressed gadolinium-enhanced T1-weighted imaging, and diffusion-weighted imaging.

ASSESSMENT: An automatic STS segmentation model was developed and compared with manual segmentations. Clinical-imaging signature (CS) models were developed to distinguish STS grade and Ki-67 expression using: (i) structural MRI (T1WI and T2WI) radiomics features, (ii) structural MRI and ADC radiomics features, and (iii) structural MRI and ADC radiomics features combined with clinical information and MRI semantic features. The diagnostic performance of radiologists (with 6, 8, and 38 years’ experience) for assessing grade and Ki-67 expression was evaluated with and without the assistance of the best-performing models.

STATISTICAL TESTS: Dice coefficient, Cohen’s κ and weighted κ, chi-square test or Fisher’s exact test, logistic regression analyses, decision curve analysis, area under the receiver operating characteristic curve (AUC), and DeLong’s test. A p value < 0.05 was considered significant.

RESULTS: The segmentation model achieved good segmentation performance (0.80 in extremity cases and 0.73 in trunk cases). LR and SVM CS models showed the best performance for grading and Ki-67 assessment, respectively. (AUC in validation cohort: 0.846 and 0.742). Using the model significantly improved the diagnostic performance of the two more-junior radiologists for grade (AUC: 0.720-0.832 and 0.735-0.835) and Ki-67 expression (AUC: 0.665-0.717 and 0.659-0.741).

DATA CONCLUSION: The CS model may assess STS grade and Ki-67 expression and improve the diagnostic performance of less-experienced radiologists.

EVIDENCE LEVEL: 3.

TECHNICAL EFFICACY: 2.

PMID:42378640 | DOI:10.1002/jmri.70424

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High-Starch Diet Prepartum Enhances IgG Concentration in Goat Colostrum Without Affecting the Transfer of Passive Immunity

J Anim Physiol Anim Nutr (Berl). 2026 Jun 30. doi: 10.1111/jpn.70089. Online ahead of print.

ABSTRACT

This study hypothesises that a high-starch (HS) diet during the last month of gestation enhances colostrum yield and composition as well as the dam and goat kid metabolism, immune status and performance. Thirty multiparous and pregnant Majorera dairy goats were randomly assigned to a prepartum dietary treatment (CON vs. HS) on wk -4 relative to the expected parturition. Goats were fed either a control (n = 15; 25% DM of starch) or HS (n = 15; 32% DM of starch) diet during the last month of gestation. Blood samples were collected on wk -4, -3, -2 and -1 relative to expected parturition, immediately at parturition (d0) and on d 1, 2, 3, 5, 10, 15, 30 postpartum in dams and goat kids. Colostrum and milk yield were recorded, and gross chemical composition, somatic cell count (SCC), Brix degrees and immunoglobulin G (IgG) concentration were determined on d 0, 1, 2, 3, 5, 10, 15, 30 postpartum. In addition, dam and goat kid blood serum metabolites and plasma IgG concentrations were determined. Data was analysed using linear mixed models in SAS (SAS 9.4) including the prepartum diet, time (T), and the interaction between both as fixed effects. The statistical significance was set as p ≤ 0.05. The high-starch diet did not have any effect either on colostrum nor on milk yield, gross chemical composition, SCC and Brix degrees. However, the excess of starch on the prepartum diet increased colostrum IgG concentration on d 0 (i.e. first milking) in the HS group compared to the control group (i.e. 85.4 and 61.2 mg/mL, respectively). Serum BHB concentration in the HS group increased progressively from wk -3 to parturition (i.e. 0.20 and 0.24 mmol/L, respectively), whereas the control group showed a sharp increase from wk -1 to parturition (i.e. 0.22 and 0.29 mmol/L, respectively). Calcium, total protein, lactate dehydrogenase, urea and albumin concentrations were lower in the HS group compared to the control group during the prepartum period. The high-starch diet prepartum did not influence serum metabolites in the postpartum period except for lactate dehydrogenase, being lower in the first 5 days after parturition in the HS group. In the goat kids, body weight (BW), milk intake and plasma IgG concentrations were not affected by the high-starch diet offered to the dams prepartum except for an increased serum total protein concentration observed on d 1 in the HS group compared to the CON group (i.e. 7.1 vs. 6.5 g/dL, respectively). The present results indicate that a high-starch diet during the last month of gestation does not affect either colostrum yield or composition but increases colostrum IgG concentration, although it did not affect circulating IgG concentrations in goat kids from both groups. Based on the slower fat mobilisation in the HS group, high-starch diets prepartum could promote a smoother transition from late gestation to early lactation in dairy goats. However, other metabolic variables should be considered in future studies.

PMID:42378621 | DOI:10.1111/jpn.70089