Nevin Manimala

Cancer Med. 2026 Mar;15(3):e71660. doi: 10.1002/cam4.71660.

ABSTRACT

AIM: Tumor flare reaction (TFR) is characterized by an increase in tumor size during immunotherapy, often resembling disease progression. This study explores the relationship between anti-tumor drugs and tumor flare reaction (TFR) through the FAERS database to assist clinicians in better patient management.

METHODS: We analyzed the FAERS database to identify TFR cases reported from Q1 2004 to Q3 2024. For signal detection, we employed disproportionality analysis with four algorithms-reported odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM). These algorithms assessed statistical correlations between anticancer drugs and TFR, based on a 2 × 2 contingency table framework.

RESULTS: From Q1 2004 to Q3 2024, 566 TFR cases were recorded in the FAERS database. The incidence of TFR peaked in 2023, with the highest increase in cases from 2021 to 2022, at 4.9%. A total of 28 anticancer drugs were identified as strongly associated with TFR, of which only 4 are explicitly listed in the medication instructions as having TFR-related adverse reactions. Lenalidomide was the most frequent drug causing TFR, accounting for 38% of all TFR reports.

CONCLUSIONS: Our findings highlight the key associations between treatment drugs and TFR, particularly targeted therapies such as Rituximab, which are not explicitly marked for this side effect in the FAERS database. The study emphasizes the need for clinicians to closely monitor TFR in patients receiving certain cancer treatments and improve therapeutic strategies to mitigate TFR risks, ensuring safer cancer treatment outcomes.

PMID:41803028 | DOI:10.1002/cam4.71660

N C Med J. 2025 Jun 26;86(3). doi: 10.18043/001c.141315.

ABSTRACT

BACKGROUND: We sought to characterize changes in single-visit long-acting reversible contraception (LARC) placement before and after the start of the COVID-19 pandemic in North Carolina.

METHODS: We utilized an interrupted time series analysis to characterize single-visit LARC placement after the start of the pandemic across a state-wide health care system.

RESULTS: Within our cohort of 4591 patients receiving a LARC, 70.36% received single-visit LARC before and 66.98% after the start of the pandemic (odds ratio [OR] = 0.85; 95% confidence interval [CI], 0.75 – 0.97). There was a slight monthly decrease in the likelihood of single-visit LARC after the pandemic started (0.001, 95% CI: -0.004 – 0.005).

LIMITATIONS: Limitations include the electronic health record data-based abstraction of variables, as well as the inability to assess patient preferences in visit scheduling.

CONCLUSIONS: Rapid increases in telehealth were associated with slight decreases in single-visit LARC placement. Further study is needed to better understand patient goals and experiences, as well as clinical and public health impacts surrounding the use of telehealth for contraceptive care.

PMID:41802991 | DOI:10.18043/001c.141315

Oral Dis. 2026 Mar 9. doi: 10.1111/odi.70259. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the real-world efficacy of combining Pembrolizumab with Nimotuzumab in patients with Recurrent/Unresectable/Metastatic HNSCC and to analyze the impact of p16 expression on treatment outcomes.

METHODS: The study included 86 patients: 41 received Pembrolizumab monotherapy, and 45 received Pembrolizumab plus Nimotuzumab. Patients were divided into four groups based on treatment and p16 status, analyzing OS, PFS, and ORR.

RESULTS: With a median follow-up of 30.2 months, the combination therapy showed a significantly higher 6-month ORR, longer 1-year PFS and OS compared to monotherapy. Additionally, the combination therapy group notably improved 6-month ORR, 1-year PFS rate, and 1-year OS rate in p16-negative patients when compared to monotherapy. However, there was no significant improvement in ORR, PFS, or OS in p16-positive patients. Adverse events occurred in 61 patients (70.93%), with incidences of 68.29% in the monotherapy and 73.33% in the combination group, showing no statistically significant difference (p > 0.05).

CONCLUSION: The combination of Pembrolizumab and Nimotuzumab demonstrates a notable enhancement in ORR and OS, maintaining a dependable safety profile. Differential p16 expression in HNSCC patients may influence the efficacy of immune-combined targeted therapy, highlighting the importance of considering p16 in the formulation of therapeutic strategies.

PMID:41802984 | DOI:10.1111/odi.70259

Brain Connect. 2026 Mar 9:21580014261421825. doi: 10.1177/21580014261421825. Online ahead of print.

ABSTRACT

INTRODUCTION: Prior visual neuroscience research has contributed ample evidence on functional anatomy of two long-range systemic visual networks, dorsal (DVN) and ventral (VVN). Their developmental course of functional connectivity was rarely studied.

METHODS: We examined within- and between-network connectivity using cortical periodic alpha band 8-13 Hz, a well-elaborated developmental marker of cognitive inhibitory control. Resting state magnetoencephalography (rsMEG) investigated age differences in functional network connectivity between carefully screened male participants: younger group (YG, 6:10-12 years) and older group (OG, 18:7-29 years). The morphology of cortical network nodes was informed a priori by pilot resting state functional magnetic resonance imaging (rsfMRI) and MRI morphometry studies. Phase Lag Index was employed to compute within- and between-network connectivity. We summarized the age differences in connectivity using graph theory metrics.

RESULTS: The power spectral density across cortical areas was comparable between YG and OG, indicating similar signal-to-noise ratios across the age groups. The dorsal brain in YG showed higher within-network connectivity for the inferior parietal/occipital (DVN) and medial posterior nodes (cingulate/precuneus) of the default mode network (DMN), functionally/anatomically linked to DVN. A significantly reduced anterior brain connectivity for VVN in YG suggested its protracted maturation. The topography of alpha connectivity between age groups displayed no statistically significant differences in the posterior dorsal nodes of DVN/DMN but significantly lower connectivity in the anterior dorsal/medial cortex in YG as compared with OG.

DISCUSSION: The current rsMEG finding on intrinsic alpha-band oscillatory connectivity in child participants is consistent with prior neuroimaging evidence in humans and primates securing an early maturational course of posterior dorsal brain networks.

PMID:41802981 | DOI:10.1177/21580014261421825

Scand J Psychol. 2026 Mar 9. doi: 10.1111/sjop.70088. Online ahead of print.

ABSTRACT

Autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and developmental language disorder (DLD) are neurodevelopmental conditions (NDCs) that share etiological factors and frequently co-occur. Despite this, they have rarely been studied together-particularly in relation to functional outcomes. In this study, we investigate the association between the developmental pattern of sustained visual attention in infancy and number of diagnoses, and map the clinical profile of 6-year-old children. A cohort of 6-year-olds, originally recruited in infancy due to elevated (n = 42) or low (n = 7) likelihood of ASD, were assessed for sustained visual attention, diagnostic outcomes, general adaptive functioning, intellectual abilities, and language skills. Participants were grouped based on the number of NDC diagnoses (ASD, ADHD, DLD, and/or Subthreshold ASD) they received at follow-up. We could not find statistical support for an association between sustained visual attention and number of diagnoses. Findings revealed no significant differences in adaptive functioning, intellectual abilities, or language skills between children with no diagnosis (n = 24) and those with a single diagnosis (n = 15). However, children with two or more diagnoses (n = 10) scored significantly lower in general adaptive functioning, intellectual ability, language production, and verbal comprehension compared to those with only one or no diagnosis. The results indicate that compared to children with only one diagnosis or no diagnosis, children with two or more diagnoses scored lower on several key functional domains, emphasizing the need to prioritize children with multiple diagnoses or confirmed functional impairment in clinical settings. Moreover, the findings indicate that a single diagnosis in preschool-aged children should not be a stand-alone outcome measure in sibling studies, if the goal is to identify early processes that predict meaningful differences in everyday functioning.

PMID:41802979 | DOI:10.1111/sjop.70088

Womens Health Issues. 2026 Mar 9:S1049-3867(26)00032-0. doi: 10.1016/j.whi.2026.01.007. Online ahead of print.

ABSTRACT

PURPOSE: Engagement with routine health care services before pregnancy provides an opportunity for providers to identify and address preexisting conditions or behaviors that may be associated with adverse maternal and infant outcomes. Research demonstrates the importance of timely and adequate prenatal care (PNC) to mitigate adverse pregnancy outcomes. This study examines the relationships between routine health care utilization in the year before pregnancy, PNC adequacy, and gestational age at birth in Mississippi residents who recently gave birth.

METHODS: A cross-sectional, secondary analysis of Mississippi Pregnancy Risk Assessment Monitoring System data from 2016 to 2021 was completed. Descriptive statistics, correlational analysis, and generalized linear models for complex survey design were conducted. Variables of interest included health care utilization in the year before pregnancy, PNC adequacy, and gestational age at birth. The adequacy of PNC was reported as a categorical variable using the Kessner Index.

RESULTS: Among a sample of 6,552, 52% engaged in routine health care in the year before pregnancy; participants who engaged in routine health care in the year before pregnancy had a higher probability of receiving adequate PNC compared with those who did not (p = .009). Compared with those without, participants with health insurance had a higher probability of receiving routine health care in the year before pregnancy and adequate PNC (p < .001). Compared with those with lower incomes, participants with higher incomes had a higher probability of receiving routine health care in the year before pregnancy and adequate PNC (p < .001). The probability of adequate PNC was 77%, with white participants having a higher probability of receiving adequate PNC than Black participants (p < .001).

CONCLUSION: Routine health care utilization in the year before pregnancy increases the likelihood of receiving adequate PNC. Providers should maximize opportunities in the prepregnancy period to address health concerns and lifestyle choices that will impact future pregnancies. Additional research focused on the barriers to routine health care is warranted as researchers seek to understand high maternal and infant mortality rates.

PMID:41802973 | DOI:10.1016/j.whi.2026.01.007

Environ Int. 2026 Mar 9:110153. doi: 10.1016/j.envint.2026.110153. Online ahead of print.

NO ABSTRACT

PMID:41802969 | DOI:10.1016/j.envint.2026.110153

Environ Int. 2026 Mar 9:110154. doi: 10.1016/j.envint.2026.110154. Online ahead of print.

ABSTRACT

The systematic review by Mevissen et al. (2025, Environment International) evaluated the evidence on the carcinogenicity of radiofrequency electromagnetic fields (RF-EMF) in laboratory animals and concluded with a high certainty of evidence (CoE) that exposure to RF-EMF increases the risk of malignant glioma and malignant schwannoma in the brain and heart, respectively. Deviating from their pre-published systematic review protocol, the authors did not perform meta-analyses. Instead, they based their assessment on whether or not statistically significant increases in tumour rates were observed in the included studies. One positive finding was deemed sufficient to conclude an adverse effect of RF-EMF exposure in a specific organ, thereby setting the target of the CoE rating for that organ. Here, we question this approach because it does not consider all the available evidence, and highlight further methodologically inconsistent decisions, while laying out a quantitative alternative based on the protocol and common guidelines for systematic reviews. Re-assessing the eligible long-term carcinogenicity experiments, we consider important studies to be sufficiently similar to be combined in a meta-analysis (MA). We calculate odds ratios as the effect measure and perform MA as well as dose-response MA. Rating the results using GRADE and OHAT guidance, we downgrade the CoE for imprecision due to the very wide confidence intervals of the pooled odds ratios, and upgrade the CoE for malignant heart schwannomas because of a positive exposure-response association, concluding moderate and low CoE for carcinogenicity of RF-EMF exposures in the heart and brain, respectively. In summary, our quantitative assessment of the evidence results in lower CoE conclusions than those of Mevissen et al.

PMID:41802968 | DOI:10.1016/j.envint.2026.110154

J Allied Health. 2026 Spring;55(1):169-173. doi: 10.21091/jah.2026.01022.

ABSTRACT

BACKGROUND: Clinical instruction plays a vital role in allied health education, including supervising students learning to manage patients presenting with persistent pain.

PURPOSE: Investigate if the number of hours of pain science continuing education (PSCE) influenced physical therapy Clinical Instructors (CIs) confidence, knowledge, beliefs, and practice patterns related to persistent pain.

METHODS: The survey included pain science knowledge, PSCE hours, beliefs, confidence, and practice patterns related to persistent pain. A Mann-Whitney-U test was utilized for statistical analysis.

RESULTS: 44 responses were received. CIs completing p≥11 hours had improved knowledge (p=0.047), confidence (p<0.001), and beliefs (p=0.021) related to managing persistent pain.

CONCLUSION: Additional PSCE has the potential to positively impact CIs ability to mentor PT students.

PMID:41802966 | DOI:10.21091/jah.2026.01022

J Allied Health. 2026 Spring;55(1):163-167. doi: 10.21091/jah.2026.01021.

ABSTRACT

Healthcare students must be prepared to work with vulnerable populations. Because of the complexity of these individuals, an interprofessional approach is crucial. The purpose of this pilot study was to evaluate the effectiveness of an interprofessional service-learning experience on students’ self-reported attainment of the Interprofessional Education Collaborative (IPEC) core competencies. Thirteen students (physical therapy and pharmacy) participated in the experience and completed the full pre and post Interprofessional Collaborative Competencies Attainment Scale (ICCAS). After participating in the experience, students showed a statistically significant improvement in 17 of the 20 items on the ICCAS. Of those 17 items, 14 exceeded the minimal detectible change. Participation in a single interprofessional experience improved students’ self-reported score of attainment of the IPEC core competencies.

PMID:41802965 | DOI:10.21091/jah.2026.01021