Nevin Manimala

JPEN J Parenter Enteral Nutr. 2026 May 17. doi: 10.1002/jpen.70103. Online ahead of print.

ABSTRACT

BACKGROUND: Malnutrition, frailty, and sarcopenia are common and interrelated in patients with cancer, yet their associations with nutrition impact symptom clusters remain unclear. This study examined the overlap of these conditions, and their relationships with symptom clusters in adults with cancer.

METHODS: Malnutrition was assessed using the Patient-Generated Subjective Global Assessment and Global Leadership Initiative on Malnutrition criteria, frailty using the FRAIL scale, and sarcopenia using the 2019 Asian Working Group for Sarcopenia consensus. Latent class analysis identified nutrition impact symptom clusters. Logistic regression models evaluated associations between symptom clusters and the three conditions.

RESULTS: This cross-sectional latent class analysis included 28,377 hospitalized adults with cancer (median age 58 years; 55.3% male). Gastrointestinal (41.0%) and lung (23.1%) cancers were the most common diagnoses. The prevalence of malnutrition, frailty and sarcopenia was 56.4%, 37.7%, and 16.9%, respectively. Weight loss and low muscle mass represent key shared features of their coexistence. Five nutrition impact symptom clusters were identified and ranked by severity. Patients with severe multi-symptom cluster had 3.87-fold higher odds of malnutrition and 6.03-fold higher odds of frailty. Patients with the gastrointestinal-dominant symptom cluster were most likely to experience malnutrition, whereas those with the sensory-alteration symptom cluster were most likely to exhibit frailty.

CONCLUSION: Maintaining stable body weight, particularly muscle mass, is crucial for cancer patients to reduce the risk of comorbidity among these conditions. Identifying nutrition impact symptom clusters and providing targeted interventions may help reduce the burden of these conditions and improve the efficiency of nutritional care.

PMID:42143564 | DOI:10.1002/jpen.70103

Clin Genitourin Cancer. 2026 Apr 14;24(5):102564. doi: 10.1016/j.clgc.2026.102564. Online ahead of print.

ABSTRACT

PURPOSE: To characterize financial toxicity (FT) of non-muscle invasive bladder cancer (NMIBC) among our uniquely diverse and urban population.

MATERIALS AND METHODS: We surveyed a cohort of patients at our institution with NMIBC using the validated COST tool (COmprehensive Score for financial Toxicity). Scores are inversely correlated to the degree of FT. Scores of 25-14 indicated “Mild FT” and < 14 indicated “Moderate FT”. Demographic and disease specific information were collected. Statistical analysis was performed using SPSS.

RESULTS: Hundred patients with NMIBC were surveyed. The median age was 74 years (IQR, 66-79). A total of 39% were female; 35% identified as Caucasian, 26% as Black, and 37% as Hispanic. The median COST score was 23 (IQR,15-33). 61% of patients reported at least mild FT (COST score 25-14). A total of 21% reported moderate FT (COST score < 14). Black patients were more likely to experience FT than Caucasians (73% vs 37%, P < .05). Caucasian patients had a mean COST score 8 points higher than all other races combined (P < .01). Overall median household income was $30,000 (IQR, $18,250-$60,750), and increasing income had a significant positive correlation with COST score (Spearman ρ = 0.502, P < .001). Risk factors for FT included non-Caucasian race and lower education level.

CONCLUSION: In a diverse, urban population, rates of FT among NMIBC patients were higher than previously reported. FT may disproportionately affect non-Caucasian patients and may be related to decreased access to care. These results highlight the need to further assess and address FT in NMIBC patients.

PMID:42143549 | DOI:10.1016/j.clgc.2026.102564

Clin Neurol Neurosurg. 2026 May 14;268:109473. doi: 10.1016/j.clineuro.2026.109473. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the association between antidepressant use and survival outcomes in patients with glioblastoma multiforme (GBM).

METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. MEDLINE, Embase, and LILACS were searched for observational studies evaluating the association between antidepressant use and survival in patients with GBM. Hazard ratios (HRs) for overall survival were pooled using a random-effects model. Subgroup analyses were performed by antidepressant class, timing of initiation, and patient age. Between-study heterogeneity was assessed using the I² statistic, and meta-regression was conducted to explore potential sources of variability.

RESULTS: Eight studies comprising 8915 patients were included. Antidepressant use was not significantly associated with overall survival (HR 1.09, 95% CI 0.76-1.55; p = 0.64), with substantial between-study heterogeneity (I² = 95%). Subgroup analyses revealed no significant survival association when stratified by antidepressant class (SSRIs alone: HR 0.95, 95% CI 0.73-1.25; SSRIs and TCAs combined: HR 1.18, 95% CI 0.62-2.26), timing of initiation (pre-diagnosis: HR 0.91, 95% CI 0.63-1.32; post-diagnosis: HR 1.28, 95% CI 0.64-2.54), or age. Leave-one-out sensitivity analysis confirmed the robustness of the null finding. Meta-regression did not identify antidepressant exposure as a significant source of heterogeneity. Gross total resection was consistently associated with improved survival across studies.

CONCLUSIONS: Current evidence does not support a survival benefit associated with antidepressant use in patients with GBM. Antidepressants should be prescribed based on psychiatric indications rather than with the expectation of oncological benefit. Prospective studies with standardized exposure definitions and molecular subtyping are needed to further clarify any potential therapeutic role.

PMID:42143537 | DOI:10.1016/j.clineuro.2026.109473

Clin Neurol Neurosurg. 2026 May 10;268:109471. doi: 10.1016/j.clineuro.2026.109471. Online ahead of print.

ABSTRACT

SIGNIFICANCE: Levetiracetam (LTM), a second generation anti-epileptic drug, is routinely prescribed to patients for seizure prophylaxis following traumatic brain injury (TBI). Limited research exists on the safety and efficacy of levetiracetam in patients aged 80 + . This study investigates the association between levetiracetam administration and outcomes in patients 80 + with severe TBI.

METHODS: Our institutional trauma registry was queried for patients aged 80 + who did not have an active anti-epileptic drug prescription and were admitted for severe TBI between January 2021 – May 2023. Statistical tests were performed to determine any significant difference in demographics or outcomes between those who received LTM and those who did not.

RESULTS: 91 patients were included in the final analysis, 32 not given LTM and 59 given LTM. Age was significantly higher in the no-levetiracetam group (87.07 vs. 85.91; p = 0.04). ISS (25 vs. 17 p = 0.04), Max AIS Head (5 vs. 4; p < 0.01), and three-month mortality rates (28.8% vs. 9.4%; p = 0.03) were significantly higher in the levetiracetam group. Three levetiracetam patients (5.08%) had their prescriptions discontinued due to adverse effects. Three levetiracetam patients experienced seizures within seven days of TBI but did not experience seizures at 3 months follow-up.

CONCLUSION: Levetiracetam is well-tolerated for seizure prophylaxis in patients 80 + following TBI based on low rates of adverse effects. Levetiracetam is generally prescribed to patients with more severe TBIs. Further studies are needed to determine long-term outcomes of levetiracetam in octogenarians with TBI.

PMID:42143536 | DOI:10.1016/j.clineuro.2026.109471

Food Chem. 2026 May 3;518:149492. doi: 10.1016/j.foodchem.2026.149492. Online ahead of print.

ABSTRACT

This study aims to characterise the milk metabolome from a seasonal pasture-based dairy system using ¹H-NMR spectroscopy. Over 41 weeks, ten dairy farms were visited weekly for the collection of raw bulk tank milk samples (n = 410) and three commercial pasteurised skimmed milks were also purchased weekly (n = 123). In total, 38 milk metabolites were quantified, 30 of which exhibited significant seasonal variation. Multivariate analysis identified several key compounds associated with seasonal metabolic changes. Winter-Feb milk, corresponding to early-lactation period, was enriched in ketone bodies, O-phosphocholine, creatinine, and glucose-1-phosphate, reflecting increased metabolic stress and negative energy balance following parturition. In contrast, autumn milk, corresponding to late-lactation, contained higher concentrations of choline and urea, indicative of improved energy status but reduced nitrogen use efficiency. These findings highlight the potential of milk metabolomics as a valuable tool for monitoring physiological status and guiding interventions to enhance sustainability in dairy systems.

PMID:42143509 | DOI:10.1016/j.foodchem.2026.149492

Spectrochim Acta A Mol Biomol Spectrosc. 2026 May 12;360:128062. doi: 10.1016/j.saa.2026.128062. Online ahead of print.

ABSTRACT

A novel meta-substituted azo compound, (E)-1-((3-methoxyphenyl)diazenyl)naphthalen-2-ol (m-AZO), was synthesized via diazotization-coupling reaction in 90% yield. The molecular structure was unambiguously determined by single-crystal X-ray diffraction, revealing a monoclinic crystal system (space group P2₁/c) with the azo group in a trans configuration. Experimental characterization was carried out using FT-IR, UV-Vis, and ¹H/¹³C NMR spectroscopy, along with elemental (CHN) analysis. The UV-Vis spectrum showed an absorption maximum at 483 nm, consistent with π-π* electronic transitions. DFT and TD-DFT calculations reproduced the experimental absorption spectrum and provided further insights into the electronic structure. Theoretical analysis of the three positional isomers (o-, m-, and p-AZO) indicated that m-AZO possesses the lowest reorganization energy for holes (λ_hole = 0.13 eV), while p-AZO exhibited the highest light harvesting efficiency (LHE = 81.05%). Photovoltaic simulations based on the Scharber model predicted a power conversion efficiency of 6.5% for the m-AZO/PC71BM heterojunction. These findings demonstrate that m-AZO combines favorable experimental properties with promising optoelectronic behavior, establishing it as a strong donor candidate for organic photovoltaic applications.

PMID:42143482 | DOI:10.1016/j.saa.2026.128062

Spectrochim Acta A Mol Biomol Spectrosc. 2026 May 14;360:128057. doi: 10.1016/j.saa.2026.128057. Online ahead of print.

ABSTRACT

Rapid and accurate identification of molybdenite is critical for optimizing beneficiation processes but remains challenging due to complex gangue interference and environmental noise. This study proposes an intelligent identification framework based on VNIR-SWIR spectroscopy that integrates novel chemometric algorithms with multi-feature fusion. To address spectral coupling mechanisms, we introduce the Multi-scale Band-coupled Interquartile Range (MC-IQR) algorithm, a preprocessing technique that combines adaptive sliding-window filtering to robustly extract overlapping spectral features. Unlike conventional single-feature methods, our approach employs a dynamically weighted fusion model incorporating Euclidean Distance, Cosine Similarity, and Spectral Information Divergence (SID). This strategy synergistically optimizes multidimensional spectral information-spanning amplitude, geometric shape, and probability distribution-to ensure adaptability in complex mining environments. Statistical validation on an independent test set reveals an Overall Accuracy of 97.8% across all target mineral categories, with an ultra-fast processing speed of <10 ms per sample. An ablation study further confirmed that the full ED-CS-SID fusion configuration outperformed all single-feature and dual-feature variants. Furthermore, blind field tests on jaw-crushed raw ore samples provide additional practical evidence for the model’s robustness to surface dust and mixed-mineral interference under field conditions. These results support the potential of the proposed method as a non-destructive and real-time tool for intelligent mineral sorting in complex mining environments.

PMID:42143478 | DOI:10.1016/j.saa.2026.128057

Ecotoxicol Environ Saf. 2026 May 16;318:120271. doi: 10.1016/j.ecoenv.2026.120271. Online ahead of print.

ABSTRACT

Groundwater is a vital resource for ensuring ecosystem balance, urban water quality, and economic development. In this study, an integrated framework was applied to investigate groundwater hydrochemistry, identify its sources, evaluate the water quality, and assess the health risks associated with groundwater chemistry in the southern region of Jinan City (SRJC). The analysis combined mathematical statistics, positive matrix factorization (PMF), and Monte Carlo simulations (MCs). The mean total dissolved solids, total hardness, and pH were 551 mg/L, 412 mg/L, and 7.63, respectively, which confirmed the main property of weakly alkaline hard fresh water. The Ca²⁺ and HCO₃^– ions played the dominant roles, and the Piper diagram presented that HCO₃-Ca was the primary hydrochemical facies. The groundwater hydrochemistry in the SRJC was found to be governed by both natural processes, particularly hydro-rock interactions, and anthropogenic inputs, mainly agricultural activities and wastewater discharge. PMF resolved five major sources, among which carbonate weathering (39.5%) and wastewater/fertilizer inputs (20.1%) were dominant. Most groundwater samples were suitable for both domestic drinking and agricultural irrigation. Compared with simplified models and 1D-MCs, 2D-MCs provided a more robust risk assessment and revealed the possibility of risk underestimation by conventional approaches. The 2D-MCs-based non-carcinogenic risk assessment further showed a markedly higher risk for children (10.7%) than for adults (3.9%).

PMID:42143474 | DOI:10.1016/j.ecoenv.2026.120271

Hum Immunol. 2026 May 16;87(7):111761. doi: 10.1016/j.humimm.2026.111761. Online ahead of print.

ABSTRACT

BACKGROUND: Type 2 inflammatory diseases (T2IDs) often coexist, but their shared genetic basis remains unclear. This study explores common genetic basis between asthma and other T2IDs and identifies pleiotropic loci and mechanisms.

METHODS: Using genome-wide association study (GWAS) summary statistics, we assessed genetic correlation between asthma and four T2IDs (allergic conjunctivitis [AC], allergic rhinitis [AR], pollen allergy [PA], atopic dermatitis [AD]) via cross-trait pleiotropy analysis, followed by functional, tissue-specificity, and multi-trait colocalization analyses.

RESULTS: Significant genetic correlations were detected in all four trait pairs. Pleiotropy analysis under the composite null hypothesis (PLACO) identified 21 pleiotropic loci, with 2 colocalized (PP.H4 > 0.75). Notable pleiotropic loci were identified, such as 4q24 (MANBA, UBE2D3, and CISD2) and 19q13.2 (SNRPA, RAB4B, MIA-RAB4B, and EGLN). MAGMA revealed 49 candidate pleiotropic genes involved in synaptic structure/function and cellular organization. Tissue enrichment analysis, stratified LD score regression (S-LDSC), and summary data-based Mendelian randomization (SMR) analysis revealed that pleiotropic mechanisms play significant roles in the brain, spleen, whole blood, and EBV-transformed lymphocytes. Hyprcoloc implicated distinct lymphocyte subtypes in shared mechanisms between asthma and AD.

CONCLUSIONS: We identified shared genetic loci and gene sets between asthma and T2IDs, offering insights into genetic mechanisms and potential therapeutic targets.

PMID:42143449 | DOI:10.1016/j.humimm.2026.111761

Eur J Oncol Nurs. 2026 May 11;82:103204. doi: 10.1016/j.ejon.2026.103204. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Cancer patients frequently experience both physical pain and emotional distress, often intensified by exposure to past traumatic events. These psychological and physiological burdens can adversely affect treatment outcomes and quality of life. This study aimed to examine the relationship between past trauma, emotional well-being, and pain among cancer patients undergoing chemotherapy across Iraq.

METHOD: This cross-sectional study was conducted from September 1st, 2024, to February 13th, 2025, across four major hospitals in Iraq, using convenience sampling. Data were collected using three standardized instruments: the Trauma History Questionnaire (THQ), the Pain Assessment Numerical Rating Scale (NRS), and the Hospital Anxiety and Depression Scale (HADS), along with a sociodemographic form. Statistical analyses were performed using SPSS version 26.0 and PROCESS Macro version 4.2. Descriptive statistics, Pearson’s correlation, multivariable and hierarchical regression, and mediation analysis with 5000 bootstrap samples were employed.

RESULTS: A total of 409 patients participated in the study. The Findings revealed significant positive correlations between trauma exposure and pain (r = 0.26-0.31), anxiety (r = 0.33-0.41), and depression (r = 0.29-0.38) (p < .05). Regression models indicated that trauma and emotional well-being significantly predicted pain (Adjusted R² = 0.39, p < .001). Mediation analysis demonstrated that anxiety and depression partially mediated the trauma-pain relationship, accounting for 38-46% of the total effect.

CONCLUSIONS: Past trauma was significantly associated with both emotional well-being and pain severity among cancer patients. Integrating trauma-informed psychological care into oncology settings may help reduce pain and enhance emotional resilience among patients.

PMID:42143438 | DOI:10.1016/j.ejon.2026.103204