Category: Nevin Manimala

Cancer Treat Rev. 2026 Jun 17;148:103170. doi: 10.1016/j.ctrv.2026.103170. Online ahead of print.

ABSTRACT

Background Early onset pancreatic cancer (EOPC), defined for the primary analysis as pancreatic ductal adenocarcinoma (PDAC) diagnosed before the age of 50 years, is an increasingly recognised clinical and epidemiological entity. Because published studies use heterogeneous age thresholds, the present review prespecified <50 years as the main definition and interpreted studies using other cutoffs in sensitivity or narrative analyses. Methods We systematically searched PubMed, EMBASE, and the Cochrane Library for studies published between January 1990 and December 2024 that reported outcomes specific to EOPC. Search terms were reformatted with standard quotation marks and included “pancreatic cancer”, “pancreatic adenocarcinoma”, “pancreatic ductal adenocarcinoma”, “early onset”, “young onset”, “young adult”, “age < 50”, “age less than 50”, and “premature”. Meta-analytic procedures and epidemiological interpretation were re-reviewed with statistical/epidemiological input. Results 40 studies encompassing more than 285,000 patients were included. Global incident EOPC cases increased from 24,480 (1990) to 42,254 (2021), representing a 72·6% rise. Age-standardised prevalence rate increased by 17·0% (1·65 per 100,000 in 2021). EOPC patients have a 3·08% per year increase in the youngest age group (20-29 years) over 2010-2021. Germline pathogenic variants were identified in 17·3% of EOPC patients (vs 6·4% in older cohorts; OR 2·41, 95% CI 1·87-3·11). EOPC patients were more likely to receive treatment (OR 2·95, 95% CI 2·54-3·43; I² = 13%) and showed modestly improved overall survival (pooled HR 0·89, 95% CI 0·80-0·99; I² = 16%) compared with average or late onset disease. Conclusions EOPC is an increasingly recognised and clinically challenging subset of PDAC. The substantial hereditary and potentially actionable molecular burden supports universal germline testing and comprehensive tumour genomic profiling, particularly in younger patients and in KRAS wild-type disease. PARP inhibitors should be described as improving progression-free survival or disease-control outcomes in selected BRCA-mutated metastatic PDAC rather than as having established a statistically significant overall survival benefit.

PMID:42341370 | DOI:10.1016/j.ctrv.2026.103170

Clin Psychol Rev. 2026 Jun 16;128:102780. doi: 10.1016/j.cpr.2026.102780. Online ahead of print.

ABSTRACT

Mindfulness, mindful eating and intuitive eating practices are associated with healthier eating and lower body weight. However, experimental research in this area has shown mixed effects on food intake and theoretical accounts are underdeveloped. This systematic review and meta-analysis aimed to examine the effect of mindfulness, mindful eating and intuitive eating interventions on food intake and appetite (hunger and fullness) in adults and children and compare effects across different subgroups to investigate potential mechanisms of action. Five electronic databases (PsycINFO, MEDLINE, EMBASE, Web of Science and Scopus) were searched for studies that experimentally manipulated mindfulness and/or mindful eating and/or intuitive eating, included a non-mindfulness control group and measured food intake (kcal or grams or percentage consumed or number of pieces consumed) and/or appetite (using visual analogue scales). Forty-one articles assessing mindfulness and mindful eating interventions were included (no relevant intuitive eating interventions were identified). Random-effects meta-analyses showed that mindfulness/mindful eating reduced food intake (n = 46 studies, SMD = -0.24, 95% CI [-0.35, -0.12], p < 0.001) but had no statistically significant effect on appetite (n = 11 studies). There were no significant subgroup differences observed between studies with different settings, interventions or food intake measures. However, effect sizes were substantially larger in laboratory-based studies. Overall, findings indicate that mindfulness and mindful eating reliably reduce food intake in controlled settings, but currently there is no evidence they influence appetite. The review underscores the need for higher quality and more ecologically valid studies using sensitive, real-world measures of appetite and food intake, and further work to clarify the mechanisms of action underpinning the effects of mindfulness and mindful eating.

PMID:42341365 | DOI:10.1016/j.cpr.2026.102780

Econ Hum Biol. 2026 Jun 20;62:101623. doi: 10.1016/j.ehb.2026.101623. Online ahead of print.

ABSTRACT

A gap in mortality rates between rural and urban areas emerged in the late 1990s as rural residents began dying at a higher rate than their urban counterparts. This mortality gap has been widening ever since. The growing mortality gap is pronounced among prime working-age adults (ages 25-54), which has important implications for rural health, productivity, and economic development. Despite the heightened mortality rates in rural areas in recent decades, there is still a limited understanding of the health-related mechanisms fueling this worsening rural-urban mortality disparity. Using nationally representative data from the 1999-2000-2017-March 2020 cycles of the National Health and Nutrition Examination Survey, we combine individual-level data, including biomarkers, and place-based characteristics to create a comprehensive dataset spanning 20 years. In a descriptive analysis, we use linear regression models to estimate the magnitude of rural-urban gaps in health behaviors and outcomes-or mortality risk indicators-for the overall adult and prime working-age populations. We document a suite of rural health disadvantages, which may be informative for understanding the growing rural longevity gap. These disadvantages are often attenuated and no longer statistically significant after accounting for county-level characteristics. A complementary decomposition analysis indicates that county characteristics account for a larger share of the variation in health measures than rural-urban status. Our results can inform decision-makers aiming to improve rural health and economic outcomes and may spur further research using biomarker data alongside place-based characteristics.

PMID:42341364 | DOI:10.1016/j.ehb.2026.101623

J Fr Ophtalmol. 2026 Jun 24;49(7):104935. doi: 10.1016/j.jfo.2026.104935. Online ahead of print.

ABSTRACT

PURPOSE: Macular edema is a significant cause of vision loss in uveitis. Effective control of underlying inflammation is essential to treating macular edema in non-infectious uveitis, typically with corticosteroids. In this study, we examine the use of sequential dexamethasone and fluocinolone acetonide steroid intravitreal implants to promote rapid improvement and sustained control in non-infectious uveitic macular edema.

METHODS: Sixteen eyes from eleven patients with recurrent uveitic macular edema who received sequential intravitreal dexamethasone and fluocinolone acetonide implants were studied via retrospective chart review in 3-month intervals over a 24-month observation window. All patients had received at least one prior dexamethasone implant, which was used both therapeutically and to assess the intraocular-pressure response to an intravitreal corticosteroid before proceeding to the fluocinolone acetonide implant. The primary outcome was the recurrence rate of clinically significant macular edema after treatment. Chart review was performed to identify recurrences and need for additional anti-inflammatory treatment. We also evaluated change in visual acuity, intraocular pressure, and central subfield thickness throughout the study duration.

RESULTS: Twelve eyes (75%) did not experience a recurrence in clinically significant macular edema after treatment with both intravitreal injections. The rate of retreatment (25%) was reduced compared to patients who only received dexamethasone. There was a rapid and sustained improvement in macular edema, though there was no statistically significant improvement in visual acuity. Intraocular pressure initially increased but stabilized after the first 3-month interval.

CONCLUSIONS: Sequential administration of dexamethasone and fluocinolone acetonide intravitreal implants reduces the rate of significant macular edema recurrences in non-infectious uveitis. There is a significant quantitative improvement in macular edema, and further studies may demonstrate a noticeable benefit in visual acuity and quality of life with fewer retreatments.

PMID:42341355 | DOI:10.1016/j.jfo.2026.104935

Psychol Rep. 2026 Jun 24:332941261457360. doi: 10.1177/00332941261457360. Online ahead of print.

ABSTRACT

The Information Technology (IT) field is growing in the direction of the need to not only possess good technical skills but also good interpersonal skills to be able to cooperate and achieve success in a project. Emotional intelligence (EI) is a concept that has been identified as significant to the effectiveness of communications among IT professionals. This is a quantitative research on how EI and communication skills (CS), and other related psychological variables, including self-efficacy (SE), communication apprehension (CA), empathy, and social influence (SI), relate to each other. The participants were 535 IT professionals, comprising software developers, system analysts, project managers, and IT consultants. The study employed a purposive sampling method to administer the structured questionnaire. Data were analyzed using Statistical Package for the Social Sciences (SPSS) for preliminary analyses and SmartPLS 4 for confirmatory factor analysis (CFA) and structural equation modelling (SEM). The results indicate that EI, SE, and empathy are positively associated with CS, CA shows a negative association, whereas SI is a significant predictor of CS in a group setting (all paths p < 0.05). The novelty of this study is its combined analysis of the EI and various communication and related psychological constructs in the specific context of IT professionals, which has not been studied extensively in the literature. The results also present practical recommendations for the IT organizations since they highlight the necessity of developing emotional competencies that can improve communication and teamwork, and consequently, improve individual and organizational performance.

PMID:42341347 | DOI:10.1177/00332941261457360

JMIR Mhealth Uhealth. 2026 Jun 24;14:e68394. doi: 10.2196/68394.

ABSTRACT

BACKGROUND: Unguided internet-based cognitive behavioral therapy (ICBT) is a low-cost and scalable treatment for major depressive disorder (MDD), but its long-term effects in Chinese populations remain unclear.

OBJECTIVE: This study aimed (1) to explore the short- and long-term effectiveness of unguided ICBT in treating adults with MDD; (2) to investigate the short- and long-term effects on disease-related symptoms, individual and social functioning, and quality of life; and (3) to assess the acceptability and satisfaction with the ICBT.

METHODS: An 8-week randomized controlled trial (ChiCTR2100046425) was conducted between August 2021 and June 2023 in Shenzhen, China, with 159 participants in the immediate ICBT group (7-module ICBT course plus usual care) and 158 in the waitlist control (WLC) group (usual care). The WLC group later completed the same ICBT course and follow-up assessments. Outcome measures (depressive and anxiety symptoms, psychological distress, social functioning, self-efficacy, quality of life, and stigma) were assessed before and after treatment and at 3-, 6-, and 12-month follow-ups for ICBT participants. Remission and response, adherence, and satisfaction were evaluated by predefined standards.

RESULTS: Among 300 participants analyzed (mean age 28.49, SD 7.0 years; female: n=225, 75%), dropout rates were 22.4% (34/152) in the immediate ICBT group versus 6.3% (10/158) in the WLC group. At posttreatment, the immediate ICBT group showed greater reduction in depressive symptoms versus WLC (mean difference -3.65, SE 0.60; P<.001; d=0.50), with higher remission (80/121, 66.1% vs 58/148, 39.2%; P<.001) and response rates (50/121, 41.3% vs 27/148, 18.2%; P<.001). At 12-month follow-up, the depressive symptoms were improved compared with that at pretreatment (mean difference -3.90, SE 0.32; P<.001; d=0.70), and no significant change was observed in comparison with the outcomes at posttreatment (mean difference -0.81, SE 0.33; P=.33; d=-0.15). ICBT treatment also exhibited similar short- and long-term effects on secondary outcomes, with significant improvement of disease-related symptoms, individual and social functioning, and quality of life. Moreover, the majority of the participants treated with ICBT reported high acceptability of and satisfaction with the ICBT course.

CONCLUSIONS: Unguided ICBT effectively reduces depressive symptoms and enhances functioning in Chinese patients with MDD, with sustained benefits over 12 months. Its scalability and low-cost nature make it a promising option for resource-limited settings.

PMID:42341343 | DOI:10.2196/68394

Appl Physiol Nutr Metab. 2026 Jun 24. doi: 10.1139/apnm-2025-0371. Online ahead of print.

ABSTRACT

Movement behaviour guidelines should be tailored to contextual factors influencing physical activity, sedentary behaviour, and sleep to support effective mobilization. Compared to urban areas, rural communities have distinct environmental characteristics and require context-specific strategies to promote healthy movement behaviours. This study aimed to evaluate awareness and knowledge of the Canadian 24-Hour Movement Guidelines for Adults (18-64 years) living in rural communities and explore how to adapt the Canadian 24-Hour Movement Guidelines Communications Toolkit for greater impact and relevance. We adopted an explanatory sequential mixed methods study design, in which adults living in rural communities of British Columbia, Canada, completed a cross-sectional survey (N = 76) followed by individual interviews (N = 12). Survey data were analysed for awareness and knowledge of Movement Guidelines using descriptive statistics and Chi-squared tests. Interview data were analyzed following a deductive thematic approach using the Behaviour Change Wheel to identify the barriers and facilitators to meeting guideline recommendations. Approximately half of the participants reported being aware of the guidelines (44.7%), 64.5% reported moderate knowledge of recommendations, and 27.6% of participants reported meeting guidelines for physical activity, sedentary behaviour, and sleep. Participants perceived factors associated with physical opportunities and psychological capabilities to have strong influences on their ability to meet movement behaviour guidelines. Recommendations for adapting 24-Hour Movement Guidelines for rural communities include providing additional information on being active outdoors and at home, information on discerning sedentary behaviour and inactivity, and tips to combat seasonal changes in daylight.

PMID:42341342 | DOI:10.1139/apnm-2025-0371

Oncol Nurs Forum. 2026 Jun 24;53(4):1-12. doi: 10.1188/26.ONF.e26535328.

ABSTRACT

OBJECTIVES: To examine the relationship between side effect severity and self-management ability in patients taking capecitabine and investigate whether medication beliefs mediate this relationship.

SAMPLE &AMP; SETTING: A secondary analysis was conducted using data from a descriptive study of 50 patients with gastrointestinal cancer receiving capecitabine at the University of Michigan Rogel Cancer Center.

METHODS &AMP; VARIABLES: Self-management ability was assessed using the Measure of Drug Self-Management. The severity of capecitabine-related side effects was measured using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events. Patients’ perceived necessity of and concerns about capecitabine were evaluated using the Beliefs about Medicines Questionnaire (adapted for capecitabine). Descriptive statistics, multiple linear regression, and PROCESS macro mediation analysis were employed.

RESULTS: Self-management ability was significantly associated with total side effect severity (beta = -1.09, p = 0.003). This relationship was partially mediated by patients’ overall beliefs about capecitabine (beta = -0.74, p = 0.04) and fully mediated by concerns about its potential harms (beta = -0.6, p = 0.11).

IMPLICATIONS FOR NURSING: Oncology nurses should adopt a patient-centered approach that includes counseling about the benefits of capecitabine, addressing concerns about adverse effects, and reinforcing patients’ self-efficacy and social support networks to enhance self-management during therapy.

PMID:42341331 | DOI:10.1188/26.ONF.e26535328

JMIR Mhealth Uhealth. 2026 Jun 24;14:e69273. doi: 10.2196/69273.

ABSTRACT

BACKGROUND: Patients with Parkinson disease (PD) along with subjective cognitive decline (PD-SCD) are considered an intermediate status between those with normal cognition (PD-NC) and those with mild cognitive impairment (PD-MCI). Wearable digital monitoring technologies and machine learning models offer significant potential for assessing cognitive impairment in patients with PD.

OBJECTIVE: We aimed to evaluate the utility of wearable technology and machine learning for identifying ordinal cognitive stages (OCS) in PD based on timed up and go (TUG) tests (including single-task TUG [TUGst] and dual-task TUG [TUGdt]).

METHODS: Patients with PD along with SCD, MCI, and NC were recruited in a movement disorder clinic. Patients performed TUGst and TUGdt gait trials wearing a motor function and motor symptom quantitative assessment system. In total, 209 kinematic parameters were synthesized for individual TUG to illustrate patients’ motion profiles. We constructed dual-task cost parameters (DTC), describing the magnitude of the effect of the cognitive challenge on motion performance. Covariate-adjusted ordered logistic regression was used to compare parameter differences among 3 groups. Multiple machine learning models were used to classify the participants into 3 cognitive impairment levels, with features being selected based on P values from intergroup statistical tests. The total population was randomly divided into a training set and an independent validation set in a 7:3 ratio, and 10-fold cross-validation was used in the training set. Furthermore, this study used permutation importance and Shapley Additive Explanations (SHAP) analysis (including summary plots, bar plots, and waterfall plots) to explain the feature importance of the final model.

RESULTS: The study included 65 age-matched patients (PD-NC: PD-SCD: PD-MCI= 14:21:30). Forty-five kinematic parameters were significantly different (P<.05) among the 3 groups, distributed across TUGst (n=25), TUGdt (n=12), and DTC (n=8) paradigms. Gait phase analysis revealed 35 parameters from walking phases, 9 from stand-to-sit transitions, and 1 from sit-to-stand transitions. Feature type distribution demonstrated predominance of variability features (n=20), followed by pace (n=12) and axial (n=8) characteristics. TUGdt paradigm analysis revealed pronounced movement differences between PD-MCI and both PD-NC and PD-SCD groups, particularly in variability, amplitude, pace, and axial domains. Cross-paradigm analysis identified consistent significant differences in specific features. These findings provide objective kinematic biomarkers for early cognitive state identification in Parkinson disease, with TUGdt parameters demonstrating superior discriminative capacity.

CONCLUSIONS: This suggests patients with PD-SCD could have early kinetic signs of cognitive impairment, positioning them between PD-NC and PD-MCI, and our multiclass support vector machine classification model with kinematic parameters achieved a recall rate above 0.70 in both training and validation datasets. The feature importance analysis revealed that DTC_Trunk-Right Rotation Max, DTC_Trunk-Max Transverse Angular Velocity, and dTUG_Lumbar-Right Sway Max Std were the most critical features for distinguishing cognitive states, providing scientific evidence for cognitive function screening based on kinematic parameters.

PMID:42341295 | DOI:10.2196/69273

JMIR Mhealth Uhealth. 2026 Jun 24;14:e75308. doi: 10.2196/75308.

ABSTRACT

BACKGROUND: The global prevalence of dementia continues to rise and demands scalable, nonpharmacological interventions. Digital cognitive training has expanded, but many older adults, who have limited digital literacy, struggle to sustain use. We designed an intervention that integrates social interaction, reward-based engagement, and an artificial intelligence (AI) conversational agent, which aims to reduce these barriers and support continuous participation.

OBJECTIVE: This study examined whether a 12-week digital cognitive training program improves cognitive function in older adults. It also tested whether a group chat service, which enables interaction among participants and with an AI agent, increases engagement and social support.

METHODS: We recruited 133 participants (mean age 64.75, SD 6.76; range 55-75 years) who had no diagnosis of dementia. All participants used the Care & Cure program for 12 weeks. The program includes an AI chatbot (Sammy Talk) and a group chat service (Our Town), which supports peer interaction. We measured cognitive function using the Korean Mini-Mental State Examination-Version 2 (K-MMSE-2). We also assessed degrees of social support (Medical Outcomes Study-Social Support Survey), depression (Short Form Geriatric Depression Scale-Korean Version), and engagement (Twente Engagement with eHealth Technologies Scale), and analyzed usage logs to examine participation patterns.

RESULTS: Participants showed improved cognitive function after the intervention (Hedges g=0.350, P<.001). Active users (n=67), who engaged more frequently with the program, showed greater improvement than nonactive users (n=66), especially among those who had lower baseline cognitive scores (Hedges g=0.523, P<.001). Social support increased, particularly emotional and informational support (t132=-6.509, P<.001). Participants reported higher engagement (t132=2.008, P<.05) and lower depression scores (t132=3.093, P<.01). Regression results showed that group chat participation, which promotes interaction with the AI agent, increased engagement in cognitive training (t131=12.395, P<.001). Increased engagement was associated with higher social support (t131=4.102, P<.001) and improved cognitive function (t131=2.467, P<.05). Cognitive training alone did not produce a significant effect. Participants showed low adherence, which indicates a need for strategies that sustain long-term use.

CONCLUSIONS: The Care & Cure program improved cognitive function and strengthened social support in older adults. Social interaction, which increases engagement, played a central role. These findings suggest that digital cognitive interventions should incorporate social mechanisms to achieve meaningful effects.

PMID:42341288 | DOI:10.2196/75308