Category: Nevin Manimala

BMC Cancer. 2026 Jun 26. doi: 10.1186/s12885-026-16308-4. Online ahead of print.

ABSTRACT

This study evaluates within-subject temporal differences between tumor and body temperatures using three cancer models: melanoma, breast cancer, and colon cancer, to monitor the effects of immunotherapy and chemotherapy on temperature differences. In the melanoma arm, TRP-2 immunotherapy led to increased tumor temperatures compared to the control group, with significant overall treatment separation observed at 58 h into the treatment protocol. For breast cancer, AC-Taxol chemotherapy resulted in a drop in body temperature for both treatment and control groups, with significant treatment group separation on tumor vs. body observed at 96 h. In colon cancer, anti-PD-1 immunotherapy showed an upward trend in tumor temperatures, with significant separation from the control group at 94 h. A series of statistical tests, including mixed-model repeated measures and non-parametric tests, revealed significant differences in temperature trends between treatment and control groups for all cancer types. Furthermore, examination of radial smoothing repeated measures models revealed how the clinical application of this technology could be applied. These results suggest that temperature-based monitoring may be an effective tool for assessing therapeutic responses in cancer treatments, highlighting the utility of thermal measurements in evaluating immunotherapy and chemotherapy efficacy.

PMID:42363127 | DOI:10.1186/s12885-026-16308-4

BMC Med Educ. 2026 Jun 26. doi: 10.1186/s12909-026-09107-9. Online ahead of print.

ABSTRACT

BACKGROUND: Acute oncology e-learning for staff who treat and care for people with cancer in the United Kingdom exists; however standardised, acute oncology competence assessment does not. This study reports the development and evaluation of a standardised acute oncology competence assessment integrated within an existing e-learning resource, which ultimately aims to improve cancer patient safety outcomes across the UK. The e-learning and assessment were developed for multidisciplinary staff working in any clinical setting where patients with cancer may present with urgent or emergency symptoms. For example, acute medical units, accident and emergency, same day emergency care, primary care and pre-hospital settings, such as paramedic services and general practice, as well an introductory resource for staff new to working in oncology.

METHODS: The study team, multidisciplinary professionals and cancer-specialist educators from across the UK co-designed a Digital Competence Assessment for ‘practice Level 1’. An existing ‘Introduction to Acute Oncology E-learning Module’ was revised to include the novel Digital Competence Assessment (together the e-learning and competence assessment were termed: The Level 1 Acute Oncology Passport). This was piloted and evaluated across the UK during Phase 2. Quantitative data from pre (n = 376) and post (n = 176) Level 1 Acute Oncology Passport responses were analysed using descriptive and inferential statistics. Free-text responses were analysed using content analysis.

RESULTS: There was a significant increase in learners’ level of confidence about their acute oncology knowledge and skills pre and post e-learning and digital competence assessment. The Level 1 Acute Oncology Passport was evaluated as relevant, pitched at the correct level and an appropriate measure for assessing acute oncology knowledge and skills competencies. The main challenge reported was lack of study time. There was also a desire for support of acute oncology knowledge and skills development in the workplace, alongside or following e-learning.

CONCLUSIONS: Acute oncology is an important area of practice for improving outcomes for people with cancer, but for acute oncology to be effective it requires a knowledgeable and skilled workforce. The acute oncology learning needs of staff caring for people with cancer in other countries are likely to be similar to the UK. Although respondents were staff who opted to complete the online learning, assessment and evaluation survey, our e-learning and digital assessment of competence Passport was found to be engaging, relevant and acceptable, demonstrating the value of co-design. It also increased learners’ confidence and knowledge about acute oncology. However, dedicated time and support are needed for healthcare staff to develop knowledge and skills to ensure safe outcomes for people with cancer. We suggest that similar education and competence assessment resources are needed to address acute oncology learning needs among the broader cancer care workforce.

PMID:42363126 | DOI:10.1186/s12909-026-09107-9

BMC Pediatr. 2026 Jun 26. doi: 10.1186/s12887-026-07191-w. Online ahead of print.

ABSTRACT

BACKGROUND: Inclusive adapted physical activity and parasport programs support physical and psychosocial well-being of children experiencing disability. Easter Seals offers opportunities for children of all abilities to engage in physical activity through introductory parasports.

PURPOSE: Our evaluation aimed to understand caregiver’s perspectives on quality participation in Easter Seals programs.

METHODS: We collected quantitative and qualitative data through surveys followed by semi-structured interviews to further explore survey data findings. Survey data were analyzed using descriptive statistics and interviews using reflexive thematic analysis.

RESULTS: Surveys highlighted caregiver-perceived participant satisfaction and a caregiver-perceived positive impact of programs on participants’ physical and psychosocial well-being. Five themes were generated: (1) caregiver support and dedication, (2) meaningful participation, (3) mastery of skills, (4) thriving alongside peers, and (5) hopes for the future.

CONCLUSION: Findings illustrate the importance of thoughtfully designed programs, focused on quality participation, for children experiencing disability and their families.

PMID:42363123 | DOI:10.1186/s12887-026-07191-w

BMC Infect Dis. 2026 Jun 26. doi: 10.1186/s12879-026-13670-3. Online ahead of print.

ABSTRACT

BACKGROUND: Prolonged antiretroviral therapy (ART) in people living with HIV (PLWH) is associated with progressive bone mineral density (BMD) loss and an elevated risk of osteoporosis and fragility fractures. However, validated diagnostic tools for osteoporosis tailored to elderly PLWH remain scarce. This study aimed to develop and internally validate a nomogram-based diagnostic prediction model for osteoporosis in elderly PLWH (postmenopausal women and men aged ≥ 50 years) receiving ART.

METHODS: This retrospective cross-sectional study enrolled elderly PLWH who had initiated ART at a single center between September 2010 and July 2022 and had received ART for ≥ 12 months. BMD was assessed by dual-energy X-ray absorptiometry (DXA) during a cross-sectional survey conducted from January to June 2022, and osteoporosis was defined according to the World Health Organization criteria (T-score ≤ – 2.5). Predictor selection was performed using the least absolute shrinkage and selection operator (LASSO) regression. Multivariable logistic regression was subsequently applied to construct a diagnostic prediction nomogram. Model performance was evaluated using the concordance index (C-index), calibration plots, and decision curve analysis (DCA). Internal validation was conducted using bootstrapping with 1,000 resamples.

RESULTS: Among 256 eligible patients, 102 (39.8%) were diagnosed with osteoporosis. LASSO regression identified six predictors with nonzero coefficients, and one additional predictor (baseline CD4 count) was incorporated based on clinical evidence, yielding a seven-variable nomogram: Sex, Ratio of Age and BMI, Duration of ART, Baseline CD4 + count, tenofovir disoproxil fumarate (TDF) regimen, β-C-terminal telopeptide of type I collagen (β-CTX), and procollagen type I N-terminal propeptide (PINP). The model achieved a C-index of 0.709 (95% confidence interval [CI]: 0.645-0.773) with good calibration (mean absolute error: 0.014). Internal validation yielded a bias-corrected C-index of 0.695. DCA demonstrated positive net clinical benefit across threshold probabilities ranging from 0.0 to 0.7.

CONCLUSION: We developed and internally validated a nomogram incorporating seven clinical and biochemical predictors including Ratio of Age and BMI, Duration of ART, TDF Regimen, β-CTX, PINP, Sex and Baseline CD4 count for the diagnosis of osteoporosis in elderly PLWH receiving ART. The model demonstrated acceptable discrimination, satisfactory calibration and favorable clinical utility. External validation in independent, multi-center cohorts is warranted before clinical implementation.

PMID:42363121 | DOI:10.1186/s12879-026-13670-3

J Clin Neurophysiol. 2026 May 7. doi: 10.1097/WNP.0000000000001261. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate and synthesize current evidence on the cost-effectiveness of EEG monitoring in postcardiac arrest care, with a focus on its utility in neuroprognostication and clinical decision making.

METHODS: A narrative review was conducted to summarize the recent literature on EEG utilization, guidelines, and cost-effectiveness analyses. Studies examining continuous EEG, routine EEG, and point-of-care EEG using cost-utility frameworks, quality-adjusted life year modeling, and health system variability were analyzed.

RESULTS: Despite class I recommendations from the AHA and ACNS, EEG remains underused in postcardiac arrest management. Although continuous EEG provides superior temporal resolution and facilitates prognostic assessment, it comes with significant costs associated with equipment, personnel, and EEG interpretation. Cost-effectiveness analysis shows that small improvements in prognostic specificity of 1% to 4% may render EEG monitoring cost-effective in a closed health care system. Routine EEG and point-of-care-EEG systems offer new strategies for expanding access and reducing costs. However, studies are predominantly retrospective, single-center, and heterogeneous in their analytic methodology, which limits generalizability.

CONCLUSIONS: EEG monitoring after cardiac arrest may be cost-effective if modest gains in prognostic accuracy are achieved. Further data from prospective, multicenter studies and long-term financial and outcome data using standardized statistical metrics will be needed for broader use. By doing so, more robust use guidelines and cost-effectiveness thresholds can be created for postcardiac arrest EEG monitoring.

PMID:42359664 | DOI:10.1097/WNP.0000000000001261

J Clin Neurophysiol. 2026 Apr 3. doi: 10.1097/WNP.0000000000001251. Online ahead of print.

ABSTRACT

Postanoxic encephalopathy is a common consequence of cardiac arrest, characterized by varying degrees of global cerebral hypoxic-ischemic injury. Despite advances in resuscitation science and critical care, neurologic outcome is essentially unchanged over the past decades. Although various treatment approaches to mitigate brain injury have been proposed, none of these has been unequivocally associated with improved neurologic outcome. This review provides an overview of the evidence from previous studies and ongoing clinical trials. Based on successes and limitations in recent research, we recommend EEG-based patient stratification and sufficiently powered subgroups for future trials. We also recommend outcome measures that provide more granularity than the current ordinal outcome scales, such as screening instruments for cognitive and emotional functioning. Adaptive randomized trial designs using a single master protocol and Bayesian statistics can provide an efficient platform for testing multiple treatments against a common control group, simultaneously. Treatments based on active stimulation of neuro- and synaptogenesis instead of prevention of secondary injury are promising.

PMID:42359658 | DOI:10.1097/WNP.0000000000001251

Laeknabladid. 2026 Jul;112(7-08):314-221. doi: 10.17992/lbl.2026.0708.900.

ABSTRACT

INTRODUCTION: Adjuvant endocrine therapy (tamoxifen/aromatase inhibitors) is used after surgery in hormone-receptor-positive breast cancer stage I-III. Administration for 5-10 years reduces recurrence and improves survival. Therapy adherence has not been assessed in Iceland. The main objective was to assess adherence to endocrine therapy among patients diagnosed with breast cancer in Iceland 2013-2018. Prognostic factors and the effect of adherence on prognosis were examined.

MATERIAL AND METHODS: This retrospective, population-based cohort study obtained data from the Icelandic Cancer Registry, the Icelandic Prescription Medicine Register and medical records. Treatment adherence was defined as prescription refills for tamoxifen and/or aromatase inhibitors for five years or until the day of death/recurrence of breast cancer. Patients were considered adherent if prescriptions covered ≥80% of the treatment period. Descriptive statistics, logistic regression analysis, and Kaplan-Meier survival analysis were performed.

RESULTS: The study included 1,008 patients, 990 women and 18 men, with a median age of 62.0 years. Logistic regression identified chemotherapy before and/or after surgery as a positive predictor (OR 2.04; 95%CI 1.36-3.10; < 0.001) and initial treatment with tamoxifen as a negative prognostic factor (OR 0.68; 95%CI: 0.50-0.94; p=0.02). Significant association was observed between treatment adherence and overall survival (p=0.025) and disease-free survival (p=0.0075).

CONCLUSION: Among patients, 27.0% were non-adherent to treatment. Significant association was observed between survival and adherence. It is important to improve treatment adherence, for example through multidisciplinary approaches within the healthcare system and increased patient education.

PMID:42359641 | DOI:10.17992/lbl.2026.0708.900

Bioelectromagnetics. 2026 Jul;47(5):e70064. doi: 10.1002/bem.70064.

ABSTRACT

Tumor treating fields (TTFields) is a non-invasive therapeutic technology that disrupts mitotic division via intermediate-frequency alternating electric fields. For non-small cell lung cancer (NSCLC) at 150 kHz, complex thoracic anatomy and heterogeneous tissue properties often hinder the attainment of the therapeutic threshold (≥ 1 V/cm). To overcome this, high-fidelity Duke (male) and Ella (female) anatomical models were employed for full-wave simulations. The coordinated deployment of orthogonal transducer arrays (AP-20, LR-20, LR-13) with sex-specific tuning substantially enhanced electric-field coverage in the lower and lateral lung regions. Furthermore, modifying lung dielectric parameters by 20% demonstrated that these configurations maintain stable therapeutic coverage, exhibiting robustness against potential physiological or pathological variations. To provide an experimental foundation, in vivo murine measurements were conducted. Rather than attempting to replicate deep spatial complexities of the human body, these experiments served as a translational bridge to validate macroscopic voltage transfer efficiency and system-level losses. By introducing a physically derived correction factor (Roi) to account for voltage delivery drops, statistical analyses confirmed a high agreement between simulated and in vivo datasets, verifying the reliability of the computational framework. Regarding safety, the computed electrode-skin current density remained strictly below 31 mA/cm², which, alongside built-in clinical hardware temperature limits, effectively mitigates the risk of thermal and stimulation-induced injuries. Ultimately, this optimized strategy provides a complementary, independent physical modality that integrates bioelectromagnetic modeling with preclinical validation, offering a reliable theoretical reference to facilitate individualized NSCLC treatment planning.

PMID:42359634 | DOI:10.1002/bem.70064

Phys Chem Chem Phys. 2026 Jun 26. doi: 10.1039/d6cp01351a. Online ahead of print.

ABSTRACT

We establish an interpretable site-resolved framework to screen high-entropy alloy catalysts for the hydrogen evolution reaction (HER). By linking local atomic environments to hydrogen adsorption free energy (ΔG_H), compositions with a higher probability of exposing near-thermoneutral active sites are statistically identified, enabling rational identification of promising HEA catalyst candidates.

PMID:42359627 | DOI:10.1039/d6cp01351a

Int J Food Sci Nutr. 2026 Jun 26:1-11. doi: 10.1080/09637486.2026.2692946. Online ahead of print.

ABSTRACT

Changes in body composition with ageing, such as fat gain and muscle loss, pose significant health challenges. Coffee consumption may influence body composition, but evidence remains inconclusive. This cross-sectional study examined associations between coffee consumption and body composition in an older Finnish population with high habitual coffee intake. The analysis included 528 men and women (mean age 67.7 years). Coffee intake was assessed using a food-frequency questionnaire, and body composition was measured by dual-energy X-ray absorptiometry (DXA). Multivariable-adjusted associations between coffee consumption (<375, 375, and >375 ml/day) and lean mass index, appendicular lean mass index, fat mass index, body mass index, and android/gynoid ratio were analysed using sex-stratified ANCOVA, with Bonferroni correction applied. Mean ± SD coffee intake was 370 ± 214 ml/day. No statistically significant differences between the coffee intake categories were observed for any body composition outcome (p-values > 0.06). In this older Finnish population, coffee consumption was not associated with DXA-assessed body composition.

PMID:42359622 | DOI:10.1080/09637486.2026.2692946