Category: Nevin Manimala

Ther Drug Monit. 2026 Jan 28. doi: 10.1097/FTD.0000000000001399. Online ahead of print.

ABSTRACT

BACKGROUND: With the patchwork legalization of cannabis in the United States and the loopholes surrounding “legal” highs, the prevalence of Δ8-tetrahydrocannabinol (Δ8-THC) has been rising, requiring the development of methods to extract, differentiate, and detect it separately from Δ9-tetrahydrocannabinol (Δ9-THC) and its metabolites. The authors focused on developing a method to detect the primary metabolite Δ8-carboxy-tetrahydrocannabinol (Δ8-THC-COOH) separately from Δ9-carboxy-tetrahydrocannabinol (Δ9-THC-COOH) in urine, a commonly collected sample in human performance toxicology.

METHODS: Liquid-liquid extraction with hydrolysis was used to isolate and extract metabolites from forensic urine samples. After evaporation, the extract was flash-derivatized using an MTBSTFA:ACN (1:3) solution, followed by gas chromatography-mass spectrometry analysis. The results were tabulated and subjected to statistical analysis.

RESULTS: Forensic human performance urine specimens (n = 127) were analyzed for ∆8-THC-COOH, ∆9-THC-COOH, and 7-carboxy-cannabidiol (7-COOH-CBD) between January 2023 and January 2024. In total, 52 samples contained only ∆9-THC-COOH, 70 contained both ∆8-THC-COOH and ∆9-THC-COOH, 3 contained only ∆8-THC-COOH, and 5 contained both 7-COOH-CBD and ∆9-THC-COOH, with 3 of these containing all 3 metabolites. The area abundances of their respective chromatographic peaks was used to calculate the ∆8:∆9 metabolite ratio when both ∆8-THC-COOH and ∆9-THC-COOH were detected. Despite a higher mean ratio in driving under the influence cases (13.87 versus 8.53), the difference between the mean values was not statistically significant (independent-sample t test: t (68) = -0.670, p = 0.505).

CONCLUSIONS: This study and its methodology provide insight into the effective separation and analysis of the compounds of interest, and discuss the potential differentiation of ∆8-THC-dominant products from traditional cannabis, and underscore the prevalence of ∆8-THC and ∆8-THC-dominant products in the current market, while highlighting the need for further studies on this topic.

PMID:41604141 | DOI:10.1097/FTD.0000000000001399

Matern Child Health J. 2026 Jan 28. doi: 10.1007/s10995-026-04227-6. Online ahead of print.

ABSTRACT

OBJECTIVES: Military families experience lifestyle and circumstance-specific stressors that may impact their parental stress, family resilience, and emotional support for parenthood. These outcomes may influence parenting behaviors and mental health that have further implications on child development and growth. Research is needed to examine these outcomes among military families in the United States on a national scale due to the importance of potential intergenerational implications.

METHODS: This cross-sectional study used data from the 2021-2022 National Survey of Children’s Health to investigate the relationship between caregiver military status and outcomes of parental stress, family resilience, and emotional support for parenthood (n = 99,869). Bivariate analyses through chi-square tests were calculated to determine differences between outcomes from military caregivers and civilian caregivers with select covariates. Multivariable regression analyses were calculated to further explore the relationship between caregiver military status and emotional support for parenthood.

RESULTS: The prevalence of emotional support with parenthood was higher among military caregivers compared to civilian caregivers (82.8% vs. 75.0%, p < 0.0001); however, this difference was not statistically significant in adjusted analyses. No statistically significant differences were found between military families and civilian families in parenting stress and family resilience.

CONCLUSIONS: This study extended previous research that have focused on state or station specific outcomes in military families by examining these outcomes on a national scale. This study has important implications towards expanding research and interventions that reduce parenting stress and improve family resilience and emotional support for parenthood to ensure continued positive outcomes.

PMID:41604131 | DOI:10.1007/s10995-026-04227-6

J Autism Dev Disord. 2026 Jan 28. doi: 10.1007/s10803-025-07204-0. Online ahead of print.

ABSTRACT

PURPOSE: Social difficulties are fundamental aspects of autism spectrum disorder (ASD). However, behavioral issues such as attention difficulties, thought problems, externalizing behaviors, and internalizing behaviors can further hinder children’s ability to develop social skills. We aimed to explore how co-occurring behavioral challenges may intensify social difficulties in autistic children and adolescents by assessing whether a higher prevalence of behavioral problems is associated with poorer social functioning in real-world scenarios.

METHODS: We surveyed parents of 225 children diagnosed with ASD. Parents completed two questionnaires-the Child Behavior Checklist (CBCL) measuring psychiatric symptoms, and the Social Skills Improvement System (SSIS) assessing observable social abilities. We statistically analyzed the connection between behavioral scores and social scores.

RESULTS: The results showed that more severe behavioral issues on the CBCL tied to weaker social skills overall on the SSIS. Among all behavioral domains, attention problems showed the strongest negative associations with total social skills and all subdomains. Thought problems also demonstrated significant negative association with several aspects of social functioning. Externalizing behaviors and internalizing behaviors were also negatively associated with social skills, though their effects were less pronounced than those of attention and thought problems.

CONCLUSION: Our findings provide real-world evidence that common co-occurring behavioral problems especially attention problems and thought problems showed strong negative associations with social skill difficulties in autistic children and adolescents. Screening for and adjusting conditions like attention problems, thought problems, and disruptive behaviors may be an important piece of helping autistic children build social competence.

PMID:41604128 | DOI:10.1007/s10803-025-07204-0

J Prev (2022). 2026 Jan 28. doi: 10.1007/s10935-026-00898-7. Online ahead of print.

ABSTRACT

Substance use and high-risk sexual behaviors remain pressing public health challenges among U.S. adolescents, with tobacco, alcohol, and marijuana being the most used substances. While previous research has shown an association between substance use and risky sexual behavior, there is limited data on how these associations vary based on demographic modifiers such as race, sex, and sexual identity among sexually active adolescents. This study explores the association between current substance use (cigarettes, e-cigarettes, alcohol, and marijuana) and high-risk sexual behaviors (having multiple sexual partners and lack of condom use), examining how these associations vary by race, sex, and sexual identity. The 2023 Youth Risk Behavior Survey (YRBS) data was analyzed for 5420 adolescents attending U.S. public and private high schools. Multiple Logistic regression was used to examine associations, and interaction effects for race, sex, and sexual identity were introduced to the model to determine variations in associations. Overall adjusted analyses revealed current use of cigarette, e-cigarette, and alcohol was associated with higher likelihood of having multiple (2 or more) sexual partners in the past 3 months. Additionally, current marijuana use was associated with a higher likelihood of not using a condom during last sexual intercourse. A statistically significant interaction was observed only for the association between current marijuana use and condomless sex during last sexual intercourse (p = 0.010). Stratified analyses indicated that this association varied by sexual identity and was stronger among heterosexual students compared to Lesbian, Gay, Bisexual, Queer, and other (LGBQ+) students. Results confirm the link between substance use and high-risk sexual behavior among youth, reinforcing our need for increased programming around substance use prevention and sexual health education. Heterosexual youth may be at increased risk for high-risk sexual behavior associated with their marijuana use, calling for tailored interventions that target the unique needs of this demographic subgroup.

PMID:41604127 | DOI:10.1007/s10935-026-00898-7

J Prev (2022). 2026 Jan 28. doi: 10.1007/s10935-026-00899-6. Online ahead of print.

ABSTRACT

The burden that multimorbidity places on people, families, and society as a whole has made it a global public health concern. While physical activity (PA) is supported by the World Health Organization (WHO) as a crucial approach for avoiding chronic diseases, there is minimal data to support its link with multimorbidity, especially among populations of middle-aged and elderly in China. Derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2018, a cross-sectional data was employed in this study. To analyze the linear connection between multimorbidity and PA, Restricted Cubic Spline (RCS) and Binary logistic regression were applied. The heterogeneity of this association across other groups was investigated using subgroup and interaction analysis. Three sensitivity analyses validated the results’ robustness. Among 19,453 participants, 25.24% of middle-aged and older individuals actively engaged in moderate vigorous PA, 58.40% often participated in vigorous PA, and the prevalence of multimorbidity was 40.18%. After adjusting for all confounding factors, compared with low-intensity PA, moderate vigorous PA (OR = 0.889, 95% CI: 0.810-0.976) and vigorous PA (OR = 0.731, 95% CI: 0.673-0.794) demonstrated a significantly attenuated risk of multimorbidity. Multimorbidity and PA did not significantly correlate linearly, according to the RCS result. Age, residence, social activities and drinking were found to have substantial modifying effects on the relationship between PA and multimorbidity, according to the subgroup and interaction analyses. The outcomes of this research underline the the association between physical activity and a reduced risk of multimorbidity. This suggests that under the premise of ensuring safety, higher levels of physical activity among middle-aged and older adults may be linked to later onset of chronic disease.

PMID:41604126 | DOI:10.1007/s10935-026-00899-6

Clin Transl Oncol. 2026 Jan 28. doi: 10.1007/s12094-025-04218-z. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates the immunohistochemical expression of SLC48A1 and GLUT-1 in different grades of oral squamous cell carcinoma (OSCC) and explores their potential association with the development of tumor. OSCC is a heterogeneous malignancy characterized by increased glycolysis and glucose oxidation. Heme plays a crucial role in oxidative metabolism and ATP production via mitochondrial oxidative phosphorylation. SLC48A1 (solute carrier family 48 member 1) facilitates GLUT-1 trafficking, enhancing glucose uptake and lactate production, thereby promoting cancer cell migration and invasion. However, the relationship between SLC48A1, GLUT-1, and OSCC remains poorly understood.

MATERIALS AND METHODS: Seventy-two formalin-fixed, paraffin-embedded OSCC tissue samples and ten normal oral mucosa (NOM) were analyzed using immunohistochemistry to assess SLC48A1 and GLUT-1 expression. Staining intensity and distribution were correlated with histopathological grades. Statistical analysis was conducted to evaluate their association with tumor behavior.

RESULTS: GLUT-1 expression showed strong expression in cases of well-differentiated OSCC, supporting its association with tumor. SLC48A1 expression was also seen to be markedly elevated in few cases of poorly differentiated OSCC.

CONCLUSION: While GLUT-1 expression correlates directly with OSCC, SLC48A1 expression was not seen to be uniformly distributed across the different histological grades. Through this study, it has been proven that both markers hold diagnostic significance and the results of the present study may serve as a future milestone for exploring these markers as potential therapeutic target for disrupting cancer metabolism as well as to correlate with the progression in different grades of OSCC.

PMID:41604111 | DOI:10.1007/s12094-025-04218-z

Cardiol Ther. 2026 Jan 28. doi: 10.1007/s40119-026-00444-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The PRECISE-DAPT score is a useful tool for predicting the risk of bleeding after percutaneous coronary intervention (PCI) requiring dual antiplatelet therapy. We aimed to validate the PRECISE-DAPT score as a mid-term mortality predictor in acute coronary syndrome (ACS).

METHODS: All patients with ACS hospitalized between October 2018 and October 2023 were analyzed. Mortality data were acquired in cooperation with the Institute of Health Information and Statistics of the Czech Republic. We used a standard PRECISE-DAPT threshold ≥ 25. A receiver operating characteristic (ROC) curve analysis was used to assess the predictive performance of the PRECISE-DAPT score for mortality with a mean follow-up of 1.9 years. Area under the curve (AUC) was calculated for each ACS subtype and different antithrombotic strategy regimes at discharge to quantify discrimination ability, with higher values indicating better prediction.

RESULTS: We included 2953 patients with ACS. There were mostly men (69.1%, n = 2040), 37.1% ST-elevation myocardial infarction (STEMI, n = 1095), 45.2% non-ST-elevation myocardial infarction (NSTEMI, n = 1336) and 17.7% unstable angina pectoris (UAP, n = 522) patients. The mean age was 67.4 (SD 12.5) years. There were 78.4% patients treated by PCI (n = 2314). The PRECISE-DAPT score best predicts mortality in STEMI, AUC = 0.84 (95% confidence interval [CI] from 0.82 to 0.87), while its predictive ability is lower for NSTEMI, 0.78 (95% CI from 0.76 to 0.80) and UAP 0.75 (95% CI from 0.71 to 0.79). Antithrombotic treatment strategy at discharge does not influence the predictive ability of the PRECISE-DAPT score (AUC = 0.78, 071 and 0.72 for dual antiplatelet therapy, dual antithrombotic therapy, and triple therapy, respectively), p = 0.61.

CONCLUSIONS: The PRECISE-DAPT score may be used for predicting mid-term all-cause mortality in acute coronary syndrome, with the best predictive ability in STEMI. The standard threshold ≥ 25 maintain acceptable prognostic performance regardless of antithrombotic treatment strategy at discharge.

PMID:41604095 | DOI:10.1007/s40119-026-00444-w

Dig Dis Sci. 2026 Jan 28. doi: 10.1007/s10620-026-09690-3. Online ahead of print.

ABSTRACT

BACKGROUND: Relative Fat Mass (RFM), a simple metric calculated from height and waist circumference, is used to estimate total body fat percentage and is often considered a more precise indicator of adiposity than Body Mass Index (BMI). While RFM is a promising metric for assessing obesity and its associated health risks, its association with diarrhea remains poorly understood. Therefore, this study aimed to examine the link between RFM and diarrhea prevalence by analyzing data from the 2005-2010 National Health and Nutrition Examination Survey (NHANES).

RESULTS: Significant differences were observed between individuals with and without diarrhea regarding age, sex, educational attainment, poverty-income ratio (PIR), marital status, BMI, smoking status, diabetes, hypertension, physical activity, and RFM levels. Logistic regression analysis showed that each 1-unit increase in RFM was associated with a 7% higher risk of diarrhea (OR: 1.07, 95% CI: 1.03-1.11, P < 0.001). In quartile analysis, participants in the highest RFM quartile (Q4) had 2.39 times higher odds of diarrhea compared to the lowest quartile (Q1) (OR: 2.39, 95% CI: 1.24-4.61, P = 0.012). Subgroup analyses suggested that the association was more pronounced in populations with higher BMI and higher levels of physical activity. The ROC analysis yielded an AUC of 0.59 (95% CI: 0.57-0.61), indicating modest predictive value of RFM for diarrhea.

CONCLUSION: This study reveals that higher RFM is significantly associated with increased diarrhea prevalence, particularly among physically active individuals and those with elevated BMI. While RFM demonstrates modest predictive capability, these findings highlight its potential utility in identifying obesity-related gastrointestinal risks within diverse populations.

PMID:41604091 | DOI:10.1007/s10620-026-09690-3

Dig Dis Sci. 2026 Jan 28. doi: 10.1007/s10620-026-09701-3. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Clinically significant post-endoscopic mucosal resection bleeding (CSPEB) is one of the most common adverse events after EMR. In this meta-analysis, we evaluated the efficacy of prophylactic clipping after EMR of proximal, large (≥ 20 mm) nonpedunculated colon polyps.

METHODS: We reviewed several databases from inception to September 19, 2025. Outcomes of interest were CSPEB, perforation, post-polypectomy syndrome, and abdominal pain. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random effects model. Subgroup analyses were performed based on trials conducted in specialized/high-volume tertiary referral settings vs mixed practice settings (including community and nonacademic hospitals).

RESULTS: There was no significant difference in risk of CSPEB between the groups RR, 0.59(95% CI 0.28, 1.23), τ² = 0.43, p = 0.16, I² = 65%. Subgroup analysis showed prophylactic clipping was associated with reduced CSPEB in trials conducted in specialized, high-volume tertiary referral settings, RR, 0.34 (95% CI 0.20, 0.57). However, trials conducted in mixed or community-based settings have not demonstrated a similar benefit, RR, 1.44 (95% CI 0.75, 2.78). Clipping corresponds to an ARR of 3.6%, yielding an NNT of 28. Certainty of evidence was low based on GRADE framework (due to inconsistency and imprecision). There was no statistically significant difference in risk of perforation between the groups RR, 0.68(95% CI 0.19, 2.41), τ² = 0, p = 0.55, I² = 0. Certainty of evidence was moderate (due to imprecision). There was no statistically significant difference in risk of post-polypectomy syndrome between the groups RR, 1.67(95% CI 0.47, 5.89), τ² = 0, p = 0.43, I² = 0. Certainty of evidence was moderate (due to imprecision). There was no statistically significant difference in abdominal pain rates between the groups RR, 1.00(95% CI 0.36, 2.71), p = 0.99, τ² = 0, I² = 0. Certainty of evidence was moderate (due to imprecision).

CONCLUSION: In conclusion, this study demonstrates that prophylactic clip closure after EMR of proximal large nonpedunculated colorectal polyps did not present a statistically significant reduction in CSPEB. However, prophylactic clipping was associated with reduced CSPEB in trials conducted in specialized, high-volume tertiary referral settings, whereas trials conducted in mixed or community-based settings have not demonstrated a similar benefit. Additional randomized controlled trials with standardized reporting of operator experience, center volume, and closure success are needed to clarify effectiveness across broader practice settings.

PMID:41604087 | DOI:10.1007/s10620-026-09701-3

Childs Nerv Syst. 2026 Jan 28;42(1):49. doi: 10.1007/s00381-026-07128-9.

ABSTRACT

OBJECTIVE: This retrospective study evaluated neurodevelopmental outcomes including cognitive, motor, language, and social functioning in children with craniosynostosis and examined the influence of suture type, syndromic status, timing of surgery, and raised intracranial pressure.

METHODS: A cross-sectional retrospective study of 150 children (ages 3-12) with craniosynostosis was conducted using medical records and standardized neurodevelopmental tests. Statistical analyses included t-tests, chi-square tests, and multivariate regression.

RESULTS: Metopic synostosis was associated with slightly lower language and higher social impairment scores, but these differences were not significant after adjustment. Surgery before 9 months conferred ~5-point advantages in cognitive and motor outcomes, particularly in sagittal and coronal synostosis. Raised intracranial pressure, present in 13%, was linked to poorer outcomes.

CONCLUSION: Neurodevelopmental outcomes in children with craniosynostosis are primarily influenced by syndromic status, timing of surgery, and raised intracranial pressure rather than suture type alone. Early surgical intervention before 9 months has been associated with improved cognitive and motor outcomes, supporting early referral and intervention.

PMID:41604010 | DOI:10.1007/s00381-026-07128-9