Category: Nevin Manimala

Riv Psichiatr. 2026 Jul-Aug;61(4):156-165. doi: 10.1708/4747.47642.

ABSTRACT

BACKGROUND: This survey aimed to investigate how physicians in Italy recognize, diagnose, and manage tardive dyskinesia (TD), as well as to assess and identify gaps in the current treatment approaches.

METHODS: A non-interventional cross-sectional online survey was conducted among Italian physicians who had managed patients with TD in the 1 year prior to the survey. The questionnaire explored physicians’ demographics, clinical experience, diagnostic methods, treatment strategies, perceptions of TD impact, and health care resource utilization related to TD. Data were summarized descriptively.

RESULTS: The survey included 70 psychiatrists and 30 movement disorder neurologists. Most patients presented with mild (49%) or moderate (35%) TD. Treatment strategies varied by TD severity; antipsychotic dose modification or switching was common, particularly to clozapine, quetiapine, and aripiprazole, whereas TD-specific add-on treatments such as tetrabenazine were rarely used (12% to 21% of physicians prescribed the treatment). Movement impairment was primarily assessed through patient or caregiver reports on quality-of-life impact, while standardized scales like the Abnormal Involuntary Movement Scale were underused, especially by psychiatrists. Physicians acknowledged significant challenges including a lack of highly effective treatments and an absence of specific Italian or European guidelines. TD was perceived as significantly affecting patients’ physical and psychosocial functioning and increasing health care resource utilization.

CONCLUSIONS: This study highlights variability and unmet needs in TD diagnosis and management among Italian specialists. Add-on treatments such as tetrabenazine are not considered standard of care in Italy due to lack of clinical practice guidelines, concerns around drug efficacy, adverse events, and overall treatment satisfaction.

PMID:42478307 | DOI:10.1708/4747.47642

Aust Endod J. 2026 Jul 21. doi: 10.1111/aej.70110. Online ahead of print.

ABSTRACT

This study evaluated the effects of kinematics (reciprocating vs. continuous rotation) and rotational speed (350 vs. 1200 rpm) on filling removal, canal transportation, and apical extrusion during retreatment of curved root canals. Vertucci type II mesial roots of mandibular molars were prepared, filled, and scanned by micro-computed tomography (micro-CT). After 30 days, specimens were assigned to four groups (n = 15): WOrec, WOctn, PF350, and PF1200. Retreatment time was recorded, and micro-CT was used to assess filling removal, canal transportation, and apical extrusion. Data were statistically evaluated and revealed that all systems significantly reduced the amount of filling material (p < 0.05). PF1200 and WOctn showed superior removal compared with PF350 and WOrec, respectively (p < 0.05). No differences were observed in extrusion (p > 0.05). Increased canal transportation occurred only in the mesiolingual canal with WOctn and PF1200 (p < 0.05). Higher speed and continuous rotation improved efficiency without increasing extrusion but resulted in greater transportation.

PMID:42478289 | DOI:10.1111/aej.70110

J Eur Acad Dermatol Venereol. 2026 Jul 21. doi: 10.1111/jdv.70594. Online ahead of print.

ABSTRACT

BACKGROUND: We report the first study of anumigilimab, a novel anti-G-CSFR antibody, in patients with neutrophil-driven skin diseases [hidradenitis suppurativa (HS) and palmoplantar pustulosis (PPP)].

METHODS: This phase 1b, open-label, repeat-dose study (NCT03972280) comprised 15-week treatment and 9-week follow-up periods. Enrolled patients had International HS Severity Score System (IHS4) score ≥4 or PPP Area and Severity Index (ppPASI) score ≥12. After ≥10 patients completed anumigilimab 0.3 mg/kg IV at 21-day intervals (Cohort 1), pharmacokinetic/pharmacodynamic modelling determined the Cohort 2 dose (0.6 mg/kg). Primary endpoints were treatment-emergent adverse events (TEAEs). Secondary endpoints were pharmacokinetics and immunogenicity. Exploratory endpoints were pharmacodynamics and clinical response.

RESULTS: Of 39 patients (HS, n = 22; PPP, n = 17), 33 patients (84.6%) experienced 198 TEAEs. Sixteen patients (41.0%) experienced 70 anumigilimab-related TEAEs; the most common were fatigue and neutropenia (both n = 7), which resolved spontaneously, and no association between neutropenia and infections was observed. No deaths or serious treatment-related TEAEs occurred. Presence of antidrug antibodies was negligible. Anumigilimab exposure and absolute neutrophil count reduction (pharmacodynamic endpoint) were dose dependent. In signal-finding exploratory analyses, 57.9% of patients with HS (n = 11/19 with data at Week 15) achieved ≥50% HS Clinical Response, IHS4 score decreased by 40.3%, and patients with PPP experienced a 40.4% reduction in ppPASI score. These clinical responses were not dose dependent, possibly due to imbalanced baseline characteristics and small sample size.

CONCLUSIONS: Anumigilimab was generally well tolerated in patients with HS or PPP, with no serious treatment-related safety concerns, and demonstrated dose-dependent pharmacology. While clinical responses in HS and PPP were observed, it should be noted that these observations were exploratory and signal-finding in nature. Importantly, the study was not powered to statistically confirm efficacy and lacked a placebo control, underscoring the need for future randomized, placebo-controlled trials to validate these preliminary signal-finding observations.

PMID:42478283 | DOI:10.1111/jdv.70594

Breastfeed Med. 2026 Jul 21:15568253261468535. doi: 10.1177/15568253261468535. Online ahead of print.

ABSTRACT

BACKGROUND: Prenatal intention to exclusively breastfeed is a proximal determinant of later infant-feeding behavior and may be shaped by breastfeeding self-efficacy, depressive symptoms, and perceived social support.

MATERIALS AND METHODS: Baseline prenatal data were analyzed from 516 third-trimester pregnant women enrolled in an ongoing prospective cohort at a tertiary university hospital in Istanbul, Türkiye. Exclusive breastfeeding intention was measured with the Infant Feeding Intentions (IFI) scale. Breastfeeding self-efficacy and depressive symptoms were assessed with the Prenatal Breastfeeding Self-Efficacy Scale-Short Form (PBSES-SF) and Edinburgh Postnatal Depression Scale (EPDS), respectively. Social support was evaluated as aggregate spouse/partner or close-family support and further characterized by emotional, informational, and practical/domestic support indicators.

RESULTS: Mean IFI, PBSES-SF, and EPDS scores were 13.12 ± 2.34, 32.23 ± 3.62, and 5.88 ± 2.05, respectively. Aggregate social support was reported by 495 participants (95.9%). Emotional, informational, and practical/domestic support were reported by 488 (94.6%), 446 (86.4%), and 465 (90.1%) participants, respectively, and were associated with higher IFI scores in bivariate analyses. In multivariable regression, PBSES-SF, EPDS, planned pregnancy, prior breastfeeding experience, and employment were independently associated with IFI; aggregate social support was not. The PBSES-SF × EPDS interaction was statistically significant.

CONCLUSION: Exclusive breastfeeding intention was associated with breastfeeding self-efficacy, depressive symptoms, selected experiential factors, and functional support indicators. Integrated antenatal counseling should address breastfeeding confidence, maternal mental health, and the quality of support available during late pregnancy.

PMID:42478261 | DOI:10.1177/15568253261468535

Disaster Med Public Health Prep. 2026 Jul 21;20:e85. doi: 10.1017/dmp.2026.10348.

ABSTRACT

BACKGROUND: Floods are increasing with climate change, and evacuating medically vulnerable people receiving home healthcare remains challenging. Patients dependent on medical devices and long-term care face complex challenges throughout the evacuation process. However, key factors influencing successful evacuation and effective support strategies remain underexamined. This study aimed to identify such factors and essential support measures across evacuation phases.

METHODS: Semi-structured interviews were conducted with 13 participants-family caregivers, healthcare providers, and municipal officials-from July 2022 to March 2023 in 3 Japanese regions. Snowball sampling was used via medical administrative institutions. Thematic analysis followed COREQ guidelines, focusing on three phases: preparation, evacuation, and post-evacuation. Ethics approval was obtained (MG2022-01).

RESULTS: Preparation showed heterogeneous readiness: some services had hazard maps and manuals/BCPs, whereas household engagement was limited and operationalization was constrained by resources. During evacuation, participants described transport and staffing limitations, difficulty in moving medical equipment, and uncertainty about feasible options, with occasional consideration of vertical evacuation. Post-evacuation challenges centered on shelter sanitation and supplies, continuity of medical support, and coordination of support systems.

CONCLUSIONS: A three-phase, multi-stakeholder perspective clarifies how constraints accumulate and informs coordinated planning among municipalities, home-care teams, and families. Limitations include a small, region-specific sample and no direct patient interviews.

PMID:42478258 | DOI:10.1017/dmp.2026.10348

Tumori. 2026 Jul 21:3008916261452431. doi: 10.1177/03008916261452431. Online ahead of print.

ABSTRACT

PURPOSE: Adolescents and young adults (AYA; 15-39 years) represent a distinct oncology population with specific biological and psychosocial needs. Despite growing awareness, AYA patients often face fragmented care between pediatric and adult settings, resulting in diagnostic delays, limited clinical trial access, and inadequate psychosocial support. In 2021, the AIOM-AIEOP AYA Working Group was established in Italy to promote awareness and address these challenges.

METHODS: An anonymous, voluntary online survey was designed by the AIOM-AIEOP AYA Working Group and distributed during the AIOM National Congress (November 2024). Using iPads at a dedicated booth, oncologists and other healthcare professionals completed a questionnaire exploring knowledge, perceptions, and access to AYA-focused services. Data were analyzed using descriptive statistics.

RESULTS: Ninety-seven professionals participated (median age 34 years; 75% female; 56% medical oncologists). Although 86% reported access to genetic counseling and 84% to fertility preservation services, only 18% had AYA-dedicated spaces and 21% employed trained AYA-specific staff. Forty-four percent felt competent in assessing hereditary cancer syndromes, and fewer than 25% were aware of AYA-focused research or trials. Psychological support was commonly available, whereas educational coaching and peer support groups were rare (5% each). Lifestyle counseling was frequent, but structured survivorship care and long-term follow-up were limited.

CONCLUSIONS: This survey reveals substantial gaps in AYA oncology services in Italy, particularly regarding dedicated staff, infrastructure, and training. National coordination and implementation of standardized frameworks, such as through the AIOM-AIEOP network, are essential to ensure equitable, comprehensive care for AYA patients.

PMID:42478256 | DOI:10.1177/03008916261452431

J Korean Med Sci. 2026 Jul 20;41(28):e286. doi: 10.3346/jkms.2026.41.e286.

ABSTRACT

Misuse of statistical methods in biomedical research remains widespread, undermining scientific integrity and public health. Flawed analyses can lead to misleading clinical guidelines, unnecessary treatments, or concealment of true treatment effects. Statistical errors often result from a structural training gap that affects the research process from study design to reporting, rather than from individual incompetence. Authors should be able to select appropriate measures of central tendency based on the data distribution, apply parametric and nonparametric tests correctly, use regression analyses with attention to statistical power and collinearity, and interpret P values in the context of confidence intervals. The growing number of retractions in statistics and the continued citation of retracted articles highlight the limitations of current peer-review processes. Statistical Package for the Social Sciences is the most widely used statistical software in health sciences research, while R/RStudio is gaining increasing adoption due to its open-source nature, analytical flexibility, and capacity for fully reproducible and transparent analyses. Software selection can significantly influence analytical outcomes due to differences in default algorithms. Therefore, full disclosure of software versions and procedures is essential for reproducibility. Integrating artificial intelligence-based tools into statistical workflows introduces risks, including output hallucination, a lack of algorithmic transparency, and unresolved accountability. These tools should not be used without internationally accepted validation guidelines. At the publisher level, employing statistical editors, enforcing open data-sharing policies, and adopting contributor role taxonomies such as Contributor Roles Taxonomy are the most effective structural interventions. Enhancing the statistical quality of biomedical literature requires coordinated, sustained efforts from all stakeholders in scientific communication.

PMID:42478255 | DOI:10.3346/jkms.2026.41.e286

J Korean Med Sci. 2026 Jul 20;41(28):e65. doi: 10.3346/jkms.2026.41.e65.

ABSTRACT

BACKGROUND: Health literacy (HL) is increasingly recognized as a crucial determinant of healthcare utilization and costs. Despite its importance, empirical evidence on the relationship between HL and healthcare expenditures in South Korea is limited. This issue is particularly timely and relevant given the country’s rapidly rising outpatient expenditure.

METHODS: This study analyzed data from the Korea Health Panel Survey conducted in 2021 (n = 8,630) to examine the association between HL and outpatient healthcare costs. HL was measured using the Korean version of the Health Literacy Survey European Questionnaire 16 (range: 0-16) and categorized as high (≥ 13) or low (≤ 12). Outpatient expenditure was defined as the sum of insurance-covered payments, out-of-pocket spending, and non-covered services, excluding pharmaceutical costs. Expenditure data were log-transformed and analyzed using multivariable linear regression. Subgroup analyses by age group were conducted under the assumption that healthcare utilization patterns vary across age categories.

RESULTS: The results showed that individuals with high HL spent 8.6% less on outpatient care than those with low HL. Subgroup analyses further revealed that this association was statistically significant only among adults aged 65 years and older.

CONCLUSION: These findings provide evidence that higher HL is associated with reduced outpatient expenditures in South Korea, particularly in older populations. Therefore, promoting HL among older adults may represent an effective strategy for improving healthcare efficiency and mitigating the burden of rising outpatient costs.

PMID:42478249 | DOI:10.3346/jkms.2026.41.e65

Cardiol Young. 2026 Jul 21:1-6. doi: 10.1017/S1047951125110901. Online ahead of print.

ABSTRACT

Neonates with ductal-dependent congenital heart disease (CHD) will receive a continuous infusion of a prostaglandin E1 analogue such as alprostadil prior to surgical correction. Alprostadil can cause apnoea, which may be mitigated in practice with the use of caffeine citrate. Caffeine citrate can lead to tachyarrhythmias, which could be detrimental in this patient population. The purpose of this study was to determine if the practice of utilising caffeine citrate in neonates with ductal-dependent CHD receiving continuous alprostadil infusions is safe. In this single-centre, retrospective, cohort study of neonates admitted to the congenital heart service from November 2017 to September 2024, patients were included if they had ductal-dependent CHD and a gestational age greater than or equal to 35 weeks. Neonates that received continuous infusion of alprostadil alone were compared to those that received alprostadil in addition to caffeine citrate. The primary outcome was the frequency of sustained tachycardia during treatment. Seventy-five patients were included for review in each cohort. The median number of incidences of sustained tachycardia per patient was 7 (interquartile range 1-20) in the alprostadil plus caffeine citrate group and 4 (interquartile range 0-18) in the alprostadil alone group (p = 0.293). Other arrhythmias during the treatment course were common and similar between each cohort. Utilising caffeine citrate was not associated with a statistically significant increased incidence of tachycardia in neonates with ductal-dependent CHD on alprostadil infusions at the University of Florida.

PMID:42478232 | DOI:10.1017/S1047951125110901

Int J Neural Syst. 2026 Jul 22:2750001. doi: 10.1142/S0129065727500018. Online ahead of print.

ABSTRACT

Artifacts are noisy signals that commonly contaminate electroencephalographic (EEG) recordings, mixing with underlying brain activity and degrading the quality of neurophysiological data. Previous research on epileptic Anomaly Detection has shown that this approach is also sensitive to unlabelled artifacts, often leading to an increased False Positive rate. While most methods focus on detecting or removing a single type of artifact, this work proposes a unified multi-class framework to classify several artifact types alongside normal and pathological brain activity within a recording using a single, simple Machine Learning classifier. A set of spectral, temporal and statistical features commonly associated with different artifact types is extracted. KNN and XGBoost classifiers are trained and evaluated under a cross-validation scheme. The results demonstrate strong performance for both models, achieving approximately 90% sensitivity across all classes while maintaining a 100% specificity. These findings highlight the effectiveness of a unified and interpretable approach for multi-class EEG artifact classification.

PMID:42478186 | DOI:10.1142/S0129065727500018