Category: Nevin Manimala

Indian J Cancer. 2025 Oct 1;62(4):528-534. doi: 10.4103/ijc.ijc_96_25. Epub 2026 Mar 7.

ABSTRACT

BACKGROUND: Epithelial malignancies, which constitute the majority of adult cancers, are relatively rare in the pediatric population, accounting for only 2% of all childhood tumors. In contrast to common childhood cancers-which typically arise from embryonal or mesenchymal tissues-epithelial malignancies originate from the epithelial lining of glands and include carcinomas of the lung, breast, colon, and genitourinary tract. Understanding the occurrence, behavior, and treatment outcomes of adult-type epithelial malignancies in children is essential for developing age-appropriate management strategies and improving long-term survival. This emerging subset of pediatric cancers warrants further investigation and collaborative efforts to establish optimal diagnostic criteria, staging systems, and therapeutic approaches tailored to younger patients. We undertook a 5-year retrospective analysis of children diagnosed with adult-type epithelial malignancies at our center.

METHODS: Study Design: This is a retrospective data analysis conducted at MVR Cancer Centre and Research Institute (MVRCCRI), focusing on pediatric patients below 18 years of age who presented between the years January 2019 and December 2024. Inclusion criteria: All children under 18 years of age who presented to MVRCCRI provided they had an adult-type neoplasm of epithelial origin were included in this study. Statistical analysis was performed. The mean, intervals and percentages in each group were calculated. Institutional ethical committee approval was obtained for this retrospective review.

RESULTS: A total of 69 children who were younger than 18 years were included in the study. There were 18 males and 51 females in the study giving a male to female ratio of 1:2.8. Three children had a family history of malignancy: one had a history of consanguinity was diagnosed with CMMRD on genetic evaluation, and the other had a mother with breast cancer and a pathological variant in the ATM gene. The third child with adrenocortical carcinoma had a pathological variant in TP53 diagnosed in mother. The children were analyzed based on the primary diagnosis. The largest group of epithelial malignancies in our cohort was thyroid malignancy, and the second largest group was carcinoma of the salivary glands. Children who presented with early stages of disease fared well in all the groups.

CONCLUSION: Adult-type epithelial neoplasms in children and adolescents are distinct entities, characterized by unique biological behaviors and genetic signatures. Treatment approaches should integrate principles from adult oncology and collaborative studies are essential to define the epidemiology, for staging and prognostic markers, and also to develop pediatric-specific treatment protocols for these malignancies.

PMID:41797589 | DOI:10.4103/ijc.ijc_96_25

Br J Psychiatry. 2026 Mar 9:1-10. doi: 10.1192/bjp.2026.10561. Online ahead of print.

ABSTRACT

BACKGROUND: People with psychosis have a life expectancy that is reduced by 15 years, mainly owing to preventable physical illnesses of which obesity is a precursor. Obesity is three times more common in individuals with psychosis, and antipsychotics are an important cause. Prediction could individualise obesity treatment, but current models are not fully actionable for individuals.

AIMS: To test whether antipsychotic-induced weight increase at 1 year is causally mediated by weight change in the first 12 weeks of treatment, and then develop and internally validate a causal actionable prediction pathway to prevent antipsychotic-induced obesity.

METHOD: This was a post hoc analysis of a clinical trial of olanzapine versus haloperidol which recruited 263 participants with first-episode psychosis. We conducted two distinct analyses: causal mediation and prediction modelling, within which there were two sequential models (a baseline model to predict 12-week outcome and a 12-week model to predict 1-year outcome), followed by counterfactual prediction. In the first analysis, we used parallel causal mediation analysis to determine the natural direct and indirect and total effects of antipsychotic choice on weight in 97 participants, considering two mediators: weight change from 0 to 12 weeks, and weight change from 12 to 52 weeks. In the second analysis, we first developed a baseline causal actionable prediction model to predict weight gain at 12 weeks in 172 participants and then a 12-week model to predict obesity at 1 year in 97 of the participants. Finally, we demonstrated counterfactual prediction.

RESULTS: Antipsychotic-induced weight gain at 1 year appeared to be causally mediated by weight change during the first 12 weeks of treatment (indirect effect 5.70; 95% CI 2.83 to 8.66). At internal validation, the discrimination c-statistic for the baseline causal actionable prediction model was 0.728 (95% CI 0.661 to 0.801), and the calibration slope was 0.768 (95% CI 0.436 to 1.21). For the 12-week model, the c-statistic was 0.904 (95% CI 0.820 to 0.961), and the calibration slope was 0.601 (95% CI -0.0633 to 1.21). We used the models to predict the counterfactual outcomes of antipsychotic choice and 12-week weight change.

CONCLUSIONS: Our results show that it may be early rather than later weight change that causally mediates antipsychotic-induced weight gain at 1 year. They also demonstrate the potential for causal actionable prediction of counterfactuals for true precision medicine, although this is tempered by the feasibility scope of this study and small sample size. Our results are hypothesis-generating and not yet clinically deployable.

PMID:41797581 | DOI:10.1192/bjp.2026.10561

BJPsych Bull. 2026 Mar 9:1-8. doi: 10.1192/bjb.2026.10219. Online ahead of print.

ABSTRACT

AIMS AND METHOD: Prolonged armed conflict profoundly impacts children’s mental health. This study investigated elevated rates of post-traumatic stress disorder (PTSD) symptoms among displaced Palestinian youth residing in Qatar. A cross-sectional study included 350 Palestinian children and adolescents aged 8–18 years displaced from Gaza. The Child PTSD Symptom Scale – Self-Report Version for DSM-5 (CPSS-5) and a Demographic and Resilience Questionnaire were used. Descriptive statistics and multiple linear regression identified factors associated with PTSD symptoms.

RESULTS: It was found that 54.9% of participants met the threshold for probable PTSD (CPSS-5 score ≥31). Intrusion and arousal symptoms had the highest average severity scores. Factors associated with higher PTSD severity included formal education, physical injury during the war and witnessing death, particularly that of close relatives.

CLINICAL IMPLICATIONS: The findings emphasise the urgent need for accessible, culturally appropriate and sustained mental health interventions. Longitudinal research is needed to understand long-term trajectories and inform comprehensive support systems.

PMID:41797574 | DOI:10.1192/bjb.2026.10219

J Biosoc Sci. 2026 Mar 9:1-21. doi: 10.1017/S0021932026100522. Online ahead of print.

ABSTRACT

Globally, child marriage is a persistent issue, adversely affecting the rights and well-being of girls. With a special focus on religious affiliation, this study explores the contributing factors leading to child marriage, such as cultural norms, religious beliefs, and socioeconomic conditions. From the Census of India 2011 data, percentage distributions of child marriage were used to assess the trends and magnitude of child marriage over the years. From NFHS-5 data, bivariate and multivariate analyses were conducted to assess factors like education and wealth index. Spatial analysis techniques, including Moran’s I statistics, helped identify the geographic distribution of child marriage. Findings reveal a history of relatively high child marriage rates among Muslims and their faster decline over the last decades. In 2011, under-14 marriages among Hindus exceeded 1.03% more than that of Muslims, with a 0.33% higher incidence of under-18 marriages among Muslims. The sample-based NFHS-5 study highlights significant disparities in child marriage based on the sample populations’ religious affiliations, regions, social categories, education, and wealth. In conclusion, the issue transcends religious boundaries, is rooted in broader social and economic contexts, and advocates for multidimensional interventions.

PMID:41797567 | DOI:10.1017/S0021932026100522

Biol Cell. 2026 Mar;118(3):e70060. doi: 10.1111/boc.70060.

ABSTRACT

Super-resolution microscopy has become an indispensable tool for investigating molecular architectures in their native cellular environment. However, most super-resolution techniques face limitations that prevent rapid, deep imaging of live samples. Random Illumination Microscopy (RIM), based on natural laser speckle illumination, is a method of choice to overcome these challenges. RIM combines laser speckle illumination at the optical resolution with an algorithm that exploits the statistical invariance of speckle patterns. In this approach, a stack of hundreds of random speckle images is acquired using a random diffusive element and then processed to reconstruct the super-resolved optical section. The invariant statistical properties of speckle patterns, which persist even as they diffuse through biological samples, enable deep-tissue imaging. Additionally, the wide-field configuration of both illumination and detection ensures high acquisition speeds and minimal sample photodamage. Here, we present the implementation of our RIM prototype within a microscopy core facility. We describe the system setup, characterization, and optimization, identifying the key elements required for its reliable operation. As a proof of concept, we also provide biological examples demonstrating the prototype’s performance in resolving subcellular structures.

PMID:41797562 | DOI:10.1111/boc.70060

J Alzheimers Dis. 2026 Mar 9:13872877261424232. doi: 10.1177/13872877261424232. Online ahead of print.

ABSTRACT

BackgroundAnticholinergic medications carry increased risk of worsening cognition, particularly in patients with dementia.ObjectiveCognitive and functional scores of patients were compared at 1-year follow up after cessation of prior anticholinergic medications to those who were not taking anticholinergics at baseline to assess whether prior anticholinergic use affected dementia prognosis in memory clinic patients.MethodsLongitudinal data from 578 consecutive patients with diagnoses including Alzheimer’s disease (AD), frontotemporal and vascular dementia, Lewy body dementia, mild cognitive impairment and dementia due to non-AD etiologies compared patients taking anticholinergic drugs to those taking none at intake. Anticholinergic drugs were discontinued in all patients at initial visit. Mini-Mental Status Examination (MMSE) and Functional Activities Questionnaire (FAQ) were administered at intake and 1-year follow up.ResultsBetween the no-anticholinergic and anticholinergic groups, MMSE at baseline did not significantly differ when the entire sample was compared. In addition, MMSE score change between baseline and follow-up did not significantly differ. Similarly, no significant differences were observed between groups in FAQ at baseline or in FAQ change between timepoints. Subgroup analysis of only those with AD yielded statistically significant differences in initial MMSE. However, these groups had statistically similar follow-up MMSE. Although initial FAQ scores were similar, there were significant differences in follow-up FAQ in patients with AD.ConclusionsFindings suggest that patients with AD presenting on anticholinergic medications may do worse cognitively and functionally than those who were never on anticholinergics despite baseline discontinuation. Anticholinergic medication use in older adults should be approached cautiously.

PMID:41797557 | DOI:10.1177/13872877261424232

Telemed J E Health. 2026 Jan 18:15305627261416295. doi: 10.1177/15305627261416295. Online ahead of print.

ABSTRACT

INTRODUCTION: The use of telemedicine, including direct-to-consumer telemedicine, has increased significantly, yet there are concerns about the quality and safety of care accessed via this model. The current study retrospectively analyzed survey data from individuals about their perceptions of the efficacy, safety, and quality of care they accessed through a telemedicine platform.

METHODS: An online survey, originally intended for the purposes of quality improvement, was sent to individuals who had accessed treatment via a national telemedicine platform. The survey, made available between June 30, 2025 and July 3, 2025, consisted of 22 questions that queried individuals about their experience with the platform. Data were de-identified and retrospectively analyzed, with descriptive statistics used to report on the number and percentage of participants who indicated agreement with survey items.

RESULTS: The survey was completed by 2,399 participants. Overall, participants (>80%) reported a positive experience pertaining to the quality and safety of care accessed via the platform. The majority (>90%) of participants reported a positive experience with the online clinical intake and with providers on the platform. Participants consistently (>90%) rated their overall experience with the platform as equal to or better than prior in-person health care experiences. There was variability with regard to participants’ awareness of specific safety practices implemented by the platform.

DISCUSSIONS: Our findings indicate that the majority of individuals who engaged with the telemedicine platform had positive perceptions of the efficacy, quality, and safety of the care they received and viewed the experience as rivaling care they had previously received in an in-person setting.

PMID:41797533 | DOI:10.1177/15305627261416295

Telemed J E Health. 2026 Jan 13:15305627251412737. doi: 10.1177/15305627251412737. Online ahead of print.

ABSTRACT

OBJECTIVE: This study assesses how providers delivered telehealth services to pregnant Medicaid enrollees, using multistate Medicaid claims data. It also examines how provider rurality and state-level telehealth policies influenced provision.

METHODS: We analyzed claims data on telehealth provision from the Transformed Medicaid Statistical Information System Technical Analytic File from January 2020 to April 2021. Monthly telehealth provision was estimated for family physicians, obstetricians and gynecologists, nurse practitioners, and physician associates, and variations therein were examined by rurality and state policy.

RESULTS: Telehealth provision peaked in April 2020, when 19.5% of providers delivered at least one telehealth service. At the peak in April 2020, rural providers were less likely to provide telehealth than urban providers (15.2% vs. 20.6%), and states with telehealth-supportive policies saw higher provision of telehealth by providers (20.9%) than those without (14.3%). Throughout the study period, rural providers from all specialties in nonsupportive policy states showed the lowest telehealth provision.

CONCLUSIONS: Provider location rurality and state policy environments significantly influenced telehealth provision. Sustained policy support is essential to ensure equitable access to perinatal care.

PMID:41797521 | DOI:10.1177/15305627251412737

J Dtsch Dermatol Ges. 2026 Mar 9. doi: 10.1111/ddg.15992. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigates the association of melanoma risk with total-body nevus count and the presence of atypical nevi in younger (< 40 years) and older (> 60 years) individuals.

METHODS: A pooled analysis was conducted within the M-SKIP project, based on multiple melanoma case-control studies. Associations were assessed through study-specific odds ratios (ORs), adjusted for potential confounders.

RESULTS: Nine case-control studies were included, analyzing common nevi (2,674 melanoma cases/2,343 controls) and atypical nevi (2,459 cases/1,740 controls). High common nevus count was associated with increased melanoma risk in both younger (summary [s]OR = 2.56; 95% CI 1.64-4.01; I² = 31%) and older individuals (sOR = 2.06; 95% CI 1.06-4.00; I² = 67%), with no significant age-group difference (p = 0.57). In contrast, younger individuals exhibited a markedly higher risk of melanoma associated with the presence of at least one atypical nevus (sOR = 4.84, 95% CI 2.18-10.76; I² = 65%) compared to older individuals (sOR = 1.71 95%CI 1.07-2.74; I² = 39%), with a p value for the difference of 0.02.

CONCLUSIONS: These findings suggest age-specific differences in melanoma risk associated with nevus burden. Specifically, atypical nevi are a stronger risk factor in younger individuals. This could have significant implications for prevention strategies and clinical management, in particular for better identification of high-risk groups for targeted secondary prevention efforts.

PMID:41797512 | DOI:10.1111/ddg.15992

Clin Transl Sci. 2026 Mar;19(3):e70520. doi: 10.1111/cts.70520.

ABSTRACT

Pharmacogenomics (PGx) utilizes genetic information to optimize medication management. Barriers to PGx implementation include limited confidence and knowledge in applying results, time constraints, and financial barriers. Clinical services across health systems vary greatly with differing consultative PGx service models. Most research on clinicians and PGx has been centered around attitudes and perspectives, with limited data regarding clinician satisfaction with PGx clinical services. An internally developed survey was created to assess clinician satisfaction with PGx services across a single health system. A survey was deployed to 645 clinicians (physicians, advanced practice providers, and genetic counselors) who utilized PGx clinical services (ordered PGx testing or a referral to the PGx clinic) within the past 3 years. Surveys were distributed via secure email in June 2025. A total of 36 out of 645 clinicians participated in the survey, which is noted as a limitation. Respondents tended to be satisfied (“somewhat satisfied” or “very satisfied”) across several clinical service domains (e.g., process of ordering PGx testing, integration into the electronic health record, and return of PGx results). Pharmacist notes and clinical decision support yielded the highest satisfaction. Most clinicians reported PGx results have positively impacted patient outcomes. Nearly half of respondents noted experiencing barriers in explaining PGx results to patients. The PGx clinic may help mitigate barriers in explaining PGx results to patients. Overall, responding clinicians were satisfied with the majority of PGx clinical services.

PMID:41797503 | DOI:10.1111/cts.70520