Category: Nevin Manimala

Neurol Ther. 2026 Jul 17. doi: 10.1007/s40120-026-00946-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Migraine is a common neurological disorder that can severely diminish quality of life. Quantifying migraine-related changes in a real-world population over time can increase understanding of the natural history of migraine and improve clinical care of individuals with migraine.

METHODS: The Observational survey of the Epidemiology, treatment, and Care Of MigrainE (OVERCOME) is a web-based study that longitudinally assessed migraine-related outcomes in a demographically representative adult population with migraine in the United States. Migraine disease status was classified as “overall improved,” “overall worsened,” or “no net change” based on changes in monthly headache days (MHDs), the Migraine Disability Assessment Scale (MIDAS) score, and the Migraine-Specific Quality-of-Life Questionnaire-Role Function-Restrictive (MSQ-RFR) domain score over 1 year. Migraine-related characteristics and patient-reported outcomes were evaluated for each group.

RESULTS: Among 11,634 individuals with migraine who completed the baseline and 1-year follow-up surveys, 40.4% were classified as having “overall improved,” 24.1% as having “overall worsened,” and 35.5% as having “no net change” migraine status at 1 year. The “overall improved” group reported decreases in MHDs [mean change from baseline (SD), -3.2 (5.0)] and MIDAS score [-15.4 (26.2)] and improvements in MSQ-RFR score [+ 13.7 (21.6)]. Additionally, the impact of migraine on work decreased, there was less stigma, and this group was less likely to overuse acute medications. The “overall worsened” group experienced more MHDs [+ 3.4 (5.7)], increased MIDAS score [+ 18.8 (29.0)], and worsening MSQ-RFR score [-14.1 (21.1)]. Migraine had a greater negative impact on their working lives, and they had a greater need for acute and preventive medications for migraine.

CONCLUSION: MHD, MIDAS score, and MSQ-RFR score together provide a robust characterization of overall change in migraine over time. This study demonstrates the profound effect of improvement or worsening of migraine symptoms on workplace productivity, migraine-related stigma, physical function, and need for treatment.

PMID:42467349 | DOI:10.1007/s40120-026-00946-8

Res Child Adolesc Psychopathol. 2026 Jul 17;54(4):93. doi: 10.1007/s10802-026-01489-0.

ABSTRACT

The Family Stress Model (FSM) is a key framework explaining the relationship between family income and child mental health. However, most studies examining the FSM are cross-sectional and do not clearly distinguish within- from between-person effects, which limits robust inferences about how family income affects child mental health at the within-person level. This study addressed this gap by applying a Random Intercept Cross-Lagged Panel Model to data from the nationally representative UK Millennium Cohort Study, focusing on children aged 3, 5, 7, 11, and 14 (N = 11,845; ~49.9% female). Findings revealed that within-person decreases in family income were associated with subsequent increases in internalizing problems for boys from ages 3 to 5 and for girls from ages 7 to 11. Further, income was associated with externalizing problems indirectly but only among girls and only through maternal, not paternal, distress. Together, these findings suggest that within-person FSM processes operate in gender- and outcome-specific ways within families. Interventions may benefit from considering both child and parent gender, with maternal mental health as a particularly relevant target during economic hardship.

PMID:42467332 | DOI:10.1007/s10802-026-01489-0

J Cancer Res Clin Oncol. 2026 Jul 17;152(7):142. doi: 10.1007/s00432-026-06551-4.

ABSTRACT

PURPOSE: The antibody-drug conjugates (ADCs) sacituzumab govitecan (SG) and datopotamab deruxtecan target trophoblast cell surface antigen 2 (TROP-2) and have shown significant efficacy in HER2-negative metastatic breast cancer (mBC). As TROP-2 may serve as a target across multiple treatment lines, detailed information on TROP-2 expression over time is of great interest.

METHODS: TROP-2 expression was analyzed in breast cancer (BC) samples from patients treated at the University Hospital Würzburg between 2004 and 2025 at clinically indicated biopsy time points (TP), and, in a subset, before and after SG treatment. Expression was assessed immunohistochemically using the H-score (range 0-300).

RESULTS: We evaluated 229 samples from 76 patients. Overall, patient-level TROP-2 expression was high (mean H-score 241.3 ± 73.2) and largely stable over time (TP1: 235.7 ± 60.8, n = 76; TP2: 244.6 ± 77.4, n = 72; TP3: 245.3 ± 84.4, n = 39; TP4: 244.9 ± 95.6, n = 8). However, 21 patients exhibited a decline in TROP-2 expression during disease progression, defined as a decrease of ≥ 50 H-score points between two consecutive TPs. Among 13 patients with paired biopsies obtained pre- and post-SG treatment, the mean TROP-2 H-score decreased from 227.0 ± 74.6 before SG to 202.9 ± 99.4 after SG (mean change – 24.1 ± 86.0; median 1.7, range – 170 to 110; Wilcoxon p = 0.542). TROP-2 H-score decreased in 6/13 patients and increased in 7/13 patients. Exploratory PFS analysis showed no statistically significant difference by post-SG TROP-2 change (log-rank p = 0.526).

CONCLUSION: TROP-2 expression was generally high and relatively stable; however, some patients showed declining levels over time.

PMID:42467304 | DOI:10.1007/s00432-026-06551-4

Eur Arch Paediatr Dent. 2026 Jul 17. doi: 10.1007/s40368-026-01244-5. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the clinical performance of Class II resin composite restorations in primary molars following pulpotomy and to compare them with Class II composite restorations in non-pulpotomised primary molars over 24 months.

METHODS: This prospective within-patient controlled study included healthy children aged 4-8 years with at least one primary molar requiring a Class II resin composite restoration with pulpotomy and one without pulpotomy. Restorations were placed under rubber dam isolation using a fifth-generation adhesive and resin composite. NeoMTA® was used for pulpotomies. Clinical evaluation was performed at 12 and 24 months by a blinded examiner using modified ‘USPHS criteria’. Cross-sectional comparisons were performed using Chi-square or Fisher’s exact tests, whilst longitudinal changes were analysed using the McNemar-Bowker test (p < 0.05).

RESULTS: Forty children (80 teeth) were enrolled initially. At 12 months, 37 children (74 teeth) were evaluated, whilst 32 children (64 teeth) completed the 24-month recall. Most restorations in both groups remained clinically acceptable throughout the study period. Marginal integrity was significantly lower in pulpotomised teeth at 12 months (p = 0.003) and at 24 months (p = 0.011). No statistically significant differences were observed for marginal discoloration, surface texture, wear, postoperative sensitivity, or recurrent caries (p > 0.05). Longitudinal analysis demonstrated significant deterioration in marginal integrity over time in the pulpotomy group (p = 0.041).

CONCLUSIONS: Resin composite restorations in primary molars showed acceptable performance in both groups. However, restorations in pulpotomised teeth demonstrated reduced marginal integrity after 24 months.

PMID:42467298 | DOI:10.1007/s40368-026-01244-5

Neurogenetics. 2026 Jul 17;27(1):50. doi: 10.1007/s10048-026-00918-y.

ABSTRACT

Objective the study investigated the association of rs57095329 polymorphism with Parkinson’s disease (PD) susceptibility, clinical features, and miR-146a expression. Methods in this case-control study (204 PD patients, 218 controls), rs57095329 genotype was performed using TaqMan assays. Serum miR-146a expression levels were detected via RT-qPCR. Statistical evaluation included ROC analysis to assess the diagnostic value of miR-146a, Pearson correlation analysis to examine its association with clinical scores (UPDRS-III, H-Y stage, and MoCA), and logistic regression to identify risk factors associated with PD. Results the dominant model genotypes (AG/GG) and the G allele conferred a reduced risk of PD compared to the AA genotype. This protective relevance was more pronounced in individuals aged ≥ 60 years and those with diabetes. Carriers of the AG/GG genotype presented with lower UPDRS-III scores and H-Y staging, together with higher MoCA scores and upregulated miR-146a levels.Serum miR-146a demonstrated outstanding diagnostic accuracy and correlated inversely with PD severity, and was identified as an independent protective factor for PD. Conclusion the miR-146a rs57095329 polymorphism confers reduced susceptibility to PD, with the G allele exerting a protective effect. Reduced serum miR-146a expression was an independent protective marker and shown promising diagnostic value for PD.

PMID:42467290 | DOI:10.1007/s10048-026-00918-y

J Rehabil Med. 2026 Jul 17;58:jrm46016. doi: 10.2340/jrm.v58.46016.

ABSTRACT

OBJECTIVE: This review explores the use of implementation science theories, models, and frameworks in rehabilitation research by describing study characteristics and assessing how the applied theories, models, and frameworks align with study purposes.

METHODS: In the scoping review, peer-reviewed articles published in English between January 2010 and October 2023 were identified from 5 datbases. Eligible studies applied or were informed by implementation science theories, models, and frameworks in any rehabilitation cotext. Data extraction covered publication characteristics, target populations, setings, study designs, used theories, models, and frameworks, and study purposes. Descriptive statistics and deductive analysis were used to synthesize findings.

RESULTS: Of 2,277 citations, 121 articles met the inclusion criteria. Most of the articles focused on neurological and paediatric rehabilitation, with qualitative and mixed-methods designs predominating. A total of 34 theories, models, and frameworks were identified, mainly determinant frameworks and process models. Theories, models, and frameworks were primarily used to identify barriers and facilitators, evaluate implementation outcomes, and describe implementation processes. However, theories, models, and frameworks selection did not always align with the study purpose.

CONCLUSION: The use of theories, models, and frameworks in rehabilitation research is increasing but remains limited. Their systematic and purposeful application is needed to enhance the usability and transferability of research findings, thereby bridging the research-practice gap, sustaining evidence-based interventions, and informing policy.

PMID:42464854 | DOI:10.2340/jrm.v58.46016

Ginekol Pol. 2026 Jul 17. doi: 10.5603/gpl.104730. Online ahead of print.

ABSTRACT

OBJECTIVES: HPV vaccines have been proven effective against genital warts and various cancers, including cervical, anal, penile, vulvar, vaginal, and oropharyngeal cancers. This study aimed to evaluate the cost-effectiveness of including the 9-valent HPV vaccine in the Turkish National Immunization Program (NIP).

MATERIAL AND METHODS: The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) framework was applied to project the potential financial and societal outcomes of introducing HPV vaccination into Türkiye’s 2024 national immunization schedule. Demographic data were obtained from the Turkish Statistical Institute (TUIK, Turkiye Istatistik Kurumu). The cost of vaccine was gathered from Ministry of Health. Epidemiologic inputs, treatment expenditure data, and additional modeling parameters were derived from previously published research sources. Model outputs included projected vaccination expenses, savings from avoided treatment, net costs, prevented cases and deaths, gained life-years, averted disability-adjusted life-years (DALYs), and estimated incremental cost-effectiveness ratios. Potential variability in model projections was examined through deterministic sensitivity testing.

RESULTS: At the national level, with the 9-valent HPV vaccination of a single age cohort in the base year, an estimated 772 cervical cancer cases and 369 related deaths could be avoided through implementation of the vaccination program. With an estimated US$13,754 per DALY gained, the 9-valent HPV vaccine fell within the acceptable cost-effectiveness threshold, defined as three times the GDP per capita. Sensitivity testing confirmed consistent outcomes across parameter variations, identifying the discount rate as the major driver influencing baseline estimates.

CONCLUSIONS: Findings from this analysis support the inclusion of HPV vaccination within the National Immunization Program (NIP) as a cost-effective public health strategy capable of reducing the burden of cervical cancer. Even when considering only cervical cancer, HPV vaccination proves to be cost-effective; when benefits against genital warts and other HPV-related cancers are included, the overall impact increases significantly.

PMID:42464849 | DOI:10.5603/gpl.104730

Ann Ital Chir. 2026 Jun 26;97(7):1308-1316. doi: 10.62713/aic.4538.

ABSTRACT

AIM: The surgical management of colonic Crohn’s disease (CD) remains controversial, with segmental resections possibly associated with a higher rate of recurrence and postoperative complications, while total proctocolectomy reduces recurrence but increases the risk of permanent stoma formation. This study compares surgical outcomes and complications in CD patients undergoing colonic resections (any colectomy with or without concomitant ileal/ileocaecal surgery) vs non-colonic resections (ileal or ileocaecal resections and/or small-bowel strictureplasties without colectomy), with particular emphasis on intra-abdominal septic complications (IASC), non-IASC events, and length of stay (LOS) in hospital.

METHODS: This monocentric observational study analysed consecutive adult patients with histologically confirmed CD who underwent intestinal surgery between January 2012 and April 2024 at Luigi Sacco University Hospital. Patients were divided into two groups according to the index operation. Group A included patients undergoing colonic resection, with or without concomitant ileal or ileocaecal resections and/or small-bowel strictureplasties. Group B included patients undergoing ileal or ileocaecal resection and/or small-bowel strictureplasties without any associated colonic resection. Outcomes included 30-day postoperative complications, LOS, and readmission rates. Statistical analysis was performed using chi-square, Wilcoxon rank-sum tests, and regression models.

RESULTS: Of 461 patients, 90 (19.5%) underwent colonic resections (Group A), while 371 (80.5%) had non-colonic resections (Group B). Overall, complications occurred in 36.2% of patients, with significantly higher rates in Group A than in Group B (48.9% vs 33.2%; p = 0.005). IASC were more frequent in Group A (18 out of 90 patients, 20.0%) than in Group B (37 out of 371 patients, 10.0%) (p = 0.008). The median LOS was 11 days overall, with a statistically significant difference between the groups (Group A: 12 days; Group B: 11 days, p = 0.012). In addition, we observed a significantly higher 30-day reoperation rate in Group A compared with Group B (14.4% vs 6.5%; p = 0.012). Thirty-day readmission rates were low and did not differ significantly between the groups (3.3% vs 1.3%, p = 0.365). Colonic resection, disease phenotype, and American Society of Anesthesiologists score were identified as independent risk factors for postoperative complications and prolonged LOS. There were no significant differences in the 30-day readmission rates among the groups, and no 30-day mortality cases were observed.

CONCLUSIONS: In this large single-centre cohort, colonic resections were associated with higher postoperative complication rates, increased IASC and longer LOS compared with non-colonic resections. These differences likely reflect greater baseline disease complexity and operative burden in patients requiring colonic resection, rather than a causal effect of the resection site alone, highlighting the need for individualised, phenotype-informed surgical decision-making. Further multicentre research is recommended to refine the surgical management of colonic CD.

PMID:42464844 | DOI:10.62713/aic.4538

Ann Ital Chir. 2026 Jul 10;97(7):1270-1278. doi: 10.62713/aic.4564.

ABSTRACT

AIM: The lymph node ratio (LNR) and the log odds of positive lymph nodes (LODDS) have been proposed as alternative indicators of nodal burden that may enhance prognostic stratification beyond conventional pN stage. This study aimed to evaluate the prognostic impact of LNR and LODDS on disease-free survival (DFS) and overall survival (OS) after curative resection for colorectal cancer, and to compare their performance with pN stage and total lymph nodes examined.

METHODS: This retrospective study included 154 patients who underwent curative-intent resection for stage I-III colorectal cancer between 2016 and 2022. Demographic, surgical, pathological, and follow-up data were analyzed. Patients were stratified according to pN stage, LNR, and LODDS categories. DFS and OS were evaluated using Kaplan-Meier survival analysis and Cox proportional hazards regression models. Receiver operating characteristic (ROC) analyses were also performed to assess the discriminatory ability of nodal parameters.

RESULTS: The median number of lymph nodes removed was 28, and adequate lymph node dissection (≥12 lymph nodes) was achieved in 94.8% of patients. During the follow-up period, 18 recurrences and 12 deaths occurred. In the DFS analysis, patients in the LNR 1-2 group showed lower 2-year DFS rates compared to the LNR 0 group (91.0% vs 96.6%). Cox regression analysis indicated a borderline increase in relapse risk in the LNR 1-2 group (hazard ratio (HR): 2.431, 95% confidence interval (CI): 0.963-6.135, p = 0.060). Although advanced pN stage was associated with lower DFS rates, statistical significance was not achieved in the regression analysis. LODDS was not significantly associated with DFS. In the exploratory multivariate analysis, the model including LNR and age showed the best discriminatory performance, and LNR remained independently associated with the risk of recurrence even after adjusting for age (HR: 2.535, 95% CI: 1.004-6.402, p = 0.049). For OS, increasing age was significantly associated with a higher risk of death (HR: 1.076, 95% CI: 1.006-1.150, p = 0.032). In addition, patients undergoing rectal surgery had a lower risk of death compared with those undergoing right/extended colectomy (HR: 0.178, 95% CI: 0.037-0.849, p = 0.030). Neither LNR nor LODDS showed a significant association with OS. ROC analysis showed limited prognostic discrimination overall, but the LNR demonstrated relatively higher predictive performance for DFS compared to pN stage and LODDS.

CONCLUSIONS: Among the lymph node parameters evaluated, LNR showed a trend toward improved prognostic discrimination for short-term DFS, whereas LODDS did not demonstrate significant prognostic value in this cohort. However, the overall discriminatory performance of all lymph node indices remained limited. Therefore, these findings should be interpreted with caution, particularly given the relatively low number of outcome events.

PMID:42464841 | DOI:10.62713/aic.4564

Ann Ital Chir. 2026 Jul 14;97(7):1146-1152. doi: 10.62713/aic.4590.

ABSTRACT

AIM: This study comparatively evaluates the efficacy and safety of contouring-assisted resection versus traditional fistula tract excision in the crus of helix cartilage region for the treatment of congenital preauricular fistula (CPF).

METHODS: This retrospective cohort study recruited 198 CPF patients who underwent surgical treatment at Ruijin Hospital between January 2018 and June 2024. Based on surgical technique, patients were divided into a contouring group (n = 98), who underwent contouring-assisted resection involving systematic dissection along the anterior and deep surfaces of the crus of helix cartilage while preserving the cartilage framework, and a traditional surgery group (n = 100), who underwent conventional fistula tract identification and excision. Baseline characteristics, recurrence rate, operative time, postoperative complications, and patient satisfaction were statistically compared between the two groups.

RESULTS: The recurrence rate was significantly lower in the contouring group than in the traditional group (2.0% vs. 18.0%, p < 0.001). Patients in the contouring group experienced significantly longer operative time (p < 0.001), while intraoperative blood loss did not differ significantly between groups. The overall complication rate was significantly lower in the contouring group (4.1% vs. 20.0%, p < 0.001), with a particularly reduced rate of incision-related infection in this group (1.0% vs. 8.0%, p = 0.044). Patient satisfaction scores were significantly higher in the contouring group (p < 0.001).

CONCLUSIONS: The contouring-assisted resection approach was associated with a significantly lower recurrence rate and higher patient satisfaction compared with traditional fistula tract excision, without an increase in specific complications such as chondritis, hematoma requiring intervention, or persistent sensory abnormality. These observations suggest this method is an effective and safe surgical option for patients with CPF in the crus of the helix region.

PMID:42464838 | DOI:10.62713/aic.4590