Category: Nevin Manimala

Muscle Nerve. 2026 Mar 7. doi: 10.1002/mus.70207. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Myasthenia gravis (MG) is associated with thymic neoplasms. However, an increased prevalence of extrathymic neoplasms has also been reported. This study aimed to evaluate the rates of malignancy in MG patients while accounting for risk factors such as disease characteristics and immunomodulatory treatments.

METHODS: We conducted a case-control study using the Clalit Health Services database, applying a machine learning (ML) algorithm to minimize diagnosis misclassification. We included MG patients aged 18 years and older, with a sex- and age-matched control group in a 1:3 ratio. We compared the prevalence and hazard ratios of extrathymic neoplasms between the groups.

RESULTS: A total of 1558 patients with a high probability of MG, according to our ML model, were included in the cohort, alongside a control group of 4674 individuals. MG patients had a higher prevalence of malignancy prior to MG diagnosis, with an odds ratio of 1.95 (95% CI, 1.65-2.08), and a higher incidence of malignancy after MG diagnosis, with a hazard ratio of 1.56 (95% CI, 1.38-1.77). The most prevalent extrathymic neoplasms after MG diagnosis were respiratory, intrathoracic, skin (specifically non-melanoma), urinary tract, soft tissue, and myelodysplastic syndrome. Risk factors for malignancy included age, male sex, and thymoma. Immunosuppressive treatment did not increase the risk of malignancy.

DISCUSSION: MG patients have a higher prevalence of both solid and hematologic neoplasms compared to non-myasthenic controls, regardless of immunosuppressive treatment. This supports the notion that malignancy is related to MG disease itself rather than external factors.

PMID:41795172 | DOI:10.1002/mus.70207

Paediatr Anaesth. 2026 Mar 7. doi: 10.1002/pan.70157. Online ahead of print.

ABSTRACT

BACKGROUND: Acute and postoperative pain in children is often undertreated, with effects on patient comfort and postoperative recovery. Extended reality (XR) interventions offer non-pharmacological pain management by distracting patients from discomfort. While effective for procedural pain, its impact on prolonged pain episodes remains underexplored.

OBJECTIVES: To systematically review and meta-analyze findings from previous studies on the efficacy of XR interventions in managing acute and postoperative pain in children, compared to standard care.

ELIGIBILITY CRITERIA: Studies involving children (≤ 18 years) with acute or postoperative pain were included if they compared XR interventions to standard care. Studies focusing on procedural or chronic pain were excluded.

METHODS: A systematic search was conducted on January 23, 2025, in MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO for studies evaluating XR interventions for acute and postoperative pain in children, using validated pain measures. Pain outcomes were extracted for an exploratory meta-analysis, with self-report as the primary and observer-report as the secondary outcome. Two reviewers independently extracted data and assessed study quality using CONSORT and TREND.

RESULTS: From 1793 records, nine studies were included, all evaluating virtual reality (VR) interventions. Seven focused on postoperative pain, two on acute pain. The primary meta-analysis (n = 6) showed a moderate but nonsignificant effect in self-reported pain (SMD = -0.61; 95% CI, -1.58 to 0.36). The secondary meta-analysis (n = 6) for observer-reported pain showed a large but nonsignificant effect (SMD = -1.04; 95% CI, -2.18 to 0.11).

CONCLUSION: This meta-analysis found no significant analgesic effect of VR on acute or postoperative pain in children. However, moderate effect sizes were observed, but the lack of statistical significance indicates that XR interventions require further investigation in pediatric pain management. Future research should prioritize pain as a primary endpoint and assess the effects of VR type, timing, and age on acute pain using validated measures.

PMID:41795162 | DOI:10.1002/pan.70157

Paediatr Anaesth. 2026 Mar 7. doi: 10.1002/pan.70167. Online ahead of print.

ABSTRACT

BACKGROUND: Albeit the numerous guidelines on pre-operative fasting in pediatric patients, clinical practice varies. Prolonged fasting can result in several complications, hypoglycemia being one of them. This systematic review and meta-analysis (SRMA) was conducted to assess the effect of prolonged pre-operative fasting on the incidence of hypoglycemia in pediatric patients posted for elective surgery.

MATERIALS AND METHODS: Relevant studies (observational and randomized controlled studies [RCTs]) with fasting duration and incidence of hypoglycemia were identified from data sources (Medline, Scopus, Cochrane Library, Google Scholar) using a systematic search strategy. A pooled relative risk (RR) of hypoglycemia and ketosis due to prolonged fasting was calculated from the RCTs.

RESULTS: This SRMA included 42 studies (15 RCTs and 27 observational studies) involving 5121 patients. There was a wide variation in the definition of hypoglycemia, fasting duration, and incidence of hypoglycemia across the studies. The pooled RR for hypoglycemia was 2.0 (95% CI: 0.57-7.03, I² = 0.00%, p = 0.28) in the prolonged fasting group compared to the non-prolonged fasting group. Although statistical significance was not reached, the direction and magnitude of the pooled effect suggest a clinically meaningful trend toward a lower risk of hypoglycemia with adherence to recommended fasting durations compared with prolonged fasting.

CONCLUSION: The findings of the review revealed the need for standardized outcome definitions and fasting protocols to enable comparisons across future studies. The meta-analysis revealed a variable relationship between fasting duration and hypoglycemia incidence. Structured interventions to facilitate the implementation of guidelines in clinical practice may mitigate the problem.

PMID:41795161 | DOI:10.1002/pan.70167

CPT Pharmacometrics Syst Pharmacol. 2026 Mar;15(3):e70230. doi: 10.1002/psp4.70230.

ABSTRACT

Vixarelimab is a first-in-class fully human monoclonal antibody targeting oncostatin M (OSM) receptor beta (OSMRβ). It has been evaluated in Phase 1 and 2 studies in healthy volunteers and patients with chronic pruritic conditions and demonstrated anti-pruritic efficacy in a Phase 2 study in prurigo nodularis, but detailed pharmacokinetic analysis has not been previously reported. In this study, a population pharmacokinetic analysis was performed to characterize the pharmacokinetics of vixarelimab and identify covariates affecting exposure. The analysis dataset contained 4032 measurements from 274 participants from three Phase 1 and 2 studies. A two-compartment target-mediated drug disposition (TMDD) model with a quasi-steady-state (QSS) approximation satisfactorily described the observed concentration-time data across studies and various dose levels. The model estimated linear clearance (CL), central volume (V_c), and peripheral volume (V_p) at 0.00649 L/h, 3.04 L, and 1.74 L, respectively, in line with values for a typical monoclonal antibody. Subcutaneous bioavailability and the absorption rate constant were estimated to be 56.6% and 0.0126 h^-1, respectively. Body weight was identified as the only statistically significant covariate, positively correlating with CL, V_c, and V_p. Model-based simulations showed that the clinical impact of body weight on vixarelimab exposure was minor, suggesting that dose adjustment based on weight is not warranted. The developed model provides a thorough understanding of vixarelimab pharmacokinetics and the impact of covariates on exposure to support future clinical development.

PMID:41795156 | DOI:10.1002/psp4.70230

Cancer Med. 2026 Mar;15(3):e71706. doi: 10.1002/cam4.71706.

ABSTRACT

BACKGROUND: The incidence of pancreatic cancer (PC) and autoimmune diseases (ADs) has been increasing worldwide. While certain associations between specific ADs, such as pancreatitis, and PC have long been well confirmed, population-focused research investigating the broader spectrum of ADs and their relationship with PC risk remains limited.

METHODS: We implemented a cohort study based on population data to analyze the relationships between ADs and PC susceptibility. Diagnostic information on 43 ADs was obtained from the Swedish Inpatient Register (1964-2018), while cancer incidence and mortality data were sourced from the National Cancer Registry and Cause of Death Register starting in 1997. Relative cancer risks were quantified using standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs).

RESULTS: Within the study’s total population of 16.4 million, 1.1 million cases of ADs were identified, and 3257 patients were later diagnosed with PC accounting for 5.42% of all cancer cases in the cohort. The SIRs for PC in patients with ADs were 1.24 (men) and 1.19 (women); 12 ADs were positively correlated with the incidence of PC. The SMRs for PC in patients with ADs were 1.28 (men) and 1.22 (women); 15 ADs were positively correlated with PC mortality. When the follow-up time was less than 1 year, the overall risk of PC in patients with ADs was 3.88; over 10 years, the risk reached 1.12.

CONCLUSIONS: We have newly discovered the relationship between several ADs and the risk of PC incidence and mortality, including discoid lupus erythematosus, lupoid hepatitis, giant-cell arteritis, and rheumatic fever. The results of this study back the notion that ADs may have a role in promoting the onset of PC.

PMID:41795138 | DOI:10.1002/cam4.71706

Anat Histol Embryol. 2026 Mar;55(2):e70100. doi: 10.1111/ahe.70100.

ABSTRACT

In this study, a comparative assessment of species- and sex-related differentiation was conducted using two morphometric approaches based on mandibles of domestic geese (Anser anser domesticus) and domestic ducks (Anas platyrhynchos domesticus). A relatively traditional approach based on linear measurements was applied alongside a more recent method employing three-dimensional scanning and landmark-based geometric morphometric techniques. The effectiveness of both methods in discriminating morphological differences associated with species and sex was evaluated. For this purpose, a total of 80 mandibles were analysed, comprising 40 domestic geese (20 females and 20 males) and 40 domestic ducks (20 females and 20 males). In species discrimination based on linear measurements, the LS measurement was found to be statistically significant (p < 0.001). Furthermore, discriminant function analysis correctly classified domestic geese at 72.5% and domestic ducks at 87.5%. In the geometric morphometric analyses, PC1 accounted for 50% of the total shape variation, while PC2 explained 16.9%, and a clear separation between species groups was observed. In the assessment of morphological differences between sex groups, all linear measurements were significantly different between sexes in domestic geese (p < 0.001). Regarding shape variation, species groups showed a relatively homogeneous distribution within each group. Overall, this study aims to demonstrate the combined applicability of linear and geometric morphometric methods and to identify mandibular morphological differences across species and sexes, thereby contributing to research on avian morphology.

PMID:41795134 | DOI:10.1111/ahe.70100

Psychiatry Res. 2026 Mar 2;360:117067. doi: 10.1016/j.psychres.2026.117067. Online ahead of print.

ABSTRACT

BACKGROUND: Differentiating bipolar depression (BPD) from unipolar depression (UPD) is clinically challenging due to symptom overlap. This study explores eye-movement differences between UPD, BPD, and healthy controls (HCs) using a multi-task eye-tracking approach.

METHODS: Eye-movement data were collected from 228 participants (60 UPD, 56 BPD, 112 HCs) across four tasks: fixation stability, free-viewing, visual search, and smooth pursuit. A total of 155 eye-movement features were extracted and analyzed using robust analysis of covariance (ANCOVA) and machine learning for classification.

RESULTS: Significant differences were identified in 53 features. BPD was characterized by shorter total, average, and first fixation durations across all fixation stability conditions. During free-viewing task, attention to happy images showed a graded decline (HC > UPD > BPD), while BPD exhibited increased fixation allocation to threatening images and reduced saccade velocity and amplitude to negative stimuli. UPD demonstrated reduced efficiency in processing happy faces in the visual search task. Machine learning achieved good discrimination (mean area under the receiver operating characteristic curve [AUC]: 0.78 for HC vs. UPD; 0.88 for HC vs. BPD; 0.87 for UPD vs. BPD), with key contributing features overlapping with those identified as significant in statistical analyses.

CONCLUSIONS: Eye-movement patterns reveal both shared and disorder-specific features in UPD and BPD, supporting the potential of eye-tracking as an objective and scalable tool for differentiating mood disorders.

PMID:41793797 | DOI:10.1016/j.psychres.2026.117067

Psychiatry Res. 2026 Feb 26;360:117027. doi: 10.1016/j.psychres.2026.117027. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigates the predictive validity of the Subjective Trauma Outlook (STO) in conjunction with the post-traumatic stress disorder (PTSD) checklist for the diagnostics and statistical manual for mental disorders (DSM-5) checklist (PCL-5) Short Form (PCL-5 SF) and the full PCL-5 for identifying probable PTSD within the context of the October 7, 2023, terrorist attack in Israel. Specifically, we examine the effectiveness of the STO in predicting PTSD and the utility of the PCL-5 SF as an alternative to the full PCL-5 in wartime.

METHOD: A national sample of 4097 Israelis was assessed following the October 7 attack. Participants completed the PCL-5 questionnaire alongside the STO. Hierarchical regression analyses were conducted to determine the predictive validity and diagnostic utility of the STO when used with both PTSD assessment tools. Receiver operating characteristic (ROC) curve analyses were performed to establish optimal STO cutoff scores for PTSD risk classification.

RESULTS: Our findings indicate a strong similarity between the STO’s predictive validity when paired with either the PCL-5 SF or the full PCL-5. The STO demonstrated robust associations with PTSD symptoms across both models, with comparable explained variance. The identified cutoff scores for the STO reinforce its utility in distinguishing individuals at risk for PTSD.

CONCLUSION: Our research contributes to the growing evidence supporting the STO as a valid screening tool for PTSD. It highlights the practical advantages of the PCL-5 SF as a viable alternative to the full PCL-5, particularly in crisis settings where rapid assessment is essential.

PMID:41793796 | DOI:10.1016/j.psychres.2026.117027

Eur J Oncol Nurs. 2025 Dec 17;81:103082. doi: 10.1016/j.ejon.2025.103082. Online ahead of print.

ABSTRACT

PURPOSE: The study was conducted to determine the effect of Reiki performed on children with leukemia between the ages of 5-7 years on pain, vital signs, oxygen saturation, and quality of life.

METHODS: The research was a double-blind, pre-test-post-test randomized controlled experimental study. The research sample consisted of 66 children with leukemia aged 5-7 years who were hospitalized in pediatric oncology wards of a university hospital between December 2020 and November 2021. The balanced block randomization method was used for randomization. The data were collected using Information Form, Wong-Baker FACES Pain Scale (W-BPS), Vital Signs Follow-up Form, The Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module. Reiki was performed to the Reiki group for 20-30 min once per day, for 3 consecutive days and pseudo-Reiki was applied to the pseudo-Reiki group by an independent nurse during the same application period.

RESULTS: There was no statistically significant difference in vital signs (heart rate, respiratory rate, body temperature) and SpO₂ values among the groups (p > 0.05). However, both children’s and mothers’ evaluations on days 1, 2, and 3 after the intervention showed that pain scores in the Reiki group were significantly lower than in the pseudo-Reiki and control groups (p < 0.001), and quality of life was significantly higher (child:p < 0.001; mother:p < 0.01) compared to the pseudo-Reiki and control groups.

CONCLUSION: Reiki did not affect the vital signs of the children but was effective in reducing pain and increasing the quality of life compared with the pseudo Reiki and control groups. It is recommended that Reiki therapy be used in addition to medical treatment to reduce pain and improve quality of life in children with leukemia aged 5-7 years.

PMID:41793784 | DOI:10.1016/j.ejon.2025.103082

Vision Res. 2026 Mar 5;243:108795. doi: 10.1016/j.visres.2026.108795. Online ahead of print.

ABSTRACT

Natural scenes are full of textures, enabling us to recognize surface materials and bringing richness and realism to our perceptual experience. While models have represented texture perception using high-dimensional statistical features, final perceptual appearance of a natural texture may be determined by more compact neural representations. Previous attempts derived such a compact space from verbal descriptors, but it captures a semantic rather than a perceptual space. Here, we derived the space directly from natural images using an unsupervised generative model. We show that the resulting ‘texture’ space, with only 12-16 dimensions, was able to generate perceptual metamers, and that distances in the space accurately aligned with human perceptual similarity judgments. While individual dimensions of the space were difficult to verbally describe, specific coordinate regions in the space corresponded to semantic descriptions such as glossiness. Furthermore, VEP analysis confirmed that visual cortical responses share a similar underlying structure, which allowed us to reconstruct the original texture stimuli. These results demonstrate that rich natural texture impressions-often resistant to linguistic description-are supported by a shared, low-dimensional structure that governs perceptual similarity, semantic interpretation, and neural encoding.

PMID:41793782 | DOI:10.1016/j.visres.2026.108795