Nevin Manimala

Discov Ment Health. 2026 Jun 25. doi: 10.1007/s44192-025-00238-x. Online ahead of print.

ABSTRACT

BACKGROUND: Providing care to a family member who has been diagnosed with cancer can be quite tiresome both physically as well as psychologically; therefore, emotional preparedness within the family will contribute significantly in offering effective care. This study investigated the effects of acceptance and commitment therapy (ACT) on communication avoidance, emotional distress and hyper arousal among caregivers of patients with advanced breast cancer.

METHODS: This study was a randomized controlled trial with pretest-posttest follow-up design. The study sample were 80 caregivers of advanced breast cancer patients from Mashhad City, Khorasan Province, Iran, in 2023, who were selected by the convenience sampling method. The research instruments included a demographic, communication avoidance, positive and negative affect, and hyperarousal questionnaire. Eight weeks of intervention was conducted following the pre-test. The post-test and follow-up were conducted one week and three month post intervention. The data were analyzed using repeated measures MANOVA.

RESULTS: A statistically significant difference was observed between the intervention and control groups in the mean scores of communication avoidance, positive and negative affect, and hyperarousal questionnaire one week and three month after intervention. The intervention group demonstrated higher scores than the control in positive affect but lower in communication avoidance, negative affect, and hyperarousal. The intervention had a positive effect on the intervention group over time, with no significant differences observed between the post-test and follow-up stages (p < .001).

CONCLUSION: According to these results, ACT was effective in reducing communication avoidance and negative emotions and decreasing hyperarousal among caregivers. Thus, results point to the potential of ACT to contribute not only to emotional regulation but also to healthier coping with the burden associated with providing cancer caregiving.

PMID:42348142 | DOI:10.1007/s44192-025-00238-x

Aging Clin Exp Res. 2026 Jun 25. doi: 10.1007/s40520-026-03441-0. Online ahead of print.

ABSTRACT

BACKGROUND: The objective of this cross-sectional observational study was to validate a scale that highlights the personal and environmental barriers that hinder adherence to regular physical exercise in older adults.

METHODS: Individuals aged 60 years or over, sedentary and/or ex-practitioners, regular practitioners of physical exercise, with Brazilian Portuguese as their mother tongue. In addition to the Regular Physical Exercise Adherence Scale (REPEAS), the following instruments were applied: sociodemographic data sheet and Baecke Habitual Physical Activity Questionnaire. The measurement properties tested were: structural validity, construct validity, reliability, consistency internal and ceiling and floor effects.

RESULTS: This research involved 200 older adults’ participants, predominantly women. The confirmatory factor analysis supported the two-domain, 12-item structure of the REPEAS, demonstrating good model fit with the following indices: chi-square/degrees of freedom = 1.60, comparative fit index = 0.965, Tucker-Lewis index = 0.957, root mean square error of approximation = 0.078, and standardized root mean square residual = 0.078. Construct validity was evidenced by a statistically significant difference (p < 0.05) in the personal factors domain between groups. Additionally, the domains of the REPEAS showed appropriate correlations with the items in the factor analysis. Reliability was acceptable, with composite reliability ≥ 0.84 and intraclass correlation coefficient ≥ 0.89.

CONCLUSION: This scale presented adequate measurement properties when tested on Brazilian older adults to assess environmental and personal barriers to regular physical exercise. However, as this was a study conducted with a convenience sample, generalization of the findings should be made with caution. Despite this, the REPEAS can serve as a practical tool for health professionals and researchers to identify modifiable barriers and guide strategies to promote physical activity among older adults.

TRIAL REGISTRATION: Not applicable.

PMID:42348141 | DOI:10.1007/s40520-026-03441-0

Isr Med Assoc J. 2026 Jun;28(6):376-382.

ABSTRACT

BACKGROUND: Post-traumatic stress disorder (PTSD) remains a significant and often refractory mental health condition. Hyperbaric oxygen (HBO) therapy has demonstrated promise in alleviating symptoms of PTSD but optimal dosing and treatment duration remain unclear.

OBJECTIVES: To evaluate the clinical efficacy and dosing effects of two HBO protocols in patients with PTSD.

METHODS: We conducted a randomized controlled trial comparing two HBO protocols: 60 daily sessions of 90 minutes at either 2.0 atmospheres absolute (ATA) or 2.5 ATA (HBO15). Adults with severe PTSD (Clinician Administered PTSD Score [CAPS]-5 ≥ 33) were randomized to treatment arms. CAPS-5 scores were recorded every 2 weeks. Secondary outcomes include measures of depression, sleep, executive function, and safety. Preliminary results are presented for the first nine patients who completed therapy (HBO10: n=5; HBO15: n=4).

RESULTS: Participants in HBO15 were younger (mean age 39 vs. 59 years, P = 0.2). Baseline PTSD severity (CAPS-5) was higher in HBO15 (median 61.5 vs. 48.0, P = 0.4). Other baseline psychological scores were similar between groups. Mean CAPS-5 improvement (ΔCAPS) was greater in HBO15 (-14.0 ± 21.2) vs. HBO10 (-5.3 ± 19.6), although not statistically significant (P = 0.8). Both groups demonstrated the largest symptom reduction by weeks 6-8, with a plateau observed thereafter despite continued treatment through week 12.

CONCLUSIONS: Preliminary data suggest both HBO protocols are associated with symptomatic improvement in PTSD, with a trend toward greater effect in the higher-pressure group (2.5 ATA). Improvements appear to peak around 6-8 weeks, potentially indicating a shorter optimal treatment duration.

PMID:42345229

Isr Med Assoc J. 2026 Jun;28(6):363-368.

ABSTRACT

BACKGROUND: Asthma poses unique challenges in aviation medicine. While strict criteria typically dictate waiver approvals in military aviators with asthma, the Israeli Air Force (IAF) applies a more individualized approach. Still, evidence to guide correct management is scarce.

OBJECTIVES: To assess the characteristics and long-term outcomes of military aircrew diagnosed with asthma.

METHODS: This retrospective study included active and reserve aircrew who were diagnosed with asthma during annual assessments at the Israeli Aeromedical Unit between 1998 and 2024. Baseline characteristics, treatment regimes, pulmonary function tests (PFTs), and asthma exacerbations were analyzed.

RESULTS: Thirty-two aircrew personnel (median age 30 years at diagnosis) were included in the study, with 44% serving at high-performance platforms. Six participants (19%) were classified as Global Initiative for Asthma step 4 or 5. Over an average follow-up period of 18.5 years, seven exacerbations were documented (4.0 per 100 patient-years), with no safety incidents reported. Participants’ pulmonary function remained stable. Forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) declined around asthma diagnosis (median of 82% predicted and 0.73, respectively) but recovered remarkably while on treatment (median 91% predicted and 0.78, respectively). Aircrew who experienced exacerbations had no statistically significant differences in demographics, disease severity or baseline PFTs.

CONCLUSIONS: With individualized management and regular monitoring, a new diagnosis of asthma in military aircrew was not associated with a significant impact on service. Our study supports a flexible, individualized approach to aeromedical management of aircrew with asthma.

PMID:42345227

Ann Med. 2026 Dec;58(1):2692729. doi: 10.1080/07853890.2026.2692729. Epub 2026 Jun 25.

ABSTRACT

BACKGROUND: Parents of children with special health care needs (CSHCN) usually hesitate to vaccinate their children, yet limited data on factors influencing parents’ willingness to vaccinate their children are available. Our study aimed to reveal parents’ willingness to immunize their children with the Expanded Programme on Immunization Vaccines and identify determinants influencing parents’ willingness.

METHODS: We conducted a cross-sectional, questionnaire-based survey using a stratified sampling approach in Wuxi, China. Description methods were used to describe guardians’ willingness to vaccinate their children, and logistic regression analysis was employed to examine the influencing factors of parents’ willingness.

RESULTS: A total of 904 parents/guardians were collected; 864 (95.58%) were willing to immunize their children. Univariate analysis revealed that parents’ knowledge of vaccines and their awareness of vaccination assessment clinics were factors that influenced vaccination willingness. The multivariate logistic regression results indicated that parental education level and awareness of vaccination assessment clinics were significant predictors of parents’ willingness to vaccinate their children.

CONCLUSION: Higher parental knowledge and use of vaccination consultation clinic services are associated with greater willingness to vaccinate among parents of children with special health care needs.

PMID:42345214 | DOI:10.1080/07853890.2026.2692729

Int Angiol. 2026 Jun;45(3):174-180. doi: 10.23736/S0392-9590.26.05523-9.

ABSTRACT

BACKGROUND: Accurate measurement of the residual sac after endovascular aortic repair (EVAR) is essential for effective surveillance, guiding detection of complications and decisions regarding reintervention. While two-dimensional ultrasound (2D-US) remains standard-of-care, it is limited by operator variability. Three-dimensional ultrasound (3D-US) with modeling software has demonstrated improved precision but remains resource-intensive. The introduction of three-dimensional Software-Assisted Ultrasound (3D-SAUS) offers an automated, on-cart alternative for more streamlined clinical use. This study compares 3D-SAUS with 2D-US in measuring maximum residual sac diameter in EVAR patients, focusing on variability and clinical applicability.

METHODS: Patients previously treated with EVAR and following US-based follow-up were scanned by three or four experienced ultrasound operators. The maximum anterior-posterior residual sac diameter was measured for all patients using 2D-US and 3D-SAUS. Outcomes were median and limits of agreement (LoA) with 95% confidence intervals for both modalities.

RESULTS: Fourteen EVAR-treated patients underwent 44 paired 2D-US and 3D-SAUS scans. Median maximum residual sac diameters were 50.0 mm with 2D-US and 50.3 mm with 3D-SAUS. LoA were 3.4 mm for 2D-US and 3.6 mm for 3D-SAUS, with overlapping 95% confidence intervals (2.2-4.6 mm and 2.5-4.7 mm, respectively). The difference in LoA was not statistically significant (P=0.61). Automatic technical success was achieved in 79% of the available 3D scans.

CONCLUSIONS: 3D-SAUS demonstrated comparable residual sac diameter measurement precision and variability to expert 2D-US in post-EVAR patients. These findings support the potential of 3D-SAUS to enhance reproducibility and standardize ultrasound-based follow-up.

PMID:42345186 | DOI:10.23736/S0392-9590.26.05523-9

Asian Pac J Cancer Prev. 2026 Jun 1;27(6):2335-2343. doi: 10.31557/APJCP.2026.27.6.2335.

ABSTRACT

OBJECTIVE: To develop and evaluate an automated deep learning-based lung cancer staging system using computed tomography (CT) scan images.

METHODS: CT scan images were obtained from publicly available datasets (LIDC-IDRI/TCIA) comprising 1,018 patient scans. The dataset consisted of three subsets, which were: training (70 percent of total), validation (15 percent), and testing (15 percent). Lung region segmentation, anisotropic filtering, and data augmentation were used as preprocessing. To classify lung cancer stages, a customized CNN network based on multi-scale feature extraction and softmax-enabled probabilistic output was trained. Statistical confidence intervals, F1-score, ROC-AUC, recall, accuracy, and precision were used to test the performance of the model.

RESULTS: Using an area under the curve (AUC) of 0.98 (Stage I), 0.96 (Stage II), 0.95 (Stage III) and 0.97 (Stage IV) the proposed model indicates a total classification of 93.0 (95% CI: 91.2-94.8). Statistical analysis revealed a significant improvement compared to baseline CNN models (p < 0.05). Compared with state-of-the-art techniques, quantitative comparisons showed either equivalent performance or slightly higher performance, particularly in separating between early-stage (I-II) and advanced-stage (III-IV) disease.

CONCLUSION: The findings demonstrate that the suggested CNN-based architecture can effectively and precisely classify the stage of lung cancer based on CT images, which assists in automated clinical decision-making and enhances the early detection process.

PMID:42345183 | DOI:10.31557/APJCP.2026.27.6.2335

Asian Pac J Cancer Prev. 2026 Jun 22;27(6):2323-2334. doi: 10.31557/APJCP.2026.27.6.2323.

ABSTRACT

OBJECTIVE: To identify the mutational landscape of oral cancers of unknown etiology by leveraging publicly available datasets.

METHODS: Oral cancer mutation data in TCGA were accessed to identify never-smoking and never-alcohol-drinking subjects with genomic, epigenomic, and transcriptomic data. Habit-free participants within published individual whole-exome sequencing studies of oral cancer were examined as the replication dataset.

RESULTS: Somatic mutation analysis of 42 habit-free TCGA oral cancer subjects revealed MUC16 and MUC5B as recurrent mutational targets in 30% of all habit-free oral cancers; the highest after previously reported oral cancer genes such as TP53, CASP8, CDKN2A, NOTCH1. Comparison against other habit-free oral cancers not only confirmed these observations but also identified additional mucin genes as frequent mutational targets, supporting their potential causal role. Gene expression and immune fraction analysis of bulk transcriptomic data showed that habit-free oral cancers were enriched for the expression of mesenchymal genes and in T-regulatory cells.

CONCLUSION: Together, these data suggest that mucin genes, specifically MUC16 and MUC5B, are important for oral carcinogenesis in the absence of tobacco and alcohol. These results are relevant given the increasing clinical utility of mucins as druggable targets in cancer, particularly MUC16.

PMID:42345182 | DOI:10.31557/APJCP.2026.27.6.2323

Asian Pac J Cancer Prev. 2026 Jun 1;27(6):2269-2278. doi: 10.31557/APJCP.2026.27.6.2269.

ABSTRACT

BACKGROUND: Fluoropyrimidine-based chemotherapy is a fundamental treatment for colorectal cancer (CRC), yet its therapeutic efficacy is often limited by significant inter-individual variability. Enzymes involved in 5-fluorouracil (5-FU) metabolism thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), and methylenetetrahydrofolate reductase (MTHFR) are critical determinants of drug response. This study aimed to evaluate the molecular correlation between TS, DPD, and MTHFR mRNA expression in paired tumor tissue and peripheral blood samples, while simultaneously developing and validating a non-invasive predictive nomogram to forecast therapeutic response to neoadjuvant CAPEOX (capecitabine-oxaliplatin) chemotherapy in advanced CRC.

METHODS: A prospective cohort study was conducted on 36 patients with stage III-IV CRC receiving CAPEOX. mRNA expression of TS, DPD, and MTHFR was quantified using qRT-PCR from paired tumor and peripheral blood samples. Chemotherapy response was evaluated using RECIST 1.1 criteria. Statistical analyses included Spearman correlation, the Mann-Whitney U test, and multivariate logistic regression. A nomogram was constructed based on significant predictors.

RESULTS: DPD and MTHFR expression levels were significantly lower in responders than in non-responders (p < 0.001), while TS expression showed no significant difference. Gene expression in tissue and blood was strongly correlated (r = 0.820 for TS, r = 0.658 for DPD, and r = 0.623 for MTHFR; all p < 0.001). Multivariate analysis identified blood-based DPD and MTHFR expression as independent predictors of response. The predictive nomogram demonstrated excellent discrimination (AUC = 0.932).

CONCLUSION: Lower DPD and MTHFR expression predicts a favorable response to neoadjuvant CAPEOX in advanced CRC. These biomarkers offer a promising, non-invasive approach to personalizing treatment strategies potentially enhancing therapeutic efficacy while minimizing unnecessary toxicity.

PMID:42345176 | DOI:10.31557/APJCP.2026.27.6.2269

Asian Pac J Cancer Prev. 2026 Jun 1;27(6):2259-2268. doi: 10.31557/APJCP.2026.27.6.2259.

ABSTRACT

BACKGROUND: Oral squamous cell carcinoma (OSCC) is the sixth most prevalent cancer globally and constitutes a major public health burden in Bangladesh, with approximately 7.5% of all cancer-related deaths. Although tobacco and betel-quid use are recognized risk factors, dietary patterns may also contribute to OSCC development.

OBJECTIVE: This study investigated the association of lifestyle and dietary factors with OSCC in Bangladeshi patients and explored the potential involvement of TERT promoter mutations and human papillomavirus (HPV) infection.

METHODS: A hospital-based, case-control study was conducted involving 47 histopathologically confirmed OSCC patients and 100 age- and sex-matched healthy controls without cancer or chronic illness. Sociodemographic, lifestyle, and dietary data were collected through a structured questionnaire. Tumor DNA was analyzed for TERT promoter mutations and HPV DNA using PCR and Sanger sequencing. Statistical analyses were performed using multivariable logistic regression to identify significant associations.

RESULTS: Excessive betel-quid chewing was strongly associated with OSCC (p < 0.01). Among 39 sequenced OSCC samples, 25 single-nucleotide polymorphisms (SNPs) at position -245 (A>G) and one hotspot mutation at position -124 (G>A) of the TERT promoter were identified substantially lower than frequencies reported in other populations. No HPV DNA was detected in any sample. Certain dietary patterns such as low fruit and vegetable intake and high consumption of betel quid were linked to increased OSCC risk.

CONCLUSION: Our findings suggest that, in Bangladeshi patients, specific dietary and lifestyle factors, rather than HPV infection or TERT promoter mutations, contribute significantly to OSCC development. Targeted public health strategies emphasizing nutritional awareness and cessation of betel-quid use are recommended.

PMID:42345175 | DOI:10.31557/APJCP.2026.27.6.2259