Nevin Manimala

Autism Adulthood. 2025 Jan 9;8(4):698-709. doi: 10.1089/aut.2024.0178. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: Prior research exploring phenotypic gender differences in autism suggests that females are less likely to meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria and receive a diagnosis. Recent findings also propose camouflaging and gendered expectations impact diagnostic rates for those who were not socialized as males, suggesting a male-oriented stereotype and bias within the diagnostic system. As such, this article explores how the male stereotype of autism impacts the diagnostic trajectory of autistic adults.

METHODS: In total, 24 autistic individuals, consisting of 14 genderqueer, 8 female, and 2 male participants, shared their experiences with the diagnostic system through interviews. The research team conducted a reflexive thematic analysis using theories of gender socialization and feminist disability models.

RESULTS: Themes revealed that the male gender is inexplicitly tied to diagnostic representation of autistic individuals, failing to encompass the difficulties experiences of those socialized as females. Clinicians and family members often gave a differential interpretation of symptoms for those who did not identify as male, leading to late or missing diagnoses. Lastly, participants discussed how their socialization as a female directly led to the suppression of their autistic traits.

CONCLUSION: These findings shed light on the pervasive impact of gender stereotypes on diagnosis and recognition of autism.

COMMUNITY BRIEF: What was the purpose of this study?: Research shows that girls and women are often less likely to be diagnosed with autism because their challenges can look different from those typically seen in boys. On top of that, some people may mask their difficulties to fit in, which makes spotting the signs even harder. Since many diagnostic tools and clinicians’ understanding of autism are based on the idea that it mostly affects boys, this article looks at how that stereotype creates barriers for non-male individuals to get an accurate diagnosis.What did the researchers do?: We interviewed 24 autistic adults. Of these, 14 identified as genderqueer, 8 as female, and 2 as male. We used reflexive thematic analysis, a method that considers both the researchers’ identities (being autistic, etc.) and explains common themes by relating them to other research in the field about disability and gender.What were the results of the study?: Our first theme showed that autism is often seen only as a “male” condition, which has led clinicians and family members to overlook the participants’ autism. In another theme, participants shared that the traits that are seen as autistic in males-like their male cousins or siblings-weren’t seen as autism in them. Overall, participants felt that their gender and the expectations that were associated with their gender impacted how they expressed their autism and how others perceived it.How will these findings help autistic adults in the future?: This suggests that the diagnostic system may be even more biased than researchers originally thought and that there may be people missing diagnoses as a result.

PMID:42383259 | PMC:PMC13315290 | DOI:10.1089/aut.2024.0178

NAR Genom Bioinform. 2026 Jun 30;8(3):lqag068. doi: 10.1093/nargab/lqag068. eCollection 2026 Sep.

ABSTRACT

Population aging is increasing the burden of age-related disease, highlighting the need for accurate molecular tools to estimate aging. DNA methylation, a heritable epigenetic mark linked to development and age-related disease, can capture biological aging and predict chronological age; however, most existing epigenetic clocks were developed primarily in non-East Asian populations and may show reduced calibration across ancestries. We analyzed methylation profiles from East Asian cohorts from Taiwan, Japan, and China to develop an East Asian-specific epigenetic clock, termed the EAS Clock. After quality control and probe filtering, a parsimonious model based on 38 CpG sites was constructed using stepwise multivariate regression with forward selection and Bayesian Information Criterion. The EAS Clock showed significant correlations between predicted and chronological age in both training and independent testing datasets, with residuals centered near zero. Functional enrichment analyses indicated that genes associated with the selected CpGs were involved in neurobiological, musculoskeletal, immune-inflammatory, and lipid-metabolic pathways. These findings support the EAS Clock as a compact methylation-based estimator of chronological age tailored to East Asian populations.

PMID:42383246 | PMC:PMC13316434 | DOI:10.1093/nargab/lqag068

Drug Alcohol Depend Rep. 2026 Jun 9;20:100456. doi: 10.1016/j.dadr.2026.100456. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: In 2023, Luxembourg partially legalised cannabis, permitting home cultivation and private-domain use. The current study aimed to evaluate the short-term impacts of this reform on consumption patterns, market dynamics, product potency, and cannabis-related driving-under-the-influence cases (DUI).

METHODS: An interdisciplinary approach was applied, combining data from cannabis seizures, wastewater analysis, toxicological data from DUI cases, and a WEB-based survey among adults who indicated to have used cannabis in the past 12 months. Indicators were compared before and after the policy change.

RESULTS: Most indicators suggested a limited overall impact of partial legalisation in the year following the reform. Tetrahydrocannabinol (THC) concentrations in seized herbal and resin samples remained stable, as did THC metabolite loads in wastewater. Results of the WEB-based survey indicated little change in patterns of use, prices, or acquisition channels, with most survey respondents continuing to purchase from illicit sources. Only a minority of respondents reported personal or intended future cultivation. In contrast, cannabis-related DUI cases increased significantly. Although average THC concentrations in blood samples remained unchanged, elevated levels of THC metabolites suggested a potential increase in chronic use among some individuals.

CONCLUSION: Partial cannabis legalisation in Luxembourg appears to have had only moderate impacts on market dynamics, patterns of use, and product potency during the first year, but was associated with an increase in cannabis-related DUI cases. Similar to findings in other countries, new initiation of cannabis consumption was limited, while people with an established pattern of frequent use may have intensified their use. These findings highlight the need for continued monitoring of impaired driving, cannabis consumption patterns, and emerging trends in self-cultivation, alongside public education on health risks.

PMID:42383236 | PMC:PMC13315646 | DOI:10.1016/j.dadr.2026.100456

Ophthalmol Sci. 2026 May 12;6(7):101228. doi: 10.1016/j.xops.2026.101228. eCollection 2026 Jul.

ABSTRACT

PURPOSE: To investigate the impact of epiretinal membrane (ERM) on the structural characteristics of acquired vitelliform lesions (AVLs) in eyes with intermediate age-related macular degeneration (iAMD).

DESIGN: Cross-sectional study.

PARTICIPANTS: Eyes of patients with iAMD-associated AVLs were identified from a tertiary referral center database.

METHODS: Multimodal imaging, including spectral-domain OCT, was reviewed. Eyes were stratified according to the presence (ERM + AVL) or absence (AVL-only) of ERM. Quantitative OCT parameters, including apical AVL height and width, and qualitative structural features such as intraretinal hyperreflective foci (IHRF), ellipsoid zone (EZ), and external limiting membrane (ELM) disruption, and AVL location relative to drusen, were assessed by masked graders. Effect sizes were calculated using Hedges’ g. Group comparisons were performed using appropriate parametric or nonparametric tests.

MAIN OUTCOME MEASURES: Differences in AVL structural characteristics between eyes with and without ERM.

RESULTS: A total of 234 eyes with age-related macular degeneration (AMD)-associated AVLs were included, of which 17 eyes had concomitant ERM. Eyes with ERM demonstrated significantly greater apical AVL height compared with AVL-only eyes (169.9 ± 52.5 μm vs. 134.8 ± 55.0 μm; P = 0.016). Acquired vitelliform lesion width was greater in the ERM + AVL group, although this difference did not reach statistical significance (811.1 ± 251.0 μm vs. 676.8 ± 416.0 μm; P = 0.057). The prevalence of IHRF, EZ disruption, ELM disruption, and AVL location over drusen did not differ significantly between groups. Effect size analysis demonstrated a moderate positive effect for apical AVL height (Hedges’ g ≈ 0.65; 95% confidence interval [CI] ∼0.15 to 1.10), whereas AVL width showed a small-to-moderate effect size with CIs crossing 0.

CONCLUSIONS: In eyes with AMD-associated AVLs, the presence of ERM is associated with increased AVL height without corresponding differences in other outer retinal structural features. These findings suggest that vitreomacular traction may selectively influence AVL configuration. Longitudinal studies are needed to determine whether traction-related modulation of AVL morphology impacts AMD disease progression and AVL collapse.

FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

PMID:42383220 | PMC:PMC13315181 | DOI:10.1016/j.xops.2026.101228

Contemp Clin Trials Commun. 2026 Jun 19;52:101660. doi: 10.1016/j.conctc.2026.101660. eCollection 2026 Aug.

ABSTRACT

INTRODUCTION: Obstructive sleep apnea (OSA) is highly prevalent, yet current treatment remains limited. Poor adherence to positive airway pressure (PAP) and barriers associated with injectable therapies can limit potential therapeutic options for moderate-to-severe OSA. The SURMOUNT-OSA trials demonstrated that tirzepatide contributes to OSA severity improvements; however, the injectable mode of administration introduces barriers that may limit accessibility and long-term adherence. Orforglipron, a once daily oral glucagon-like-peptide-1 receptor agonist, may offer a more feasible and accepted therapeutic option. ATTAIN-OSA was developed to evaluate the efficacy and safety of oral orforglipron in adults with moderate-to-severe OSA.

METHODS: ATTAIN-OSA is a master protocol with two multicenter, randomized, double-blind, placebo-controlled Phase 3 trials enrolling adults with moderate-to-severe OSA and obesity or overweight. Study 1 includes participants unable or unwilling to use PAP. Study 2 includes participants who use PAP and complete a protocol-mandated washout before baseline polysomnography. Participants are randomly assigned to placebo or orforglipron capsule formulation at maximum tolerated dose (12, 24, or 36 mg) for 52 weeks following a standardized dose escalation schedule.

RESULTS: The primary endpoint is change in Apnea-Hypopnea Index (AHI) at Week 52. Key secondary endpoints include sleep apnea-specific hypoxic burden, Patient-Reported Outcomes Measurement Information System sleep-related impairment, high-sensitivity C-reactive protein, and body weight, and other AHI-related endpoints. Overall, 712 participants have been randomized to orforglipron or placebo (Study 1, n = 363; Study 2, n = 349).

CONCLUSION: ATTAIN-OSA evaluates if once-daily oral orforglipron can provide an effective and more accessible therapeutic approach to treat moderate-to-severe OSA in adults with obesity or overweight.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT06649045.

PMID:42383207 | PMC:PMC13316212 | DOI:10.1016/j.conctc.2026.101660

ESMO Real World Data Digit Oncol. 2026 Jun 23;13:100721. doi: 10.1016/j.esmorw.2026.100721. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: The costs of cancer therapies are rising rapidly worldwide, with novel therapies such as targeted treatment and immunotherapies being major contributors, but their effectiveness can be low or uncertain due to limited postmarket surveillance. Reliable biomarkers to identify patients highly unlikely to respond to cancer therapies represent an increasingly important clinical and societal need, as they could prevent unnecessary treatments, reduce side effects, and alleviate pressure on health care systems.

MATERIALS AND METHODS: We developed a robust statistical framework for the identification of nonresponse biomarkers for systemic treatments and applied it to whole-genome and transcriptome sequencing data of cancer patients (N = 2594) with advanced disease.

RESULTS: Our approach identified known and potentially novel genomic and transcriptomic biomarkers of nonresponse, such as immune evasion driver events in skin melanoma patients treated with anti-programmed cell death protein 1 checkpoint inhibitors and KRAS ^G12 mutations in metastatic colorectal cancer patients treated with different chemotherapy regimens. Analytical power analysis revealed that for most treatments and/or cancer types, the cohort sizes remain underpowered.

CONCLUSIONS: Systematic identification of nonresponse signals reveals multiple potential biomarkers that will require larger cohort sizes for prospective clinical implementation.

PMID:42383193 | PMC:PMC13316273 | DOI:10.1016/j.esmorw.2026.100721

Med Image Comput Comput Assist Interv. 2022;13436:207-216. doi: 10.1007/978-3-031-16446-0_20. Epub 2022 Sep 17.

ABSTRACT

We propose LiftReg, a 2D/3D deformable registration approach. LiftReg is a deep registration framework which is trained using sets of digitally reconstructed radiographs (DRR) and computed tomography (CT) image pairs. By using simulated training data, LiftReg can use a high-quality CT-CT image similarity measure, which helps the network to learn a high-quality deformation space. To further improve registration quality and to address the inherent depth ambiguities of very limited angle acquisitions, we propose to use features extracted from the backprojected 2D images and a statistical deformation model. We test our approach on the DirLab lung registration dataset and show that it outperforms an existing learning-based pairwise registration approach.

PMID:42383192 | PMC:PMC13316773 | DOI:10.1007/978-3-031-16446-0_20

Eur Urol Open Sci. 2026 Jun 22;90:42-49. doi: 10.1016/j.euros.2026.06.001. eCollection 2026 Aug.

ABSTRACT

BACKGROUND AND OBJECTIVE: Stress urinary incontinence (SUI) remains a debilitating complication after treatment for prostate cancer or benign prostatic obstruction. While artificial urinary sphincter (AUS) implantation is the gold standard, sling procedures are widely adopted for selected patients. We aimed to analyze long-term trends, perioperative outcomes, and explantation patterns of AUS and sling procedures for male SUI in Germany.

METHODS: We performed a population-based study using the German Nationwide Inpatient Sample (GRAND) from 2005 to 2023. Men undergoing AUS or sling implantation were identified through procedure codes. Primary outcomes were in-hospital morbidity, mortality, and length of stay (LOS). Multivariable regression models were adjusted for age, comorbidities, prior radiotherapy, and year of surgery. Reasons for explantation and reimplantation were also assessed.

KEY FINDINGS AND LIMITATIONS: A total of 24 234 men underwent SUI surgery (AUS: 63%, nonadjustable sling: 32%, and adjustable sling: 4.7%). Median age was 72 yr. AUS implantation remained most frequent, although it declined slightly in recent years. Use of nonadjustable sling peaked in 2012 but decreased thereafter, whereas use of adjustable sling procedures increased steadily. Procedure volumes markedly decreased during COVID-19. Perioperative mortality was <0.1% across groups. Nonadjustable slings were associated with a higher risk of acute urinary retention (odds ratio [OR]: 1.1, p = 0.020) but with a lower risk of wound infection (OR: 0.5, p < 0.001) than AUS. No statistically significant differences were observed between adjustable slings and AUS in terms of perioperative morbidity. LOS was longer in AUS (median 6 d) than in slings (median 5 d; p < 0.001). Two-cuff AUS were associated with longer LOS than single-cuff devices. Explantations occurred most often due to infection or mechanical failure for AUS, and for different reasons for slings. Limitations include reliance on administrative coding without functional or long-term patient-reported outcomes.

CONCLUSIONS AND CLINICAL IMPLICATIONS: Male SUI surgery is safe, with AUS remaining the most frequent procedure in Germany. Adjustable slings represent an expanding option for selected patients.

PMID:42383187 | PMC:PMC13316223 | DOI:10.1016/j.euros.2026.06.001

Environ Epidemiol. 2026 Jun 30;10(4):e501. doi: 10.1097/EE9.0000000000000501. eCollection 2026 Aug.

ABSTRACT

BACKGROUND AND OBJECTIVE: Fractional exhaled nitric oxide (FeNO) is a biomarker of type-2 lung inflammation. Standardized measurement is essential for accurate diagnosis and monitoring. We assess seasonality and environmental determinants of FeNO in individuals with and without chronic respiratory diseases in the general population.

METHODS: This is a cross-sectional study on 412 individuals with chronic respiratory diseases (asthma, chronic bronchitis/chronic obstructive pulmonary disease, rhinitis) and 605 individuals without these conditions. Participants, aged 20-65 years, were recruited in the Gene-Environment Interactions in Respiratory Diseases study in Verona, Italy (2008-2014). Geocoded residential addresses were linked to daily PM₁₀ and air temperature at the time of the clinical examination using previously developed spatiotemporal models. Associations with log-FeNO were analyzed using adjusted linear regression, accounting for seasonality and disease status.

RESULTS: FeNO levels were higher in subjects with respiratory diseases during the warm season, even after adjusting for pollen exposures; a milder seasonal pattern was observed in subjects without chronic respiratory diseases (P for interaction = 0.001). A 10 μg/m³ increase in mean PM₁₀ concentration at lag 0-1 (day of FeNO measurement and day before) was associated with a 3% higher FeNO concentration (Ratio of Geometric Means, RGM: 1.03, 95% confidence interval: 1.00, 1.06) after adjusting for seasonality.

CONCLUSION: FeNO is a sensitive biomarker of environmental exposures. Overlooking seasonality and environmental factors might impact clinical decision-making in chronic respiratory diseases.

PMID:42383180 | PMC:PMC13318099 | DOI:10.1097/EE9.0000000000000501

Future Healthc J. 2026 Jun 3;13(3):100542. doi: 10.1016/j.fhj.2026.100542. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: Legislative moves to legalise assisted dying in the UK have renewed discussion on future clinicians’ preparedness for new potential responsibilities. This study examined medical students’ ethical attitudes, legal understanding and curricular exposure.

METHODS: VOICE was a national cross-sectional survey of UK and Ireland medical students in 2025 (n = 896). The questionnaire assessed ethical views, confidence, legal knowledge and teaching exposure. Descriptive statistics, thematic analysis and multivariable logistic regression explored predictors of ethical agreement, curriculum coverage and legal knowledge.

RESULTS: Most students (64.5%) believed that assisted dying can be ethically justified, yet legal knowledge was limited; only 7.6% correctly identified all eligibility criteria. Nearly 70% reported minimal curricular coverage. Formal teaching was associated with higher confidence and greater ethical agreement. Regional variation and concerns about coercion and inequalities were common.

CONCLUSION: Students show broad ethical support but have very limited confidence, legal understanding and curricular preparation, highlighting the need for structured education.

PMID:42383174 | PMC:PMC13315502 | DOI:10.1016/j.fhj.2026.100542