Nevin Manimala

JAMA Neurol. 2026 Jul 27. doi: 10.1001/jamaneurol.2026.2333. Online ahead of print.

ABSTRACT

IMPORTANCE: Gefurulimab is a novel dual-binding nanobody that blocks complement component 5 activation. Complement activation is a key pathogenic mechanism in anti-acetylcholine receptor antibody-positive (AChR-Ab+) generalized myasthenia gravis (gMG).

OBJECTIVE: To evaluate the efficacy and safety of gefurulimab in adults with AChR-Ab+ gMG.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial, PREVAIL, was a phase 3, double-blind, placebo-controlled study conducted at 113 sites in 20 countries. Patients were screened and randomized from November 2022 to November 2024; the randomized controlled treatment period was 26 weeks. Participants were adults (aged ≥18 years) with AChR-Ab+ gMG, a Myasthenia Gravis Foundation of America classification II through IV, and a Myasthenia Gravis Activities of Daily Living (MG-ADL) total score of 5 or higher.

INTERVENTION: Gefurulimab or placebo via once-weekly subcutaneous self-injection.

MAIN OUTCOMES AND MEASURES: The primary end point was change from baseline in MG-ADL total score at week 26. The key secondary end point was change from baseline in Quantitative Myasthenia Gravis (QMG) total score at week 26. Safety was also assessed.

RESULTS: Of 405 patients screened, 145 were excluded; 260 met eligibility criteria and were randomized (gefurulimab, n = 131; placebo, n = 129); 249 patients completed the 26-week randomized controlled treatment period. The mean (SD) age was 52.8 (15.73) years; 157 (60.4%) patients were female and 103 (39.6%) were male. All primary and secondary end points were met with statistical significance. Improvements occurred within 1 week for MG-ADL score and 4 weeks for QMG score and were sustained through week 26. Least-squares mean change from baseline at week 26 for MG-ADL and QMG total scores for gefurulimab vs placebo were -4.2 vs -2.6 (treatment difference, -1.6; 95% CI, -2.4 to -0.8; P < .001) and -4.5 vs -2.4 (treatment difference, -2.1; 95% CI, -3.1 to -1.1; P < .001), respectively. The incidence of adverse events (AEs) was similar between groups. Most common treatment-emergent AEs with gefurulimab were injection site reactions, headache, back pain, and nasopharyngitis. No meningococcal infections were reported.

CONCLUSIONS AND RELEVANCE: Gefurulimab demonstrated both early and sustained clinical benefit in AChR-Ab+ gMG and was well tolerated, supporting its potential as a convenient, once-weekly, self-administered treatment regimen.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05556096.

PMID:42507440 | DOI:10.1001/jamaneurol.2026.2333

Eur J Dermatol. 2026 Jun 1;36(3):256-265. doi: 10.1684/ejd.2026.5079.

ABSTRACT

Traditional Chinese medicine (TCM) has been increasingly applied in treating diabetic pruritus. Objectives: To conduct a systematic review and meta-analysis evaluating the efficacy and safety of TCM or integrated TCM-Western therapy for diabetic pruritus. This systematic review and meta-analysis was registered with registration number: INPLASY202570074. Major Chinese and international databases (China National Knowledge Infrastructure, PubMed, Web of Science and ScienceDirect) were searched between their inception and December 2024. Eligible randomised controlled trials (RCTs) investigating TCM or integrated TCM-Western therapies for diabetic pruritus were included. Two independent researchers performed literature screening, data extraction and quality assessment according to predefined inclusion and exclusion criteria. Outcome indicators included clinical efficacy rate, pruritus severity (Visual Analogue Scale [VAS] score) and incidence of adverse reactions. Meta-analyses were conducted using RevMan 5.4, Stata 16.0 or R 4.x. A total of 13 RCTs were included, with 557 participants in both the control group and the experimental group. Meta-analysis showed that TCM or integrated TCM-Western therapies significantly improved clinical efficacy compared with control groups (risk ratio [RR]=1.30, 95% CI:1.17-1.45, p<0.001). Most studies favoured TCM or integrated therapy in reducing VAS scores. Pooled estimate (mean difference=-1.09, 95% CI: -2.20-0.03, p=0.06) did not reach statistical significance due to high heterogeneity (I²=92.8%), indicating substantial variability among studies. Despite the heterogeneity, the existing evidence suggests that TCM or integrated TCM-Western therapies have potential -clinical advantages in treating diabetic pruritus, including improved efficacy and lower incidence of adverse reactions.

PMID:42507401 | DOI:10.1684/ejd.2026.5079

J Fam Psychol. 2026 Jul 27. doi: 10.1037/fam0001530. Online ahead of print.

ABSTRACT

Reports an error in “Parental warmth, COVID-19 peritraumatic distress, and emotional problems among Chinese adolescents: A cross-lagged panel study” by Tong Xiao, Xun Zhu, Qing Zeng, Ying Peng and Minqiang Zhang (Journal of Family Psychology, 2025[Sep], Vol 39[6], 735-744; see record 2026-21867-001). In the article, the analytical procedure was incorrectly described. In the Data Analysis section, the sentence “In addition, we performed exploratory factor analysis to evaluate common method bias for all items, with poor model fits indicating the absence of significant common method bias (Podsakoff & Organ, 1986)” should read “In addition, we performed confirmatory factor analysis to evaluate common method bias by testing a one-factor model, with poor model fit indicating the absence of significant common method bias (Podsakoff & Organ, 1986).” In the Preliminary Analysis section, the sentence “Subsequently, we employed exploratory factor analysis to assess common method bias” should read “Subsequently, we employed confirmatory factor analysis to assess common method bias.” This error does not affect the reported results, interpretations, or conclusions of the study. (The following abstract of the original article appeared in record 2026-21867-001). It is well-established that parenting plays a crucial role in shaping the mental health of adolescents. This study aimed to investigate the longitudinal association between adolescents’ perceived parental warmth, COVID-19 peritraumatic distress, and emotional problems. Participants were recruited from schools in Zhuhai, Xinyang, and Ningxiang. A total of 579 adolescents (55.4% girls, M_age = 12.83; SD_age = 0.76) took part in this three-wave study conducted in January 2023 (Time 1), March 2023 (Time 2), and May 2023 (Time 3), with each wave being 2 months apart. The results from the cross-lagged panel model supported significant bidirectional relations between emotional problems and COVID-19 peritraumatic distress. In addition, the influence of maternal or paternal warmth on subsequent emotional problems was not statistically significant. The COVID-19 peritraumatic distress at Time 2 mediated the longitudinal effect of emotional problems at Time 1 on paternal warmth at Time 3. Nevertheless, COVID-19 peritraumatic distress did not significantly influence subsequent maternal warmth. These findings contribute to our understanding of the varying responses to adolescents’ stress across parental gender. Furthermore, they imply potential strategies to protect the healthy development of adolescents. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42507394 | DOI:10.1037/fam0001530

Psychol Trauma. 2026 Jul 27. doi: 10.1037/tra0002236. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examined the mental health and resilience of combatants and their partners during the 2023 Israel-Hamas war, with a focus on self-compassion as a protective factor. While soldiers’ mental health has been widely studied, the psychological burden on their partners, especially during active conflict, is less understood. The transition of reservists from civilian to combat roles, coupled with the upheaval faced by their families, provides a unique opportunity to assess resilience in this dyadic context.

METHOD: A total of 134 couples (N = 268), combatants serving in Gaza and their partners, participated in the study. Both completed self-report questionnaires tapping posttraumatic stress disorder (PTSD), depression, anxiety, stress, and self-compassion. Descriptive statistics and paired t tests examined distress levels, while actor-partner interdependence models assessed the impact of self-compassion on psychological outcomes.

RESULTS: Both dyadic partners reported elevated distress, with partners consistently showing higher scores on PTSD, depression, anxiety, and stress scales. Self-compassion was inversely related to distress in both partners. Results indicated that in couples where the combatant met the PTSD cutoff, the partner’s self-compassion significantly predicted lower depression and stress in the combatant; no such effect was found in the non-PTSD group.

CONCLUSIONS: The findings underscore the need to address the psychological needs of partners of reserve combatants during wartime. This study is fundamental in understanding the mental health needs of military families during an ongoing war. Clinically, integrating self-compassion-based interventions for individuals and couples, and expanding trauma-informed care to include partners, can enhance support for military families and improve outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42507374 | DOI:10.1037/tra0002236

Psychol Methods. 2026 Jul 27. doi: 10.1037/met0000844. Online ahead of print.

ABSTRACT

Longitudinal designs are widely used to assess causal effects that develop over time. But treatment-confounder causal feedback complicates adjusting for time-varying confounding. An established solution from the causal inference literature is parametric g-formula. In this tutorial, I introduce a streamlined variant: the iterated conditional expectation (ICE). Parametric g-formula using ICE requires only a sequence of regression models for the mean outcomes at consecutive time points. It is thus ideally suited for repeatedly measured outcomes, as frequently encountered in psychological research. Unlike conventional Monte Carlo parametric g-formula, ICE does not require modeling or simulating random draws from the joint distribution of time-varying confounders and outcomes. This makes ICE less susceptible to model misspecification biases and more versatile in handling continuous and noncontinuous (e.g., binary or categorical) time-varying confounders. A doubly robust version of ICE using correctly specified treatment models can further protect against biases from incorrectly specified outcome models. To make parametric g-formula with ICE accessible to a broad audience of applied researchers, I offer an implementation using lavaan, a popular, user-friendly, and free statistical modeling software in R. A running example of the causal effect of social exclusion on depression over time aids in perceiving the causal assumptions, interpreting the causal effect estimands, and following the estimation procedure. Finally, I illustrate how to apply ICE using data from a real-world study. Parametric g-formula using ICE is elegant, computationally efficient, and easy to apply in practice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42507366 | DOI:10.1037/met0000844

Can J Exp Psychol. 2026 Jul 27. doi: 10.1037/cep0000405. Online ahead of print.

ABSTRACT

Humans adjust to statistical regularities in their environment. For example, responses to more frequent stimuli are faster and less error-prone than responses to less frequent stimuli. Here we ask whether this adjustment to relative stimulus-response frequencies is local, that is, specific for stimulus locations, or global, that is, generalized across stimulus locations. In two experiments, participants responded to two colours of stimuli presented with different relative frequencies in upper and lower locations on a monitor, but equal relative frequencies in left and right locations. In the first experiment, reaction times and error rates differed between responses to the stimuli with different relative frequencies presented at the upper and lower locations and less so for responses to the stimuli with identical relative frequencies at left and right locations; for left and right locations, the effect of relative frequency was accompanied by a modulation of the Simon effect. In the second experiment, additional stimuli presented in a central location served to equate the overall frequency of the stimulus colours and responses. In this experiment, only a small effect of relative frequency remained for responses to stimulus colours in upper and lower locations where they actually had different relative frequencies. According to these results, there are both a global, location-independent effect of relative stimulus-response frequency and a local, location-dependent effect. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42507357 | DOI:10.1037/cep0000405

J Craniofac Surg. 2026 Jul 27. doi: 10.1097/SCS.0000000000013180. Online ahead of print.

ABSTRACT

PURPOSE: Levator function (LF) is a key parameter in the evaluation and surgical planning of blepharoptosis; however, it does not always correlate with clinical severity or outcomes. This study aimed to compare the histopathological characteristics of the levator palpebrae superioris (LPS) muscle in congenital and acquired (involutional) ptosis with different LF levels.

METHODS: This retrospective study included 38 eyelids from patients with congenital or acquired ptosis who underwent anterior levator surgery. Patients were categorized into 3 groups based on LF: congenital ptosis with LF >5 mm (group 1, n=10), acquired ptosis with LF 9 to 13 mm (group 2, n=12), and acquired ptosis with LF >14 mm (group 3, n=16). Excised levator aponeurosis and muscle tissues were examined histopathologically. Muscle tissue, fat infiltration, fibrosis, edema, and inflammation were evaluated.

RESULTS: Muscle tissue was present in all specimens. Fat infiltration differed significantly among groups (P=0.029), being more frequent in groups 1 and 2 compared with group 3 (P=0.041 and 0.039), with no difference between groups 1 and 2 (P=0.218). Severe fibrosis was observed only in group 1, without statistical significance (P=0.193). Edema and inflammation showed no significant differences between groups (P=0.771, P=0.359). Correlation analysis revealed a significant negative correlation between LF and fat infiltration (r=-0.23, P=0.017) and a positive correlation between LF and muscle content (r=0.27, P=0.011) in groups 2 and 3.

CONCLUSION: Fat infiltration and muscle content are associated with LF and may partially explain functional variability independent of ptosis etiology.

PMID:42507352 | DOI:10.1097/SCS.0000000000013180

J Craniofac Surg. 2026 Jul 27. doi: 10.1097/SCS.0000000000013199. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the clinical efficacy and safety of our standardized 3-step ultrasound-assisted liposuction technique for the dorsocervical fat pad.

METHODS: A retrospective analysis was conducted on clinical data from 48 patients with dorsocervical fat pad admitted to our hospital between May 2024 and April 2025. All patients underwent minimally invasive liposuction using an ultrasonic emulsification aspirator combined with a fat balancer. The operation time and intraoperative liposuction volume were recorded. The therapeutic effect and patient satisfaction were evaluated at 3 months postoperatively; the incidence of complications was statistically analyzed; and recurrence was observed during the 6- to 12-month follow-up period.

RESULTS: All 48 patients successfully completed the operation, with an average operative time of 72.5 minutes and an average aspirated volume of fat and fibrous tissue of 326.4 mL. At 3 months postoperatively, the total improvement rate evaluated by physicians was 97.92%, and the self-evaluated total improvement rate by patients was 95.83%. The patient satisfaction rate was 95.83%, including 36 cases (75.00%) very satisfied, 10 cases (20.83%) basically satisfied, and 2 cases (4.17%) dissatisfied. A total of 4 cases of minor complications occurred postoperatively, including 3 cases of subcutaneous ecchymosis and 1 case of local induration, all of which recovered spontaneously without special treatment. No serious complications such as infection, skin necrosis, or nerve injury occurred. No recurrence was observed in any patient during the follow-up period, and the dorsocervical contour was natural and smooth.

CONCLUSION: Our standardized 3-step ultrasound-assisted liposuction technique has proven efficacy in treating the dorsocervical fat pad, with the advantages of minimal trauma, reduced bleeding, rapid recovery, and few complications. It achieves high patient satisfaction and warrants clinical promotion.

PMID:42507350 | DOI:10.1097/SCS.0000000000013199

Minerva Med. 2026 Jul 26. doi: 10.23736/S0026-4806.26.09922-2. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder in individuals with type 2 diabetes mellitus (T2DM). MASLD ranges from simple liver steatosis to metabolic dysfunction-associated steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. New glucose-lowering agents have demonstrated benefits beyond glycemic regulation. This study assesses the effects of receptor agonists (GLP-1RA) and SGLT2 inhibitors (SGLT2i) on metabolic parameters, hepatic steatosis, and fibrosis in patients with MASLD and T2DM.

METHODS: Prospectively, 192 patients were enrolled: 132 added therapy with one novel glucose-lowering drug (GLP-1RA or SGLT2i) or their combination, and 60 patients continued with other glucose-lowering therapies (such as sulfonylureas, PPAR-γ agonists, DPP-4 inhibitors, metformin or insulin). Metabolic parameters, fibrosis indices (APRI, FIB-4, NFS, stiffness), and steatosis assessed by ultrasound-based attenuation imaging (ATT), were evaluated at baseline, 6 and 12 months.

RESULTS: The four treatment groups had comparable biochemical profiles. At 6 months, significant reductions were observed in the ALT, AST, GGT, and ALP levels (P<0.01). Both GLP-1RA and SGLT2i significantly improve glycemic control at 6 and 12 months; the reduction in HbA1c was associated with a decrease in serum cholesterol (statistically significant in the SGLT2i group). Non-invasive fibrosis scores (FIB-4, APRI, NFS) showed no significant changes; however, NFS showed modest improvement in the SGLT2i group. Liver stiffness values decreased significantly after 12 months in GLP-1RA, SGLT2i, or combination therapy groups. ATT consistently improved hepatic steatosis.

CONCLUSIONS: GLP-1RA and SGLT2i improve glycemic control and reduce hepatic steatosis and stiffness in patients with MASLD and T2DM.

PMID:42507338 | DOI:10.23736/S0026-4806.26.09922-2

Eur Arch Paediatr Dent. 2026 Jul 27. doi: 10.1007/s40368-026-01250-7. Online ahead of print.

ABSTRACT

PURPOSE: Co-sleeping or bed sharing is a common practice that is believed to offer convenient and longer breastfeeding time, although it may contribute to the development of early childhood caries (ECC). This study aimed to explore the association between co-sleeping or bed sharing practices and ECC.

METHODS: A search was conducted across electronic databases, journals, and National repositories from their inception to December 2025. The Newcastle-Ottawa scale for cohort studies and a modified version was used for cross-sectional studies to assess the risk of bias. The random effects model was used for meta-analysis and the certainty of evidence was evaluated using ‘Grading of Recommendations, Assessment, Development and Evaluations’ criteria.

RESULTS: A total of 10,635 articles were identified, and the full-text review led to the inclusion of six articles with 2587 participants. A total of 267 children reported co-sleeping, 1193 practiced bed sharing, 1023 engaged in night-time breastfeeding, and 849 were diagnosed with ECC. One study revealed moderate risk, while five studies demonstrated low risk of bias.

STATISTICS: Substantial heterogeneity was observed across the studies (I² = 90%). The meta-analysis revealed a statistically significant association between bed sharing and ECC (OR = 2.77, 95% CI 1.36-5.64, p = 0.005). The certainty of evidence was found to be moderate.

CONCLUSIONS: This review shows a positive correlation between co-sleeping or bed sharing practices and ECC which is a significant concern worldwide.

PMID:42507329 | DOI:10.1007/s40368-026-01250-7