Nevin Manimala

Cancer Biother Radiopharm. 2026 Feb 6:10849785261420926. doi: 10.1177/10849785261420926. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the clinical impact of docetaxel and capecitabine administered under ultrasound-mediated enhancement in patients with advanced triple-negative breast cancer (TNBC), with an emphasis on safety, quality of life, immunological modulation, and therapeutic efficacy.

METHODS: A total of 80 patients with advanced TNBC who received treatment at this institution between October 2021 and October 2022 were chosen at random and placed in either the control group (CG, n = 40) or the observation group (OG, n = 40). While the OG received capecitabine and docetaxel supplemented by an ultrasound-mediated drug delivery strategy intended to enhance intratumoral absorption, the CG received cisplatin and docetaxel. The groups were compared in terms of clinical response, immunological function, quality of life (FACT-B), incidence of adverse events, and serum tumor markers.

RESULTS: Compared with the CG, the OG showed a considerably greater response rate (RR) and disease control rate (p < 0.05). Immunoglobulin (Ig)G, IgM, and IgA levels in the CG dramatically decreased after two treatment cycles (p < 0.05), while levels in the OG were maintained and continued to be greater than those in the CG (p < 0.05). Both groups’ FACT-B scores dropped (p < 0.05), but the OG’s reduction was less noticeable (p < 0.05), suggesting that ultrasound-enhanced therapy improved quality-of-life preservation. The OG had decreased incidence of adverse events; however, this difference was not statistically significant (p > 0.05). Following therapy, tumor markers CA125 and CA153 reduced in both cohorts (p < 0.05), with the OG showing larger reductions (p < 0.05).

CONCLUSIONS: Capecitabine and docetaxel administered via ultrasound improve therapeutic efficacy in advanced TNBC, lessen immune suppression brought on by treatment, improve quality of life, and support a positive safety profile while encouraging higher decreases in tumor marker expression. These results demonstrate the potential therapeutic benefit of using ultrasound-based medication delivery techniques into TNBC systemic therapy.

PMID:41645929 | DOI:10.1177/10849785261420926

Acad Emerg Med. 2026 Feb;33(2):e70239. doi: 10.1111/acem.70239.

ABSTRACT

BACKGROUND: Prolonged emergency department waiting times are associated with increased mortality among older patients. In January 2025, the ED of Linkoping University Hospital, Sweden, implemented a low-resource routine to expedite the workup of older patients living with frailty by prioritized physician assessment and subsequent workup.

AIM: To investigate if a frailty alert using the Clinical Frailty Scale followed by prioritized clinical assessment influences ED operating metrics.

DESIGN: This was an observational before and after study of a pre-implementation group (control) and a post-implementation group (intervention) between October 2024 and February 2025.

SETTING/PARTICIPANTS: Consecutive patients aged > 64 years, with a documented CFS assessment during the ED visit at the Linkoping University Hospital, Sweden, who consented to participation, were included.

METHOD: Standard ED operating metrics, Time to physician, ED length of stay (LOS), and admission rates were compared between a pre-implementation group and a post-implementation group.

RESULTS: A total of 542 ED visits were analyzed (248 pre-implementation, 294 post-implementation). Time to physician was shorter in the post-implementation group at 31 min (IQR 15, 65) versus 44 min (IQR 20, 94) (p < 0.001). ED LOS was reduced from 352 (IQR 266, 515) to 319 (IQR 240, 458) minutes (p = 0.014). The admission rate was unchanged at 59% and 60% (p = 0.4).

CONCLUSION: Frailty alerts based on the CFS with prioritized workup reduced ED LOS and time to physician in older patients living with frailty in this single center study and may be a low-resource intervention to reduce the risks of adverse events in the ED.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06869148.

PMID:41645916 | DOI:10.1111/acem.70239

J Sleep Res. 2026 Feb 6:e70301. doi: 10.1111/jsr.70301. Online ahead of print.

ABSTRACT

Adolescents frequently use smartphones, smartwatches, personal computers, tablets, and other electronic devices during the day and at night. Whilst these devices are kept close to the eyes, they emit artificial light at night (ALAN) and generate noise. ALAN and noise are also emitted from other indoor and outdoor sources, such as home appliances, road traffic, street lighting, and advertising boards. However, the effect of these exposures has been studied mainly in the adult population, and little is known about their combined effect on adolescents. The present study aims to bridge this knowledge gap by examining the combined effect of ALAN and noise on the quality of sleep of junior high and high school students. Study participants included 81 adolescents (age 13-18 years) living in Tamra, a town in northern Israel. A 41-day experiment was carried out during which participants wore smartwatches, connected to Android smartphones, to monitor their exposures to ALAN and noise and their sleep patterns. The collected data were then analysed using statistical tools and showed that an increase in ALAN in a plausible range of 40-150 lx before sleep is estimated to reduce sleep efficiency (SE), all other factors being constant, by ~18% (t < -16, p < 0.01), whilst an increase in noise from 30 to 60 dB was estimated to reduce SE by ~22% (t < -14, p < 0.01). These estimates are higher than those found for the adult population in previous studies, according to which the effects of these environmental risk factors on sleep duration and quality were estimated to be ~8%-9%.

PMID:41645901 | DOI:10.1111/jsr.70301

Acta Oncol. 2026 Feb 6;65:75-82. doi: 10.2340/1651-226X.2026.44970.

ABSTRACT

BACKGROUND AND PURPOSE: Advanced breast cancer (ABC) involves substantial end-of-life (EOL) healthcare use and costs. Understanding cost drivers can inform care delivery and resource allocation. Patient/material and methods: We conducted a retrospective, population-based study of individuals (n = 1,437) who died with breast cancer in the Stockholm Region (2015-2023). Healthcare utilization and costs during the last 12 months of life were obtained from the Stockholm Regional Healthcare Data Repository (VAL) and estimated using the Region Stockholm cost model. Variables included age, sex, socioeconomic status (Mosaic), Charlson Comorbidity Index, Hospital Frailty Risk Score (HFRS), systemic therapy, and place of death. Descriptive statistics and generalized linear models assessed cost associations.

RESULTS: Total costs rose toward EOL, increasing 140% in the final 3 months versus the prior quarter. Hospitalizations and specialized palliative care drove costs, while outpatient visits declined. Younger age (18-69 years), high frailty (HFRS > 15), and systemic therapy were independently associated with higher costs. Hospital death was associated with lower expenditures than dying elsewhere (rate ratio [RR]: 0.84, 95% confidence interval [CI]: 0.78-0.91). The top 5% of cost users were mainly younger, frail patients receiving systemic therapy.

INTERPRETATION: ABC-related costs escalate in the final year of life, driven by hospitalizations, palliative care, and systemic therapies. Younger, frailer patients incur higher costs, while those dying in hospital settings are associated with lower costs. Early palliative integration and frailty-based risk stratification were associated with distinct patterns of healthcare utilization and costs toward the EOL.

PMID:41645873 | DOI:10.2340/1651-226X.2026.44970

J Chem Inf Model. 2026 Feb 6. doi: 10.1021/acs.jcim.5c02978. Online ahead of print.

ABSTRACT

We validate semiempirical sTDA-xTB and sTD-DFT-xTB methods for high-throughput screening of thermally activated delayed fluorescence (TADF) emitters using 747 experimentally characterized molecules─the largest such benchmark to date. Our framework achieves >99% computational cost reduction versus TD-DFT while maintaining strong internal consistency (Pearson r ≈ 0.82) and reasonable agreement with 312 experimental singlet-triplet gaps (MAE ≈ 0.17 eV). Large-scale analysis statistically validates key design principles: D-A-D architectures outperform other motifs, and optimal torsional angles of 50^°-90^° maximize TADF efficiency, while PCA confirms a low-dimensional property space. This work establishes xTB methods as cost-effective tools for accelerating TADF discovery.

PMID:41645809 | DOI:10.1021/acs.jcim.5c02978

Geospat Health. 2026 Feb 2;21(1). doi: 10.4081/gh.2026.1455. Epub 2026 Feb 5.

ABSTRACT

While the relationship between socioeconomic status and Early Childhood Development (ECD) is well-documented, less is known about how developmental outcomes and child malnutrition cluster and interact across geographically proximate areas. This study applies spatial analysis to examine regional disparities in ECD in Pakistan and to assess the extent of spatial dependency in these outcomes. Using cross-sectional data from multiple indicator cluster survey (120,151 children across 144 districts) covering 2017- 2018, Moran’s I statistics revealed significant positive spatial autocorrelation, consistent with Tobler’s First Law of Geography. Districts with high (or low) ECD outcomes tended to be surrounded by similar districts. A distinct core periphery pattern emerged, with Punjab and Gilgit-Baltistan forming high-high clusters and Sindh, Khyber Pakhtunkhwa and Balochistan forming low-low clus- ters. Ordinary Least Squares (OLS) and Spatial Error Models (SEM) confirmed that stunting, underweight and overweight negative- ly affect ECD, while female literacy, access to mass media and child engagement in playing activities influence development posi- tively. Wasting showed no significant relationship. Results reveal that unobserved regional factors contribute to child development across districts, indicating that developmental deficits often cluster geographically. These findings extend spatial dependency theory to the ECD context in South Asia, underscoring the need for geographically coordinated interventions that address both local deter- minants and regionally shared underlying influences on child development.

PMID:41645800 | DOI:10.4081/gh.2026.1455

Euro Surveill. 2026 Feb;31(5). doi: 10.2807/1560-7917.ES.2026.31.5.2600068.

ABSTRACT

In interim 2025/26 analyses, the Canadian Sentinel Practitioner Surveillance Network estimates influenza vaccine reduced the risk of medically-attended acute respiratory illness due to predominant influenza A(H3N2) viruses, including antigenically distinct subclade K, by about 40% relative to unvaccinated individuals. Vaccine effectiveness was about 30% against A(H1N1)pdm09, with insufficient case numbers for interim influenza B estimation. Meaningful protection against subclade K, despite substantial vaccine mismatch, is interpreted in the context of immuno-epidemiological considerations, including potential viral glycosylation, imprinting, and pre-immunity effects.

PMID:41645799 | DOI:10.2807/1560-7917.ES.2026.31.5.2600068

Arch Ital Urol Androl. 2026 Feb 6:14624. doi: 10.4081/aiua.2026.14624. Online ahead of print.

ABSTRACT

PURPOSE: Venous thromboembolic (VTE) complications contribute substantially to perioperative morbidity and mortality. The decision for mechanical and/or chemo-prophylaxis is currently based on VTE risk assessment models since conventional laboratory assays of coagulation usually fail to detect changes indicating hypercoagulability. Rotational thromboelastometry is a novel assay of coagulation, that it could potentially be used in objectively selecting patients at risk for VTE, who should indisputably undergo prophylaxis. We evaluated the association of conventional and novel assays of coagulation and VTE risk.

METHODS: VTE risk was preoperatively assessed in 45 patients scheduled for endoscopic, open and laparoscopic urologic surgery, including transurethral resection of prostate, transurethral resection of bladder tumor, endoscopic vesical or ureteral stone lithotripsy, open prostatectomy, open cystectomy and urinary diversion, open or laparoscopic radical or partial nephrectomy, between March 2021 and October 2022, using three different risk assessment models (RAMs): the European Association of Urology (EAU) RAM, the American Urological Association (AUA) RAM, and the Caprini model. Patients under antiplatelet or anticoagulation agents were excluded. Patients’ coagulation profile was determined by measuring PT, fibrinogen, aPTT, and rotational thromboelastometry analysis. For rotational thromboelastometry analysis, extrinsic rotational thromboelastometry and fibrinogen rotational thromboelastometry were examined in every patient. Statistical analysis was performed with ANOVA test and χ2 test.

RESULTS: Mean values of all rotational thromboelastometry variables did not vary significantly among different EAU VTE categories. In extrinsic rotational thromboelastometry assessment, a significant difference was observed in the mean values of the Clotting time (CT) between the different risk groups based on AUA RAM. In the comparison between the risk groups defined based on the Caprini score, statistically significant differences were observed in the extrinsic rotational thromboelastometry clot formation time (CFT). In fibrinogen rotational thromboelastometry analysis, significant differences were identified in the clot amplitude after five minutes (A5) and maximum clot firmness (MCF) indices between the AUA risk groups, along with a significant difference in the mean clot formation rate (CFR) value between the risk groups defined based on the Caprini score.

CONCLUSIONS: Rotational thromboelastometry can provide a detailed evaluation of the hemostatic status in patients undergoing urologic surgery that can be used as an adjunct to the VTE risk assessment models and thus, help to offer prophylaxis on a rather personalized basis. Future studies should assess the utility of thromboelastometry in identifying patients at high risk for VTE after major urological procedures.

PMID:41645782 | DOI:10.4081/aiua.2026.14624

Age Ageing. 2026 Feb 1;55(2):afag016. doi: 10.1093/ageing/afag016.

ABSTRACT

BACKGROUND: Primary care services play a key role in dementia care, yet activity may vary between subtypes.

OBJECTIVE: To investigate longitudinal determinants of primary care contact across Alzheimer’s disease (ad), vascular dementia (VD), dementia with Lewy bodies (DLB), and Parkinson’s disease dementia (PDD) 5 years pre-and-post-diagnosis, encompassing clinical, cognitive, functional, and sociodemographic factors.

DESIGN: Retrospective cohort study.

METHODS: Data on 4384 individuals with first dementia diagnoses (2008-2023) were obtained from a South London catchment linking dementia services with primary care records. Linear mixed-effects models were run on 3-month interval counts (up to 40 intervals per individual, 20 pre-and-post-diagnosis). Separate pre-and-post-diagnosis models assessed longitudinal trends, adjusted for age, sex, and antidepressant use, with subgroup analyses by dementia subtype and cognitive status.

RESULT: Service utilisation increased over time, with VD showing a steeper pre-diagnosis rise and PDD moderate post-diagnosis increases compared to ad. Across both periods, worse cognitive impairment and antipsychotic receipt were associated with lower contacts, while older age and Black/British Black ethnicity were associated with higher contact. Pre-diagnosis, agitation, depressed mood, relationship and living conditions problems were linked to lower contact, whereas hallucinations were associated with higher use. Post-diagnosis, hypnotic/anxiolytic use predicted lower contact, while acetylcholinesterase inhibitor receipt, comorbidities, daily living difficulties, and mixed ethnicity were associated with increased utilisation.

CONCLUSION: Person-centred care pathways should anticipate subtype-specific and individual patterns, providing targeted support for those with reduced pre-diagnosis contact who may have unmet needs, while considering early intervention for groups anticipated to require increased service use after diagnosis.

PMID:41645773 | DOI:10.1093/ageing/afag016

Vet Ital. 2026 Feb 6;62(1). doi: 10.12834/VetIt.3932.39205.1.

ABSTRACT

Varroa destructor is the main parasitic threat to Apis mellifera colonies worldwide and represents a major concern for honey bee health and apicultural sustainability. Oxalic acid (OA) is widely used for the control of varroosis; however, its efficacy is strongly influenced by the presence of capped brood. This pilot field study aimed to evaluate the efficacy and safety of a combined treatment protocol based on Api-Bioxal® administered by trickling and sublimation. The study was carried out in a permanent apiary located in the province of Bergamo (Northern Italy) from October 2024 to February 2025 and involved ten A. mellifera colonies housed in Dadant-Blatt hives. The experimental protocol consisted of one OA trickling treatment followed by two OA sublimations and a control treatment with amitraz. Treatment-induced mite fall was recorded daily for 117 days; brood presence, ambient temperature and pollen influx were monitored throughout the study period, and colony strength was assessed at the beginning and end of the trial using the Liebefeld method. Differences between pre- and post-treatment measurements were analysed using the Wilcoxon signed-rank test. An overall mean of 563.6 Varroa mites per colony was recorded as treatment-induced mite fall. The highest efficacy of OA was observed when treatments were applied in broodless conditions, whereas the presence of capped brood markedly reduced acaricidal efficacy. No abnormal honey bee mortality or adverse effects on colony health were observed. Colony strength increased in 8 out of 10 colonies, with statistically significant differences between pre- and post-treatment assessments (p < 0.012). These results indicate that Varroa destructor populations remain susceptible to oxalic acid when treatments are properly timed in relation to brood presence. A combined protocol of OA trickling and sublimation may enhance varroosis control without negative effects on colony health. Further large-scale studies are required to confirm these preliminary findings and to support evidence-based adjustments to national Varroa control guidelines.

PMID:41645768 | DOI:10.12834/VetIt.3932.39205.1