Nevin Manimala

Support Care Cancer. 2026 Jan 31;34(2):150. doi: 10.1007/s00520-026-10342-5.

ABSTRACT

OBJECTIVES: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy, affecting more than half of cancer patients. This scoping review aimed to summarize the incidence and factors associated with falls in patients with CIPN and to visually map the distribution of existing evidence, thereby providing a theoretical foundation for the development of preventive measures and intervention strategies.

METHODS: A systematic search was conducted in PubMed, Embase, Web of Science, Cochrane Library, Chinese Biomedical Literature Database (CBM), Knowledge Infrastructure (CNKI), Chongqing VIP Information (CQVIP), and Wan Fang Data. The search included articles published from database inception to August 16, 2024. To enhance the synthesis of evidence, a bubble plot-based evidence map was constructed.

RESULTS: A total of 11,649 records were identified, of which 19 studies were included. Most were quantitative non-randomized studies (n = 17): eight achieved a quality rating of 100%, eight scored 80%, and one scored 60%. Two studies were quantitative descriptive (one scored 80% and one scored 40%). Sixteen studies reported the incidence of fallers among CIPN patients, ranging from 5.6% to 57.4%. Seventeen studies examined fall-related factors in CIPN, which were categorized into 11 groups. Within the evidence map, high-quality and high-OR evidence was observed for CIPN symptoms/severity, advanced or unknown cancer stage, and chronic liver disease. CIPN-related factors were the most frequently reported, followed by demographic factors, suggesting that these domains, particularly those with both high quality and high OR, should be prioritized as targets for future intervention strategies. The adjusted odds ratios (ORs) ranged from 0.997 to 2.67.

CONCLUSION: Falls are common among patients with CIPN, with high-quality evidence primarily concentrated in the domains of CIPN-related burden, demographic and clinical characteristics of participants, and comorbidities. Future research should (1) conduct multicenter prospective longitudinal cohort studies with time-updated measurements of CIPN and treatment exposures, using standardized definitions of falls and observation windows; (2) strengthen outcome measurement by following COSMIN/Delphi recommendations, including the development of a gold-standard CIPN scale, specification of assessor qualifications, standardized training, and reporting of inter-rater reliability; and (3) re-examine currently unadjusted signals within rigorously controlled multivariable models.

PMID:41619098 | DOI:10.1007/s00520-026-10342-5

Metab Brain Dis. 2026 Jan 31;41(1):24. doi: 10.1007/s11011-026-01789-w.

ABSTRACT

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Autism Spectrum Disorder (ASD) is characterized by persistent difficulties in social communication and interaction, together with restricted and repetitive behaviors, interests, or activities. The diagnosis of ASD currently relies on comprehensive assessments of developmental history and behavioral patterns, as there are no validated laboratory tests for a definitive clinical diagnosis. While evidence-based interventions are largely restricted to educational and behavioral programs, many individuals with ASD and their caregivers explore complementary approaches, including dietary interventions. Among these, the gluten-free, casein-free (GFCF) diet is one of the most frequently adopted strategies. A leading hypothesis posits that those increased concentrations of opioid peptides such as gluteomorphin and caseomorphin derived from the incomplete digestion of gluten and casein may contribute to the severity of ASD symptoms. It is further suggested that eliminating these dietary proteins could reduce opioid peptide concentrations in biofluids and improve clinical outcomes. The present systematic review was created by reviewers who searched PubMed, Web of Science, and Scopus databases, covering the period from January 1980 to March 2025. The search strategy combined standardized keywords and Medical Subject Headings terms. The search strategy included a combination of keywords commonly used in the literature to represent ASD, opioid peptides, and GFCF diets. A systematic literature search was carried out on PubMed and Web of Science and a total of 17 articles were included. Although preliminary findings from clinical and laboratory studies are promising, conclusive evidence regarding the efficacy of the GFCF diet remains lacking. This review aims to synthesize current findings on the relationship between opioid peptides and ASD, with a particular focus on the neurological effects of food-derived peptides and their potential role in therapeutic dietary interventions.

PMID:41619084 | DOI:10.1007/s11011-026-01789-w

Anat Sci Int. 2026 Jan 31. doi: 10.1007/s12565-026-00918-w. Online ahead of print.

ABSTRACT

Although previous research has examined the first lumbar (L1) vertebra for sex estimation, studies focusing on its role in age estimation have been limited. This study expands on earlier work by investigating the morphological variations in shape and size of the L1 vertebra across different age groups within the Malaysian population. A sample of 440 abdominal CT images was collected from the Radiology Department at Universiti Kebangsaan Malaysia Medical Centre. These images included adults aged 18 to 80, who visited the department in 2019. Twenty-seven 3D landmarks were marked on each L1 vertebra using digitized 3D CT scan images. Statistical analyses were performed using a geometric morphometric approach to evaluate age-related variations in the shape and size of the L1 vertebra. Principal Component Analysis identified 74 shape variables describing the shape of the L1 vertebra, with the first five principal components explaining 38.27% of the variance. The Canonical Variate Analysis scatter plot showed slight separation among the confidence ellipses for the three age groups, with significant p-values (p < 0.001). Procrustes ANOVA revealed significant differences in both the size and shape of the L1 vertebra across all age groups. Additionally, multivariate regression of shape on continuous age revealed a significant, biologically meaningful pattern (R² = 0.022, p = 0.001). This study shows that the size and shape of the L1 vertebra differ across various age groups. In elderly individuals, the L1 vertebra is characterized by longer spinous processes and shorter, flatter vertebral bodies. Conversely, younger individuals tend to have L1 vertebrae with shorter transverse spinous processes and taller vertebral bodies.

PMID:41619075 | DOI:10.1007/s12565-026-00918-w

Int Ophthalmol. 2026 Jan 31;46(1):91. doi: 10.1007/s10792-026-03961-8.

ABSTRACT

PURPOSE: This study aimed to determine the efficacy of various types of topical anesthesia prior intravitreal injection in an effort to lessen adverse effects such as pain and subconjunctival bleeding.

METHODS: This randomized controlled study included 239 patients. All patients were randomly assigned to either receive: (1) Lidocaine gel 3% (Anaesthetic BL 3% gel), (2) Lidocaine gel 10% (Anaesthetic BL 10% gel), (3) Oxybuprocaine 0.4% eye drops (Localin), (4) Tetracaine HCl 1%, eye drops (Tetracaine) (5) A combined Oxybuprocaine 0.4% eye drops (Localin) and an ice patch. Patients’ discomfort, itching, burning and pain (using Visual Analog Scale), and bleeding size (using images) were measured one and ten minutes post-injection. Tolerability was calculated by averaging patients’ pain, discomfort, itching, and burning scores.

RESULTS: In the one- and ten-minute post-injection analyses, the groups receiving Tetracaine (0.60 ± 0.63, 0.50 ± 0.61) and the combined Oxybuprocaine and ice patch anesthesia (0.55 ± 0.66, 0.38 ± 0.58) had the lowest mean tolerability scores. In most parameters (discomfort burning, and pain scores) the Tetracaine and the combined Oxybuprocaine and ice patch anesthesia demonstrated the lowest mean scores. All subjective criteria assessed by the surgeon immediately following the injection were not found to be significantly different at any group, such as movements during injection (p = 0.19), complaints during injection (p = 0.56), complaints following injection (p = 0.21). Bleeding size (area or circumference) was not statistical different between groups.

CONCLUSION: This study demonstrated a considerable reduction in pain and overall tolerability with Tetracaine or a combination of ice patch and Oxybuprocaine anesthesia. These findings may lessen patients’ discomfort and improve their tolerance.

PMID:41619065 | DOI:10.1007/s10792-026-03961-8

Cancer Causes Control. 2026 Jan 31;37(3):39. doi: 10.1007/s10552-026-02135-2.

ABSTRACT

PURPOSE: To assess the screening outcomes and cost of patient navigation (PN) to improve colorectal cancer (CRC) screening uptake of stool-based tests and colonoscopies in a safety net setting.

METHODS: We conducted a quantitative assessment of a PN program at MedStar, a nonprofit hospital system based in the Washington, DC area. We collected and analyzed data for the 2023 calendar year on sociodemographic characteristics of patients, screening test completion, barriers to screening, and the labor and non-labor costs of the PN program. The main outcome measures for this study included the number of patients navigated, overall screening uptake and follow-up procedure completion rates. We also calculated the cost of the PN program, the average cost per person navigated, and the cost per patient who completed a screening or follow-up procedure.

RESULTS: MedStar’s PN program navigated 1,287 patients, of whom 77.5% were reached and 43.5% completed screening or follow-up procedures. Another 20.9% of persons navigated were still in the process of completing screening or follow-up colonoscopies (e.g., awaiting appointments). The most common barriers reported were challenges related to bowel preparation (25.3%) and comorbidities (13.7%). The average cost per person to deliver navigation was $209.83, while the average cost per patient successfully navigated to complete procedures was $482.23.

CONCLUSION: PN is effective in increasing CRC screening and follow-up and this improvement can be achieved at a reasonable cost in safety net settings. Future research should investigate approaches to reach all patients referred for navigation and optimal approaches to address patient barriers.

PMID:41619063 | DOI:10.1007/s10552-026-02135-2

Sports Med Open. 2026 Jan 31;12(1):7. doi: 10.1186/s40798-026-00978-2.

ABSTRACT

OBJECTIVE: The purpose of this study was to examine whether the ACTN3 R577X polymorphism was associated with injury rate and recovery time from non-contact muscle injuries in youth academy players and professional soccer players.

METHODS: The ACTN3 rs1815739 genotype was identified in 76 male soccer players (22 professional, 27 U19 and 27 U17) from a top-level French soccer club. Over three consecutive competitive seasons (2020/21 to 2022/23), the players were prospectively monitored. The club’s medical staff systematically recorded all injuries sustained during soccer exposure. Injury incidence was calculated based on total soccer exposure, and return-to-play time (RTT) for each injury was determined by the medical staff. A total of 312 injuries were documented, including 144 non-contact muscle injuries. Injury incidence rates (IRs) and rate ratios (RRs) were compared across player genotypes, both overall and within each category, using Poisson or negative binomial regression models with exposure time as an offset. RTT was analyzed by genotype using the Kruskal-Wallis test.

RESULTS: Overall genotype distribution was RR, 52.6%; RX, 30.3%; and XX, 17.1%. Across all players, XX carriers had the highest injury incidence (8.54 [6.54-10.39]/1000 h) followed by RX players (6.65 [5.39-7.91]/1000 h) and RR players (5.15 [4.35-5.95]/1000 h), although these differences did not reach statistical significance. The RRs for XX compared with RR players was 1.66 (95% CI: 0.85-3.23, p = 0.140), indicating a non-significant tendency toward higher incidence in XX players. However, RTT differed significantly among genotypes (p = 0.007), with median [IQR] values of 13 [10, 16] days for RR, 16 [14, 22] days for RX, and 18 [13, 19] days for XX. Subgroup analyses showed that RTT differences were significant in U17 players (p = 0.004), with XX requiring longer recovery (23 days) compared to RR players (11 days). However, these genotype-related differences in RTT were not significant among professional soccer players.

CONCLUSION: The ACTN3 R577X polymorphism was associated with recovery characteristics following non-contact muscle injuries in soccer players. Specifically, players with the XX genotype required significantly longer return-to-play times, a pattern evident in youth academy players but not in the professional group.

PMID:41619045 | DOI:10.1186/s40798-026-00978-2

Cancer Causes Control. 2026 Jan 31;37(3):38. doi: 10.1007/s10552-025-02122-z.

ABSTRACT

PURPOSE: The collection of biospecimens in population-based studies enables investigation of molecular mechanisms underlying health outcomes but faces implementation challenges. We describe biospecimen collection outcomes in the Ovarian Cancer Epidemiology, Healthcare Access and Disparities (ORCHiD) study and identify key predictors of consent and return.

METHODS: Among 764 ORCHiD participants recruited from seven state cancer registries (March 2021-October 2024), optional participation in a biospecimen sub-study requiring self-collection of saliva and vaginal swabs was offered. We used Poisson regression with robust error variance to estimate relative risks (RRs) and 95% confidence intervals (CIs) for sociodemographic, clinical, geographic, and logistical factors associated with biospecimen consent and return.

RESULTS: Overall, 435 (56.9%) consented and 230 (52.9% of consenters) returned samples. In unadjusted analyses, unemployed participants were significantly less likely to consent (RR = 0.72, 95% CI: 0.53-0.98). In adjusted models, participants who were not married (RR = 1.16, 95% CI: 1.00-1.34) and those recruited from California (RR = 1.23, 95% CI: 1.02-1.49) were more likely to consent. Black participants were more likely than White participants to return biospecimens (RR = 1.31, 95% CI: 1.03-1.65), as were retired versus employed participants (RR = 1.28, 95% CI: 0.99-1.65). Return rates were lower from California (0.66, 95% CI: 0.48-0.90) and North Carolina (RR = 0.61, 95% CI: 0.41-0.90) versus New York.

CONCLUSIONS: Higher return rates among Black participants suggest that culturally responsive engagement and follow-up strategies may support equitable biospecimen participation in population-based studies.

PMID:41619026 | DOI:10.1007/s10552-025-02122-z

J Neural Transm (Vienna). 2026 Jan 31. doi: 10.1007/s00702-026-03110-6. Online ahead of print.

ABSTRACT

Electroconvulsive therapy (ECT) is an established treatment for severe affective and psychotic disorders. However, there are only few studies on metabolic short-term changes, for example in acid-base balance and electrolyte concentrations after ECT. In this study, serial venous blood gas analysis was utilized to systematically record alterations in these parameters and evaluate them in relation to safety-relevant aspects. Blood samples were obtained via a peripheral intravenous catheter immediately, and then 5, 15, 30, and 60 min after ECT in patients requiring either first or repeat ECT. Blood-gas analyses were performed to monitor concentrations of electrolytes and acid-base status among others. A repeated measures analysis of variance was applied to test for longitudinal changes of blood gas parameters. 47 ECT sessions were included in the final data analysis (19 patients, mean age 54.4 ± 12.7 years, 12 females). Following ECT, there were significant changes in electrolytes and acid-base parameters. The most significant effects were observed in the acid-base status, where there was decline in pH (reference range 7.35-7.45) from a mean of 7.39 to 7.29 followed by a recovery to near normal values within one hour (F(3.4;156.4) = 105.5; p < 0.001; n = 47). Except of an increase in calcium, there were no relevant changes in electrolyte levels. This study demonstrates a statistically significant drop of serum pH after ECT based on complementary alterations in lactate and carbon-dioxide levels. Most of these alterations may simply be due to the convulsive exertion of the tourniquet region. However, they are short-lived and return to baseline within one hour confirming the safety of the method with respect to acid-base alterations.Clinical Trial Registration This study was prospectively registered on April 20, 2020 in the German trial register ( https://www.drks.de/drks_web/ ) The trial registration number is DRKS00021467.

PMID:41619018 | DOI:10.1007/s00702-026-03110-6

Eur Radiol. 2026 Jan 31. doi: 10.1007/s00330-026-12347-4. Online ahead of print.

ABSTRACT

OBJECTIVES: This study developed an automated AI-based method for accurate image reconstruction, stenosis detection and plaque calculation in high-resolution magnetic resonance vessel wall imaging (HR-MRVWI) and compared its performance with radiologists.

MATERIALS AND METHODS: A deep learning algorithm trained on HR-MRVWI was collected retrospectively from three tertiary hospitals. An independent test set was collected prospectively at another hospital. Model performance was evaluated via the Dice similarity coefficient, average centerline distance and average surface distance in centerline extraction and vessel wall segmentation. Two radiologists reviewed the reconstructed images in randomized order to determine whether the quality matched the clinical diagnosis. The stenosis diagnosis and plaque calculation of the algorithm were compared with the ground truth of the consensus by two radiologists. The relationships of the calculated parameters with plaque vulnerability were also analyzed.

RESULTS: 476 patients (mean age 61 years ± 15 [SD], 286 men) were evaluated. The accuracy of image reconstruction in the independent test set was 92.3%. The consistency between the radiologists and the deep learning-assisted algorithm for stenosis detection was 0.89 (95% CI: 85.4, 90.2) in ≥ 50% stenosis. The accuracies of algorithm in normalized wall index, eccentricity and remodeling indices were 0.94, 0.83 and 0.87. The normalized wall index was highly related to plaque vulnerability. The AI-assisted in diagnosis and vessel wall analysis, which reduced the time from 32.0 ± 11.8 to 12.9 ± 4.3 min (p < 0.001).

CONCLUSION: A deep learning algorithm for HR-MRVWI interpretation could achieve image reconstruction, vessel stenosis and plaque calculation, which has satisfactory diagnostic performance.

KEY POINTS: Question Can a deep learning system achieve image reconstruction, stenosis diagnosis and plaque calculation in high-resolution MR vessel wall imaging (HR-MRVWI)? Findings The overall time reduced from 32.0 ± 11.8 to 12.9 ± 4.3 min (p < 0.001) with the aid of the system. Clinical relevance This effective deep learning system has great potential for processing head and neck HR-MRVWI images; it assists radiologists’ workloads and saves considerable time in hospitals. Additionally, it provides plaque-related parameters automatically for the evaluation of atherosclerosis patients.

PMID:41619006 | DOI:10.1007/s00330-026-12347-4

Eur Radiol. 2026 Jan 31. doi: 10.1007/s00330-026-12330-z. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the diagnostic accuracy of chest CT for rib fractures in live children investigated for suspected physical abuse (SPA), using initial and follow-up chest radiographs (CXRs) as the reference standard.

MATERIALS AND METHODS: A retrospective 10-year (September 2011-2021) multicentre search was performed for children less than two years of age who received CXRs and chest CT for SPA. Nineteen consultant radiologists independently read the images: Round 1 (initial CXRs only), Round 2 (CTs only) and Round 3 (initial and follow-up CXRs). No reporter performed Round 3 before Round 1 or 2. Radiologists reported the presence of rib fractures, fracture age, fracture location and confidence level. CT diagnostic accuracy (sensitivity, specificity, and accuracy) was calculated per patient, per rib and per specific location along the rib arc.

RESULTS: A total of 64 patients (36 boys) with a median age of 2 months were included and assessed by 19 independent consultant radiologists. Patient level analysis: CT sensitivity = 90.6% (95% confidence interval [CI]: 88.2-92.6), specificity = 74.2% (95% CI: 70.2-78.0). Rib level analysis: CT sensitivity = 85.6% (95% CI: 84.1-87.0), specificity = 94.16% (95% CI: 93.8-94.4). Location level analysis: CT sensitivity = 75.7% (95% CI: 74.0-77.4), specificity = 97.09% (95% CI: 96.9-97.2).

CONCLUSION: Chest CT confers accurate rib fracture detection in live children with SPA, with the potential to replace the current standard of performing six CXRs as part of initial and follow-up imaging for SPA.

KEY POINTS: Question What is the diagnostic performance of chest CT in detecting rib fractures in live children with SPA, using CXR as a reference standard? Findings Chest CT showed 90.6% sensitivity and 74.2% specificity for detecting rib fractures on patient-based analysis, with 79.7% sensitivity for posterior rib fractures. Clinical relevance Chest CT accurately detects rib fractures in children investigated for SPA and may serve as an alternative to initial and follow-up CXR, supporting timely clinical assessment and management.

PMID:41619005 | DOI:10.1007/s00330-026-12330-z