Tag: pubmed

Clin J Oncol Nurs. 2026 Aug 3;30(4):E67-E73. doi: 10.1188/26.CJON.E67-E73.

ABSTRACT

BACKGROUND: Palliative care (PC) is specialized health care that can improve quality of life for patients with cancer. However, PC tends to be underutilized or relegated to end-of-life care, limiting patients’ ability to benefit from patient-centered, goal-concordant care. Patients with pancreatic cancer, who are often diagnosed at an advanced stage and with high symptom burdens, could benefit from PC. A chart review conducted in 2022 at a southern New Jersey academic medical center and cancer center found that among 77 patients diagnosed with cancer, only 26 were referred to palliative care services. Of those referred, just 6 received referrals for goal-concordant care discussions; the remaining 20 were referred primarily for cancer-related pain and symptom management or hospice care.

OBJECTIVES: This pilot observational quality improvement study sought to increase PC referrals for patients with pancreatic cancer, and to determine whether the PC received was goal concordant.

METHODS: Patients (N = 19) received referrals to PC and completed pre- and postvisit surveys.

FINDINGS: All patients who completed the postvisit survey (N = 9) expressed satisfaction with care received from the PC team. However, there were significant delays from diagnosis to the PC visit. Nurses support oncology care and tend to be aware of patients’ needs; including nurses in discussions about PC may be a mechanism to increase referrals for this patient population.

PMID:42555779 | DOI:10.1188/26.CJON.E67-E73

Biomed Tech (Berl). 2026 Aug 6. doi: 10.1515/bmt-2026-0390. Online ahead of print.

ABSTRACT

OBJECTIVES: Self-etching primers have simplified the process of direct bonding of dental resins and orthodontic brackets. The aim of this study was to evaluate the cytotoxic impact of the leached components to L-929 fibroblast cultures.

METHODS: Transbond™ Plus self-etching primer (3M Unitek, 2724 South Peck Road, Monrovin CA 91016 USA) was applied to enamel pieces in three different conditions and the specimens were added to L-929 fibroblast cultures. The incubation time was 72 h and the cells were counted by flow cytometry. Statistics was carried out using descriptive and explorative data analyses.

RESULTS: In direct contact assays, the self-etching primer without bracket exhibited mild to moderate cytotoxicity. The application of primer, composite and bracket showed no relevant decrease of cell viability. After seven days, the cytotoxic effects had largely disappeared. Overall, the combination of self-etching primer, composite, bracket exhibits no significant cytotoxicity during the observation period.

CONCLUSIONS: When self-etching primers are used according to the recommended clinical protocols in orthodontics, the method is regarded as safe and the release of leachables seems to have no adverse clinical effect.

PMID:42555748 | DOI:10.1515/bmt-2026-0390

Indian J Med Res. 2026 Aug;164(2):203-219. doi: 10.25259/IJMR_3200_2025.

ABSTRACT

Background and objectives Despite substantial research on immunotherapy, its efficacy and safety in treating advanced non-small cell lung cancer (NSCLC) without identifiable driver mutations remain unclear. The objective of this review was to examine the efficacy and safety of immunotherapy, used as monotherapy or alongside chemotherapy, vs. chemotherapy alone in patients with advanced driver mutation-negative NSCLC. Methods A comprehensive literature search of PubMed, Embase, Scopus, and CENTRAL databases was conducted until December 2024. The protocol was registered in PROSPERO (CRD42024585050). Randomised controlled trials (RCTs) evaluating the efficacy and safety of immunotherapy, either as monotherapy or in combination with chemotherapy, compared with chemotherapy alone, were included. A random-effects meta-analysis was performed. Risk of bias was assessed using the Cochrane RoB 2 tool, and the certainty of evidence was evaluated using the GRADE framework. Results Twenty-three RCTs (n=14605 participants) were included. Immunotherapy (± chemotherapy) significantly improved overall survival [22 RCTs; 14,375 participants, hazard ratio (HR): 0.77; 95% Confidence interval (CI): 0.72-0.83] and progression-free survival (22 RCTs; 14,003 participants, HR: 0.67; 95% CI: 0.58-0.76) compared with chemotherapy alone. The objective response rate was also higher with immunotherapy (23 RCTs; 12,967 participants, RR 1.38, 95% CI: 1.24-1.54). No statistically significant differences were observed between the groups in terms of overall adverse event rates. Interpretation and conclusions Immunotherapy, whether administered alone or in combination with chemotherapy, provides significant survival benefits in patients with advanced driver mutation-negative NSCLC.

PMID:42555694 | DOI:10.25259/IJMR_3200_2025

Indian J Med Res. 2026 Aug;164(2):311-315. doi: 10.25259/IJMR_3672_2025.

ABSTRACT

Background and objectives Globally, measles cases remain above 10 million despite the introduction of two dose measles vaccination schedule since 2000. India reported 13220 cases during 2023-2024, ranking fourth globally. This raises concern regarding the effectiveness of the ongoing programme to achieve measles elimination. Tribal dominated regions in countries such as India needs particular attention due to their higher burden of childhood morbidity and mortality. This study aimed to estimate the proportion of children developing protective antibody levels following two doses of measles vaccine in a tribal location and to identify potential risk factors associated with non-response. Methods A tribal dominated region, the undivided Phulbani district of Odisha, India, was randomly selected. Using cluster sampling, 1375 Infants aged 8 months were enrolled from 30 tribal habitations and followed to document vaccination status. Blood samples (n=1185) were collected three months after the second measles vaccine dose, and their measles IgG antibody levels were quantified. Variables likely to influence antibody response were recorded and statistically evaluated. Results Two-dose measles vaccine coverage was 99.6%; however, 55.1% (n=653) of children demonstrated seropositivity (IgG titre ≥ 250 IU/L). Male gender was significantly associated with suboptimal antibody response. Age, nutritional status, interval between first and second vaccine doses, and vaccination logistics were not found to influence antibody response. Interpretation and conclusion This study provides the first evidence of suboptimal measles antibody response among children from a tribal area of Odisha, India, despite high vaccination coverage. There is a need to understand the immune persistence among such a vulnerable population, where measles control remains a challenge.

PMID:42555691 | DOI:10.25259/IJMR_3672_2025

Lang Speech Hear Serv Sch. 2026 Aug 5:1-16. doi: 10.1044/2026_LSHSS-25-00193. Online ahead of print.

ABSTRACT

PURPOSE: During the assessment process, speech-language pathologists (SLPs) have the opportunity to account for the involvement, thoughts, and views of children with speech sound disorders (SSDs). This is in alignment with the Convention on the Rights of the Child (CRC; UNICEF, n.d.; United Nations, 1989) including CRC Article 12 (Respect for children’s views), Article 13 (Sharing thoughts freely), and Article 23 (Children with disabilities), which affirms SLPs’ role to facilitate participation and consider perspectives. The International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) offers a holistic framework that can guide assessment practices, including accounting for children’s views of their own speech. While previous research has been limited to theoretical application, the current study provides preliminary data regarding how American SLPs practically utilize the ICF framework in the evaluation of children with SSDs.

METHOD: An online survey was created using REDCap and disseminated to currently practicing SLPs across the United States. A total of 296 surveys were completed, and data were analyzed using descriptive and inferential statistics.

RESULTS: Over 50% of American SLPs were unfamiliar with the ICF, which was reflected in how they selected assessments of Body Functions more than Activities/Participation and Contextual Factors for children with SSDs. Furthermore, under 10% of SLPs included an assessment tool that measures a child’s communicative participation or self-reported attitudes.

CONCLUSIONS: Findings demonstrated a need for greater exposure to holistic assessment of children with SSDs in the United States. Recommendations extend to faculty and researchers to integrate the ICF framework in teaching and research to promote evidence-based assessment practices and patient-reported outcome measures to protect the CRC.

PMID:42554573 | DOI:10.1044/2026_LSHSS-25-00193

JACC CardioOncol. 2026 Jul 30:S2666-0873(26)00277-2. doi: 10.1016/j.jaccao.2026.07.008. Online ahead of print.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitor (ICI) myocarditis typically develops soon after treatment initiation (<90 days) but may also occur as a delayed complication after discontinuation of ICI therapy. The clinical and histopathologic differences between early- and late-manifestation ICI myocarditis remain unclear.

OBJECTIVES: This study sought to compare the clinical features and myocardial histopathology of early- versus late-manifestation ICI myocarditis.

METHODS: We conducted a retrospective national cohort study of patients diagnosed with myocarditis after ICI initiation who underwent endomyocardial biopsy. Biopsy samples were analyzed for inflammatory cell infiltration, severity of myocardial inflammation, and collagen volume fraction.

RESULTS: Among 35 patients (mean age: 66 ± 13 years; 71.4% male), 26 (74.3%) developed early-manifestation myocarditis (<90 days), whereas 9 (25.7%) had late-manifestation myocarditis (≥90 days). Early-manifestation cases showed significantly more severe myocardial inflammation; higher levels (median [Q1-Q3]) of CD3⁺ T cells (432 [173-1,381] vs 121 [43-400] cells/mm²; P = 0.036), CD8⁺ T cells (289 [73-994] vs 86 [21-168] cells/mm²; P = 0.019), and CD 68⁺ macrophages (307 [116-841] vs 57 [36-200] cells/mm²; P = 0.008); and higher CD4⁺ T-cell levels that did not reach statistical significance (P = 0.054). There were no significant differences in regulatory T cells or collagen volume. Clinically, early-manifestation myocarditis was characterized by higher cardiac biomarker levels and older age, whereas left ventricular ejection fraction was similar between groups. Mortality due to myocarditis occurred in 2 early-manifestation cases and in no late-manifestation cases. Conversely, cancer-related mortality was more frequent in the late-manifestation group (n = 3) than in the early-manifestation group (n = 2). ICI therapy was reinitiated in only 2 patients overall.

CONCLUSIONS: Late-manifestation ICI myocarditis may represent a temporally distinct or partially attenuated inflammatory phase. Despite a milder inflammatory profile, higher cancer-related mortality was observed, suggesting that cautious ICI reinitiation may warrant consideration in selected patients within this subgroup.

PMID:42554546 | DOI:10.1016/j.jaccao.2026.07.008

JACC Heart Fail. 2026 Aug 2:103295. doi: 10.1016/j.jchf.2026.103295. Online ahead of print.

ABSTRACT

BACKGROUND: Despite robust evidence that quadruple guideline-directed medical therapy (GDMT), comprising angiotensin receptor-neprilysin inhibitors (ARNIs), evidence-based beta-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter 2 (SGLT2) inhibitors, reduces mortality and hospitalizations in heart failure with reduced ejection fraction (HFrEF), implementation in clinical practice remains markedly incomplete.

OBJECTIVES: This study aimed to provide updated national estimates of the eligible untreated HFrEF population and to quantify deaths and hospitalizations preventable with optimal implementation of quadruple GDMT in the United States.

METHODS: The authors performed a population-level decision analytic modeling study using contemporary U.S. epidemiologic data. National HFrEF prevalence estimates were derived from the American Heart Association Heart Disease and Stroke Statistics 2026 report, and annual HFrEF hospitalization counts were derived from the National Inpatient Sample 2022-2023. Eligible untreated populations were estimated after sequential exclusions and therapy-specific contraindication adjustments using primary treatment rates from Epic Cosmos 2023-2025, with sensitivity analyses using alternative treatment-rate sources. Trial-derived numbers needed to treat and relative risk reductions were applied to estimate deaths preventable over 12 months and annual heart failure (HF) hospitalizations prevented.

RESULTS: An estimated 2.76 million U.S. adults with chronic symptomatic HFrEF were eligible for quadruple GDMT, yet only 18.2% received it. Eligible untreated populations included 733,891 for beta-blockers, 1,856,531 for ARNIs, 1,543,967 for MRAs, and 1,717,444 for SGLT2 inhibitors. Class-specific projected deaths preventable over 12 months were 26,210 for beta-blockers, 34,495 for ARNIs, 26,620 for MRAs, and 26,422 for SGLT2 inhibitors; the aggregate estimate across treatment gaps was 113,747 (95% uncertainty interval [UI]: 90,173-149,875). Optimal implementation was also projected to prevent 357,332 HF hospitalizations annually (95% UI: 297,493-425,674).

CONCLUSIONS: Incomplete implementation of quadruple GDMT in HFrEF remains a major modifiable opportunity to reduce preventable deaths and HF hospitalizations in the United States.

PMID:42554537 | DOI:10.1016/j.jchf.2026.103295

Drug Test Anal. 2026 Aug 5. doi: 10.1002/dta.70125. Online ahead of print.

ABSTRACT

Discrimination between endogenous and exogenous Gamma-hydroxybutyrate (GHB) in hair matrix is a major challenge in the forensic context. According to the UNODC, to verify a possible intake, GHB concentration should be compared with the subject’s basal level. Most published studies investigated endogenous GHB on a single hair segment, without considering possible intra-individual variation. The present study aimed to detect endogenous GHB in hair using a newly validated method, with a focus on the relevance of segmental analysis. Two hundred subjects were tested. After the removal of the first 0.5 cm from the proximal end, each hair strand was divided into three segments of 1 cm. A water extraction was performed during the pulverization process, and the extract was injected into a LC-MS/MS system. Data have been statistically analyzed. Overall, endogenous GHB concentration ranged from < LOD (0.1 ng/mg) to 6.6 ng/mg, with 27% of samples having a value < LOD in at least two segments. Within the remaining subjects, neither gender nor age significantly influenced the concentration. On the other hand, results confirmed that hair treatment can modify endogenous GHB concentrations. Intra-individual variability was limited, with the highest percentage of cases showing minimal changes in concentration (0-0.1 ng/mg) between contiguous segments. However, in up to 4% of cases, the variation resulted to be higher than 1 ng/mg between contiguous segments. The present study then confirms the need to perform in forensic cases the segmental analysis, to be sure that any potential increase of GHB depends exclusively on external administration.

PMID:42554518 | DOI:10.1002/dta.70125

J Cachexia Sarcopenia Muscle. 2026 Aug;17(4):e70353. doi: 10.1002/jcsm.70353.

ABSTRACT

BACKGROUND: The Skeletal Muscle Function Deficit (SMFD) score integrates muscle mass, strength, power and quality into a single construct that evaluates the multidimensional status of muscle health. The aim of the study is to investigate the longitudinal associations of systemic inflammation and caloric intake with SMFD-score trajectories in older adults from the InCHIANTI study.

METHODS: Data were obtained from the InCHIANTI population-based longitudinal cohort. A total of 1035 community-dwelling older adults (mean age 74.97 ± 7.39 years; 44.25% men) contributed 3196 repeated observations across four study waves. SMFD-score (range 0-20) was derived from sex-specific quintiles of lower-limb muscle mass, muscle density, grip strength and lower-limb power; participants unable to perform a test received a score of 0 for that component. Interleukin-6 (IL-6) and caloric intake (kcal/day) were assessed at all study waves. Longitudinal associations between time-varying IL-6 tertiles, caloric intake tertiles and SMFD-score trajectories were evaluated using linear mixed-effects models adjusted for baseline age and sex and time-varying multimorbidity and body mass index.

RESULTS: Across follow-up, SMFD-score declined significantly from 9.60 ± 4.20 at baseline to 7.07 ± 4.00 at the last wave (p < 0.001), whereas IL-6 increased from 3.65 ± 2.50 pg/mL to 4.39 ± 3.10 pg/mL (p < 0.001). Mean caloric intake showed a non-significant upward trend (1912.83 ± 562.37 to 1976.00 ± 580.54 kcal/day; p = 0.07). In mixed-effects models, higher IL-6 levels were associated with accelerated SMFD decline over time (IL-6 tertile × time interaction β = -0.31 ± 0.02; p < 0.001). Higher caloric intake was associated with higher SMFD-score and a slower functional decline (caloric intake tertile main effect β = 1.19 ± 0.16; p < 0.001; caloric intake tertile × time interaction β = 0.24 ± 0.03; p < 0.001). In the model including the combined IL-6 × caloric intake × time interaction was statistically significant (β = 0.14 ± 0.04; p < 0.001), indicating that higher caloric intake partially attenuated the negative longitudinal association between IL-6 and SMFD-score.

CONCLUSIONS: SMFD-score captures longitudinal muscle function decline during aging and reflects the opposing influences of inflammation and caloric intake. These findings support the SMFD-score as a clinically relevant construct for identifying potentially modifiable determinants of muscle health and functional decline in older adults.

PMID:42554491 | DOI:10.1002/jcsm.70353

Early Interv Psychiatry. 2026 Aug;20(8):e70244. doi: 10.1111/eip.70244.

ABSTRACT

AIM: Childhood-onset Obsessive-Compulsive Disorder (OCD) has been associated with an increased vulnerability to psychosis, yet no prospective studies have examined this risk in paediatric populations.

METHODS: In this pilot prospective study, 59 adolescents with a primary diagnosis of OCD were assessed at baseline for psychotic vulnerability, measured through Cognitive-Perceptual basic symptoms (COPER) and the high-risk criterion Cognitive Disturbances (COGDIS), as well as for OCD severity and psychosocial functioning. The number of subjects who developed a first episode of psychosis (FEP) during the 18-month follow-up period was evaluated. Logistic regression and moderation analyses were performed.

RESULTS: During the follow-up period, 18.6% of participants presented with a FEP. These patients were older and displayed poorer psychosocial functioning compared with those who did not develop a FEP. Logistic regression identified higher COPER symptoms and lower psychosocial functioning as the only significant predictors of FEP. Although moderation effects were not statistically significant, exploratory simple slopes suggested that both COPER and COGDIS symptoms were more strongly associated with psychosis onset in adolescents with lower psychosocial functioning.

CONCLUSIONS: This study highlights a notable rate of progression to psychosis among adolescents with OCD over an 18-month period. Despite methodological limitations, our findings offer preliminary evidence that COPER symptoms and impaired psychosocial functioning are key risk factors in adolescents with OCD for progression to psychosis.

PMID:42554468 | DOI:10.1111/eip.70244