Journals
2026 EN
Sassine Samuel · Coltin Hallie · Kondyli Maria
+20 more
ABSTRACT Purpose Infants with cancer are rare and face unique challenges. Our study aims to describe the incidence of infantile cancers in Canada and to compare treatment‐related mortality (TRM) and their outcomes with those of older children. Methods We conducted a retrospective cohort study using the Cancer in Young People in Canada database, including all infants (0 to <1 year old) with newly diagnosed cancer from 2001 to 2020. Population‐based data were used to estimate annual cancer incidence. Cox proportional hazards models were used to compare TRM, event‐free survival (EFS) and overall survival (OS) between (1) neonates (<30 days old) and older infants (≥30 days to <1 year old, (2) younger (<6 months) and older infants (≥ 6 months), and (3) all infants with older children (≥1 to ≤10 years old). Results A total of 2256 infants were included. The incidence was 30.8 per 100,000 infant‐years, and this incidence increased with an annual percent change of 1.6%, p < 0.001. Neonates had significantly higher TRM (6.1 vs. 3.6%, HR 2.76, p < 0.001) as well as infants younger than 6 months (5.2 vs. 2.7%, HR 2.05, p < 0.001). Compared with older children, infants experienced higher risk of TRM (4.1 vs. 2.1%, HR 2.45, p < 0.001) and had inferior 5‐year EFS (66.2 vs. 68.6%, HR 1.27, p < 0.001) and OS (77.5 vs. 78.6%, HR 1.22, p < 0.001). Conclusion The annual incidence of infantile cancers in Canada has increased and their outcomes are significantly worse than those of older children, as they face a higher risk of TRM, particularly in younger infants. Précis The incidence of cancer in infants has increased significantly in Canada between 2001 and 2020 and their outcomes are significantly lower than those of older children, being at greater risk of TRM.
Journals
2026 EN
Papyan Ruzanna · Hoveyan Julieta · Guscott Martin
+10 more
ABSTRACT Background Long‐term survival for high‐risk neuroblastoma has increased from 40% to 60% by optimizing chemotherapy, surgery, radiation therapy, and the addition of anti‐GD2 antibody therapy. However, the high cost of this antibody presents access issues globally. This study evaluates the availability, financial coverage, and barriers to accessing these therapies across diverse healthcare settings. Methods An online survey collected data on demographics, treatment practices, financial coverage, regulatory status, and barriers to anti‐GD2 therapy. Fisher's exact test was used to compare categorical variables between high‐income countries (HICs) and low‐ and middle‐income countries (LMICs). A retrospective cost analysis estimated the financial burden of anti‐GD2 therapies using standardized dosing for a representative 3‐year‐old patient. Results Responses came from 100 facilities in 80 cities and 59 countries. Anti‐GD2 therapy for frontline maintenance was available in 93% of HIC centers, but only 21% of LMIC centers; 65% of LMIC centers reported no access, while the remainder had limited or irregular availability ( p < 0.0001, Fisher's exact test). When unavailable, isotretinoin was most often used alone. Financial coverage differed significantly: HICs relied on government or insurance funding, while LMICs depended on out‐of‐pocket or non‐profit support. Cost analysis showed a full treatment course would cost approximately $192,750 for dinutuximab, $142,695 for dinutuximab beta, and $610,800 for naxitamab, highlighting the substantial financial burden these therapies impose. Conclusion Global access to anti‐GD2 therapy is highly unequal. Strategic measures, including negotiations for reduced drug costs, research‐based access, and WHO Essential Medicines List inclusion, could help address these disparities.
Journals
2026 EN
Thamby Julie M. · Beckhorn Catherine B. · Soto Alexandria L.
+10 more
ABSTRACT Background A new solid tumor diagnosis imposes substantial burdens on children and their families. Prior studies have quantified burden using direct medical costs but often exclude indirect costs, logistical stress, and life disruptions. In this study, we quantify burden of care by assessing healthcare utilization and estimating the associated logistical burden during the first year following diagnosis. Procedure We conducted a retrospective chart review of 166 children (2012–2022) treated within 1 year of an extracranial solid tumor diagnosis at a single institution. We collected data on treatment modalities, healthcare utilization, estimated travel, and job opportunity costs. Results Altogether, 166 children (55% male, 63% White) with median age at diagnosis 2.2 (IQR 1.1–4.8) years were included. The most common diagnoses were neuroblastoma (41%), retinoblastoma (25%), and nephroblastoma (17%). Sixty‐four children (39%) received ≥3 treatment modalities and 75% required tumor resection surgery. Children cumulatively spent a median of 9 days receiving medical care (5–18) at 1 month, 22 (12–35) days at 3 months, 35 (21–68) days at 6 months, and 54 (30–106) days at 1 year. Families traveled a median one‐way distance of 79 (35–136) miles. Estimated annual travel costs were $2,079 ($1129–$4267) and lost wages were $15,277 ($7477–$27,101), ∼21% of median household income. Advanced‐stage disease was associated with significantly more days spent receiving medical care, longer travel, and greater lost wages. Conclusion We characterize the substantial medical and financial burdens on families of children with solid tumors. Decentralized care delivery, multidisciplinary care models, and policy‐level approaches such as expanded insurance coverage may reduce logistical and financial burdens.
Journals
2026 EN
Mo Devons · Palmer Catherine S. · Kimmey Jacqueline M.
The immune system exists in perpetual co‐evolution with pathogens, and microbial pathogenesis is inexorably linked to the cyclical interactions between the pathogen and the host. Because pathogens exploit the immune system in unique ways, the antimicrobial efficacy of any given immune process varies between pathogens, and the consequences of activation or inhibition of antimicrobial programs must be interpreted in the context of the given pathogen. An increasing body of literature shows that numerous facets of the immune system are tightly regulated by the circadian clock, with multiple immune processes demonstrating increased activity during certain times of the day. However, the field of circadian immunology has generally given its attention to unraveling the mechanism of circadian regulation and comparatively little attention to how these circadian oscillations may influence the ultimate outcome of diseases. Therefore, this review aims to interpret these findings in the context of a select number of clinically relevant pathogens: Salmonella enterica , Listeria monocytogenes , and Streptococcus pneumoniae . In this way, we hope to discuss the complex factors that determine how the circadian clock regulates disease progression.
Journals
2026 EN
Ilié Marius · Malapelle Umberto · AlixPanabières Catherine
+11 more
Liquid biopsy has transformed molecular oncology by enabling noninvasive, real‐time monitoring of cancer progression, treatment responses, and detection of minimal residual disease. Despite technological advances, educational gaps, regarding standardized, comprehensive training for molecular pathologists, remain. To address these, a new educational program, the European Masters in Molecular Pathology (EMMP) developed a dedicated educational module aimed at providing pathologists with specialized competencies in liquid biopsy. In this perspective, we discuss how embedding liquid biopsy training within the integrative pathology framework, linking molecular diagnostics, histopathological findings, and clinical context, enhances diagnostic accuracy and therapeutic decision‐making in the clinic. Furthermore, we emphasize the importance of decentralizing liquid biopsy expertise to local pathology units, reducing dependency on external commercial platforms, ensuring data sovereignty, and enabling rapid, cost‐effective diagnostics. Finally, integrating health policy and ethical considerations within liquid biopsy education prepares future molecular pathologists to engage meaningfully in shaping policy frameworks that support equitable and sustainable clinical implementation of precision oncology. In summary, we propose the EMMP module as a comprehensive educational strategy for training molecular pathologists in the latest liquid biopsy technologies and advancements.
Journals
2026 EN
Ganesan Sukirth M. · Yadav Meeta · Ghimire Sudeep
+10 more
ABSTRACT Objective Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by inflammation, demyelination, and neurological impairment. While the gut microbiota's role in MS is extensively studied, the association between the oral microbiota and MS remains underexplored, particularly in North American cohorts. This study aimed to investigate the microbiota (bacterial) composition as well as functional pathways and immune profiles of the oral cavity in 60 patients with relapsing–remitting MS (RRMS), stratified by treatment status, compared to 44 healthy controls (HC). Methods Unstimulated saliva was collected for genomic DNA extraction and salivary cytokine quantification. Oral bacterial composition and diversity were analyzed using 16S rRNA sequencing, with functional pathways inferred using PICRUSt2. Salivary cytokine levels were measured via multiplex immunoassays. LEfSe and random forest models identified key discriminatory taxa, and correlations between microbiota and cytokines were assessed using Spearman's rank analysis. Results RRMS patients exhibited distinct microbial communities compared to HC and a higher Bacteroidota to Firmicutes ratio. Key taxa such as Campylobacter, Lachnoanaerobaculum , and Porphyromonas were enriched in RRMS. Functional profiling revealed 49 differentially abundant pathways, including the enrichment of lipopolysaccharide biosynthesis in MS. Elevated levels of IFN‐γ, IL‐6, and other cytokines correlated with the altered microbiome. IL‐21, elevated in HC, correlated with anti‐inflammatory pathways, suggesting a protective role in immune homeostasis. Interpretation This study provides, for the first time, insights into oral microbiome‐host interactions in North American RRMS patients, underscoring the interplay between microbial dysbiosis, functional pathways, and immune dysregulation. The oral microbiome shows potential as a biomarker for MS‐related immune alterations.
Journals
2026 EN
Ramanan Athimalaipet V. · Guly Catherine M. · Simonini Gabriele
+5 more
Objective To evaluate the efficacy and safety of baricitinib in pediatric patients with active juvenile idiopathic arthritis–associated uveitis (JIA‐U) or chronic anterior antinuclear antibody–positive uveitis, who had an inadequate response to methotrexate (MTX) or biologic disease‐modifying antirheumatic drugs (bDMARDs). Methods JUVE‐BRIGHT was an open‐label, active‐controlled phase‐3 multicenter trial that used a novel design, including 1:1 randomization to an active reference arm. The primary efficacy endpoint was the proportion of responders at week 24 (W24), defined according to the Standardization of Uveitis Nomenclature (SUN) criteria as a two‐step decrease in the level of inflammation (anterior chamber cells) or decrease to zero through W24 in the most severely affected eye at baseline. Study success was based on a prespecified Bayesian success rule: the study was deemed successful if there was >80% posterior probability that the baricitinib SUN criteria response rate at W24 was at least 57%. Results This study enrolled 30 pediatric patients. The study primary endpoint was not met. In the baricitinib group, 36.8% of MTX–inadequate responder (MTX‐IR) and bDMARD‐IR patients and 20% of MTX‐IR patients achieved a two‐step decrease in SUN criteria at W24. Eight patients (33.3%) achieved a response at W24, resulting in 1.03% posterior probability of a response rate of >57%. Safety data were consistent with the established safety profile in other baricitinib indications in pediatric and adult patients. Conclusion Although the primary endpoint was not met, the data provide important information on baricitinib for the treatment of children with JIA‐U refractory to both MTX and bDMARDs. Baricitinib safety profile in this study was consistent with previous studies in children and adults with other diseases.
Journals
2026 EN
Carrico Justin · McGuiness Catherine · Yasuda Marie
+5 more
Objective Adults with rheumatic diseases are at increased risk for herpes zoster (HZ). Recommendations for the recombinant zoster vaccine (RZV) were expanded in 2021 to include those aged ≥19 years at increased risk for HZ due to immunodeficiency or immunosuppression because of disease or therapy, but the impact of these expanded recommendations is unclear. This study assessed the impact of the updated recommendations on RZV uptake among adults with rheumatic disease in the US. Methods A retrospective cohort analysis used open‐source claims data to estimate RZV uptake, series completion, and dosing schedule compliance among unvaccinated adults with rheumatic disease from October 2021 to June 2023. Interviews with rheumatologists were conducted and thematically analyzed to characterize RZV vaccination practices related to managing patients with rheumatic disease. Results RZV uptake among adults with rheumatic disease and without prior RZV over the 20‐month period following the updated recommendations was gradual (7.0%–10.4% across conditions) and low, and was particularly less likely among adults <50 years of age. The odds of RZV uptake were higher among those of older age, those with a household income greater than or equal to $50,000, and those of a non‐White race or ethnicity. Financial concerns, lack of formal processes for tracking vaccination records and delivering reminders, and insufficient education and awareness were key barriers to RZV vaccination according to rheumatologists. Conclusion RZV uptake among adults with rheumatic disease has gradually increased, and opportunities to improve HZ prevention exist, some of which may be addressed through targeted educational efforts.
Journals
2026 EN
Sanders Hailey S. · Price Catherine G. · de Almeida Barreto Ana F.
+3 more
ABSTRACT Light‐mediated healthcare has several very attractive features, including minimally invasive administration, reduced possibility of side effects, and potential for patient‐specific treatment. However, the shallow penetration of light into skin and tissue is an inherent physical limitation that restricts the use of phototherapy to superficial sites of disease. To mitigate this major problem, researchers and clinicians are developing miniature light devices that can be implanted at strategic deep‐tissue locations within a living subject. The work is leveraged by emerging new classes of light‐absorbing drugs and light‐activated drug delivery methods. This Perspective summarizes the major concepts and recent technical advances in this interdisciplinary subfield of advanced phototherapeutics. Fundamental factors are described, such as the wavelength dependence of light penetration and scattering through tissue, and the required power levels for the desired phototherapeutic effect. The implanted devices can be powered by an attached wire or otherwise powered wirelessly, and each approach has its own engineering challenges to produce desired performance features. A forward‐looking conclusion section envisions future phototherapies that use implanted miniature light devices with the capacity to deliver phototherapy and monitor therapeutic response using sensors that provide immediate feedback and dose control.
Journals
2026 EN
Albano Lucas J. · Bingham Robin A. · Correa Sulma
+4 more
Abstract Premise Extreme events are an understudied aspect of ongoing anthropogenic climate change that could play a disproportionate role in the threat that rapid environmental shifts pose to natural populations. Methods We exposed plants originating from seeds that were harvested before (ancestors) and after (descendants) multiple extreme heat events from six populations across the range of Mimulus cardinalis (Phyrmaceae) to a short‐term heat‐wave treatment in controlled growth chamber environments. We assessed physiological, performance, and functional responses (stomatal conductance, leaf temperature deficit, photosystem II efficiency, relative growth rate, specific leaf area, and leaf dry matter content) to the heat‐wave treatment, along with evolutionary responses (differences between ancestors and descendants) of M. cardinalis populations to the recent natural extreme heat event. Results Plants in the heat‐wave treatment increased their overall performance, and the magnitude of increase was generally greatest among trailing‐edge populations. Despite limited overall trait differences between ancestors and descendants, there was some evidence of divergent evolutionary responses among regions to the natural extreme heat event. However, we did not find evidence of adaptive evolution that affected how M. cardinalis populations responded to the heat‐wave treatment. Conclusions These results demonstrate that many M. cardinalis populations may reside in environments that are below their optimum average temperature, revealing potential resiliency to future warming. However, limited evolutionary responses in M. cardinalis to the recent extreme heat wave could still indicate potential for future vulnerability to extreme climate events of increased intensity, frequency, and duration.