Category: Nevin Manimala

Tech Innov Patient Support Radiat Oncol. 2026 Jun 4;39:100417. doi: 10.1016/j.tipsro.2026.100417. eCollection 2026 Sep.

ABSTRACT

PURPOSE: To determine if version upgrades to treatment planning system software have an impact on the clinical application of a knowledge-based planning model built in a previous version.

METHODS: Twenty patients’ data sets treated for prostate cancer were retrospectively selected for planning on three different versions of Eclipse (Varian Medical Systems) treatment planning system, (Vn13.6, Vn15.6, Vn16.1) using a multi-centre RapidPlan model that was built in Vn13.6. Each plan was created using identical beam arrangement, and optimisation objectives and calculation settings. The RapidPlan model was also re-trained in Vn15.6 and Vn16.1 and the datasets were replanned using these models with the same method.

RESULTS: Seven plan comparisons were performed, evaluating four target metrics and eight organ at risk (OAR) metrics. Statistically significant differences to median values for target dose metrics were observed in 10 out of 28 plan comparisons and for OARs in 23 out of 56 plan comparisons. Re‑extracted and re‑trained models in Vn15.6 and Vn16.1 improved target coverage and several OAR dose metrics. Small increases were observed in some OAR metrics for a subset of plans using the Vn15.6 model; however, the largest variations were minor (≤1.4%), including Bladder_65Gy (<1.3%), Bladder_70Gy (<0.7%), Rectum_65Gy (<0.9%), and Rectum_70Gy (<1.4%).

CONCLUSION: Eclipse version upgrades will have varying effects on the resultant plans optimised using a RapidPlan models developed and trained in earlier versions. This study confirms the recommendation from the vendor that it is important to re-extract and re-train RapidPlan models when an Eclipse version upgrade is undertaken to ensure optimal dosimetry is achieved.

PMID:42376610 | PMC:PMC13311788 | DOI:10.1016/j.tipsro.2026.100417

Cancer Manag Res. 2026 Jun 23;18:604901. doi: 10.2147/CMAR.S604901. eCollection 2026.

ABSTRACT

PURPOSE: Prostate-specific antigen (PSA), a common screening tool for prostate cancer (PCa), has a high false-positive rate and is largely suboptimal. PSA is also weakly validated in men of African ancestry (moAA), who disproportionately bear the disease burden, necessitating investigation into its widespread use. Previously, we found that plasmacytoma variant translocation 1 (PVT1) exons 4A, 4B, and 9 are overexpressed in PCa tissues. Here, we report on the first serum-based evaluation of these exons to determine their utility in improving detection and risk stratification of PCa.

PATIENTS AND METHODS: Total RNA was extracted from serum samples obtained retrospectively from 144 multiracial men with elevated PSA who underwent prostate biopsy. Likelihood ratio test was used to evaluate the potential benefit of utilizing these alone or in combination with PSA. Regression analysis was used to evaluate the association of individual biomarkers with the odds of PCa and for evaluating endpoint predictions. Model generalizability was assessed using cross-validation and area under the receiver operating characteristic curve (ROC-AUC). All statistical tests were performed at a 5% level of significance using the Sklearn library in Python.

RESULTS: Our results indicate that combining PSA with PVT1 exon 4A or 9 improves PCa risk stratification in the general population, increasing AUC from 0.72 to 0.75 as well as PCa detection, increasing specificity from 0.41 to 0.59. Within moAA, combining PSA with PVT1 exon 4A improves PCa detection substantially, increasing AUC from 0.44 to 0.67. Remarkably, PVT1 exon 4A alone achieves an AUC of 0.79.

CONCLUSION: Our study provides preliminary exploratory evidence to support PVT1 exon 4A and PVT1 exon 9 as promising PCa risk biomarkers that can reduce disparity in PCa detection and management. Further validation in larger patient cohorts will be necessary to establish the clinical utility of these novel biomarkers.

PMID:42376599 | PMC:PMC13310659 | DOI:10.2147/CMAR.S604901

Cancer Manag Res. 2026 Jun 25;18:603191. doi: 10.2147/CMAR.S603191. eCollection 2026.

ABSTRACT

PURPOSE: To investigate the effects of Jianpi Rougan method on lenvatinib (LEN) relative dose intensity (RDI), toxicity-related treatment discontinuation, and treatment tolerability in intermediate-to-advanced hepatocellular carcinoma (HCC).

METHODS: A real-world, retrospective study was conducted on 152 intermediate-to-advanced HCC patients receiving LEN. Patients were grouped based on concurrent use of Jianpi Rougan decoction (combined, n = 73) or not (monotherapy, n = 79). Primary endpoints were RDI at weeks 8, 12, and overall, and the proportion of RDI ≥ 80%. Secondary endpoints included toxicity-related discontinuation, adverse events, and short-term efficacy (objective response rate, ORR; disease control rate, DCR). Propensity score matching (PSM, 1:1) was employed to balance baseline confounders.

RESULTS: After PSM (65 pairs, n = 130), baseline characteristics were balanced. The combined group showed significantly higher RDI at week 12 (P = 0.001) and overall (P = 0.003), increased proportion of RDI ≥ 80% (P = 0.029), fewer dose reductions (P = 0.022) and interruptions (P = 0.045), reduced toxicity-related permanent discontinuation (P = 0.021), decreased overall discontinuation (P = 0.034), and longer treatment duration (P = 0.042). Decreased appetite was less frequent in the combined group (P = 0.036), with trends towards less diarrhea and transaminase elevation. ORR and DCR were higher in the combined group, but the differences were not statistically significant (P > 0.05).

CONCLUSION: Jianpi Rougan method combined with LEN was associated with improved RDI, lower rates of toxicity-related treatment discontinuation, and enhanced treatment persistence in real-world practice, supporting its role as a feasible integrative strategy to maintain targeted therapy intensity.

PMID:42376598 | PMC:PMC13313011 | DOI:10.2147/CMAR.S603191

OTO Open. 2026 Jun 29;10(3):e70275. doi: 10.1002/oto2.70275. eCollection 2026 Jul-Sep.

ABSTRACT

OBJECTIVE: To systematically review the literature for medical therapies that promote facial nerve regeneration and recovery.

DATA SOURCES: PubMed/Medline, Embase, and SCOPUS databases were searched for English-language studies published from inception through May 2025.

REVIEW METHODS: Human studies evaluating the efficacy of medical therapy on facial nerve regeneration using validated facial nerve grading scales were included.

RESULTS: Nine studies were included in qualitative analysis, and 6 were included in a meta-analysis. Treatments included nimodipine (n = 6), pentoxifylline (n = 1), co-enzyme Q10 (n = 1), and extracellular vesicles (n = 1). All studies used HB score, and recovery was defined as HB score ≤3. Recovery was observed in 94% (95% CI:[90%, 97%]) of patients treated with nimodipine and 84% (95% CI: [70%, 97%]) of control patients; this was not statistically significant (OR 2.26, 95% CI: [0.97, 5.26]). Nimodipine significantly decreased HB score by 1.66 (95% CI: [0.81, 2.52]) before and after treatment. Pentoxifylline and extracellular vesicles demonstrated some efficacy, while co-enzyme Q10 was not efficacious.

CONCLUSION: Nimodipine improved HB score but was not significantly associated with recovery to HB score ≤3 compared to controls. Pentoxifylline and extracellular vesicles may have some efficacy, but co-enzyme Q10 is not effective. Further research is required to uncover additional treatments.

PMID:42376590 | PMC:PMC13312993 | DOI:10.1002/oto2.70275

Front Microbiol. 2026 Jun 15;17:1746922. doi: 10.3389/fmicb.2026.1746922. eCollection 2026.

ABSTRACT

Insect gut microbiomes are recognized as potential reservoirs of enzymatic activities relevant to plastic metabolism. Here, we investigated the taxonomic and functional dynamics of the Tenebrio molitor gut microbiota under dietary exposure to low-density polyethylene (LDPE) and polyethylene terephthalate (PET) using 16S rRNA sequencing and shotgun metagenomics. Significant compositional shifts were detected at the ASV level, with plastic-fed cohorts showing enrichment of taxa implicated in xenobiotic metabolism. Predicted functional changes suggested altered abundance of pathways related to aromatic compound processing and redox homeostasis. Metagenomic assembly and functional annotation, performed through a reproducible open-source workflow, revealed several putative proteins with distant homology to enzymes such as phthalate dioxygenases, urethanases, and polyhydroxyalkanoate depolymerases. A metagenome-assembled genome (MAG) assigned to Enterococcus accounted for most recovered protein-coding sequences. Although gene-level comparisons did not show statistically significant differences, Gene Set Enrichment Analysis (GSEA) highlighted ABC transporter signatures and stress-response ATPases under plastic-exposed conditions. Overall, this exploratory study reveals microbial shifts and putative genetic indicators of metabolic potential within the T. molitor gut, providing a reproducible analytical framework for future investigations into the microbial role in plastic bioconversion.

PMID:42376574 | PMC:PMC13311072 | DOI:10.3389/fmicb.2026.1746922

World J Surg Oncol. 2026 Jun 29. doi: 10.1186/s12957-026-04466-5. Online ahead of print.

ABSTRACT

BACKGROUND: Axillary management in breast cancer has evolved toward de-escalation to reduce complications, particularly breast cancer-related lymphedema (BCRL). This study aimed to assess current practices and trends of axillary surgery and BCRL management in China.

METHODS: A nationwide survey was conducted across hospitals performing ≥ 200 breast cancer surgeries annually in 2022. The questionnaire evaluated institutional characteristics, clinical practices of axillary surgery and BCRL care. Data were compared with those from the 2017 national survey involving 110 hospitals to assess temporal changes in hospital-reported practice patterns.

RESULTS: The 198 hospitals surveyed performed a total of 123,237 breast cancer surgeries in 2022. SLNB for cN0 patients was routine practice, with 59.6% of hospitals performing SLNB in > 90% of these cases, whereas the use of SLNB in patients with clinically suspicious axillary nodes and FNA-confirmed metastasis remained cautious. The omission of ALND for patients with limited SLN metastasis (1-2 positive SLNs) remained conservative, particularly for mastectomy cases. However, significant increases were observed compared with the 2017 survey (breast-conserving surgery: median 30.0% vs. 9.0%, P = 0.001; mastectomy: median 11.0% vs. 6.6%, P < 0.001). The timing of SLNB in patients receiving neoadjuvant chemotherapy (NAC) shifted toward the post-NAC setting compared with 2017 (54.0% vs. 45.5%). Comprehensive assessment after NAC, including targeted axillary dissection (TAD) with dual-tracer mapping, was underutilized (23.7%). Hospital-reported BCRL care teams had been established in 52.0% of hospitals, while surgical BCRL interventions remained rare (11.6%).

CONCLUSION: Compared with the 2017 national survey, hospital-reported adoption of axillary de-escalation strategies in China was broader, although implementation remained cautious and uneven across clinical scenarios and institutional settings. As a hospital-level practice-mapping survey, this study describes implementation patterns rather than patient-level oncologic safety or efficacy. These findings suggest that tracer accessibility, evidence-based protocols, and multidisciplinary BCRL care may be important areas for future improvement.

PMID:42374488 | DOI:10.1186/s12957-026-04466-5

BMC Sports Sci Med Rehabil. 2026 Jun 29. doi: 10.1186/s13102-026-01830-6. Online ahead of print.

ABSTRACT

BACKGROUND: Feedback is considered a fundamental component of motor skill learning, yet evidence comparing the effectiveness of visual, verbal, and combined feedback modalities in youth gymnastics remains limited. This study examined the effects of mixed (visual + verbal), visual, and verbal feedback on the acquisition of selected gymnastics skills using two-dimensional kinematic analysis.

METHODS: Sixty female gymnasts aged 7-11 years were randomly assigned to mixed feedback (n = 20), visual feedback (n = 20), or verbal feedback (n = 20) groups. Participants completed an 8-week gymnastics training program. Performance in the Front Scale, Back Scale (Knee-Knee), Back Scale (Shoulder-Knee), and Split Jump was assessed at pre-test, mid-test, and post-test using Kinovea-based kinematic analysis. A mixed-design ANOVA was conducted to evaluate the effects of feedback modality, time, and the Group × Time interaction. Bonferroni-adjusted post hoc comparisons were performed where appropriate.

RESULTS: Significant Group × Time interactions were observed for the Back Scale (Knee-Knee) (F = 3.375, p = .020, η² = .106), Back Scale (Shoulder-Knee) (F = 32.662, p < .001, η² = .534), and Split Jump (F = 3.510, p = .023, η² = .110), indicating that performance improvements differed across feedback conditions. Mixed feedback generally led to greater improvement than visual or verbal feedback for these skills. In contrast, although Front Scale performance improved over time, the Group × Time interaction was not statistically significant (F = 1.680, p = .160), suggesting that improvement patterns did not differ significantly among feedback modalities for this skill. Across all analyses, verbal feedback alone tended to produce smaller improvements than mixed or visual feedback.

CONCLUSION: The findings indicate that the effectiveness of feedback modalities may depend on the specific gymnastics skill being learned. Mixed feedback appears particularly advantageous for skills requiring greater coordination and postural control, whereas no clear superiority of any feedback modality was observed for Front Scale performance. Integrating visual demonstrations with verbal instruction may therefore represent an effective strategy for enhancing motor skill acquisition in youth gymnastics.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT07082647). Registered retrospectively on July 15, 2025.

PMID:42374486 | DOI:10.1186/s13102-026-01830-6

BMC Oral Health. 2026 Jun 29. doi: 10.1186/s12903-026-09021-y. Online ahead of print.

ABSTRACT

BACKGROUND: Comprehensive dental care includes health education strategies that highlight the importance of disease prevention and reach as many people as possible. Bacteria are central to most oral diseases, yet few studies have explored the impact of including specifics of microbial pathogenesis on oral health education. Therefore, the objectives of this study were to determine if oral hygiene instructions (OHI) provided to undergraduate students in a group-setting positively impacted oral health knowledge and beliefs, and whether integration of microbiology-focused instructions and activities further improved these oral health measures.

METHODS: A pre-test/post-test experimental study was conducted among undergraduate life-science students. Participants were allocated to the control group, (n=35) receiving Standard OHI (SD-OHI) and the experimental group (n=40) receiving Microbiology-focused OHI (MICRO-OHI). Each group completed questionnaires before and after the educational intervention for measurement of changes in oral health knowledge, beliefs, and behaviors.

RESULTS: Descriptive statistics were conducted on the pre-test/post-test responses for SD-OHI and MICRO-OHI. Both groups showed improved responses on items related to oral health knowledge and beliefs and high agreement with statements on intention to adhere to routine oral hygiene practices. Microbiology-related items had significant improvement in the MICRO-OHI group compared to the SD-OHI group (p<0.05). Qualitative analysis of responses to “Why should we brush our teeth?” revealed that a higher percentage of MICRO-OHI responses added emphasis on bacteria/biofilm removal compared to SD-OHI.

CONCLUSIONS: Both methods of group-based instruction increase health-promoting responses and the addition of microbiology-focused instructions has the potential to uniquely augment comprehensive oral healthcare strategies.

PMID:42374485 | DOI:10.1186/s12903-026-09021-y

BMC Oral Health. 2026 Jun 29. doi: 10.1186/s12903-026-08866-7. Online ahead of print.

ABSTRACT

BACKGROUND: Smokeless tobacco products and areca nut, widely used in Uttar Pradesh, are strongly associated with oral cancer, which ranks among the top three cancers in India. Data from the Population-Based Cancer Registry, Varanasi, highlights one of the highest oral cancer burdens across India. Despite the availability of national guidelines, frontline health workers (ASHAs) remain underutilised for tobacco cessation counselling and oral cancer symptom-based screening. This study assessed the impact of a structured training intervention on their knowledge, practices, and legal awareness.

METHODS: A pre-post intervention study was conducted in one rural block of Varanasi district between January and May 2023. A total of 202 ASHAs were enrolled through purposive sampling. The one-day training, based on Government of India modules, covered epidemiology, clinical features, determinants of tobacco use, cessation counselling, symptom-based oral cancer screening, and relevant legislation. Data were collected using a validated questionnaire before and after training. Descriptive statistics, Stuart-Maxwell tests, and Spearman’s correlations were applied for analysis.

RESULTS: Baseline scores revealed substantial knowledge and practice gaps: 45.6% of ASHAs had poor epidemiological awareness, 56.9% poor clinical knowledge, and 81.7% poor understanding of determinants of tobacco use. Only 19.8% reported routinely performing symptom-based screening for oral cancer, and while 64.8% “always” provided counselling, legal literacy was limited (only 38.1% aware of the COTPA Act). Following the intervention, significant improvements were observed across all domains (p < 0.01). Post-intervention most ASHAs reported willingness for oral cancer screening (64.8%) and provide tobacco cessation counselling (75.7%). Awareness of the COTPA Act increased to 65.4%. Strong positive correlations were observed between knowledge domains, suggesting synergistic gains.

CONCLUSION: A structured, government-endorsed training programme significantly improved ASHAs’ knowledge, attitudes, and practices related to tobacco cessation and oral cancer screening, demonstrating the feasibility of leveraging frontline workers for community-based cancer prevention. However, achieving higher competency levels requires more intensive, competency-based training with supportive supervision. Integration within routine health systems and further research on long-term impact are warranted.

CLINICAL TRIAL REGISTRATION NUMBER: Trial registration Clinical Trials Registry India CTRI/2021/02/031306. Date of registration 16/02/2021.

PMID:42374470 | DOI:10.1186/s12903-026-08866-7

Genome Biol. 2026 Jun 29. doi: 10.1186/s13059-026-04176-x. Online ahead of print.

ABSTRACT

BACKGROUND: Genetic variants in the 3′ untranslated regions (3′-UTRs) of mRNAs can alter binding of RNA-binding proteins and microRNAs and thereby influence regulation by affecting RNA stability, localization, and translation. Despite their potential impact on the risk for complex traits, including alcohol use disorder, the contribution of 3′-UTR variants has not been systematically explored. We evaluate the impact of 3′-UTR variants within loci associated with substance use and neurological disorders using a massively parallel reporter assay (MPRA) in neuroblastoma and microglia cells.

RESULTS: Of the 13,515 variants tested, 400 and 657 variants significantly alter gene expression in neuroblastoma and microglia cells, respectively. These functionally impactful variants account for more heritability of alcohol-related traits than non-functional variants. We develop a computational framework, MPRA-mediated Gene Expression Association (MGExA), that combines MPRA-derived variant effects with GWAS summary statistics and identify 31 genes whose expression changes may contribute to alcohol-related traits. CRISPR inhibition of 7 of these genes in neuronal cells leads to gene expression changes associated with neurodegenerative disorders and the oxidative phosphorylation pathway. Pharmacoepidemiological analysis of drugs that had similar effects on gene expression linked RBM14 and KANSL1 to risk for alcohol use disorder.

CONCLUSIONS: We identify genetic variants in 3′-UTR regions that affect gene expression. By integrating these functional genomics data and pharmacoepidemiological assessment with GWAS analysis, we identify genes whose expression differences could contribute to alcohol related traits. This approach provides a framework for moving from GWAS data to identifying biologically and clinically relevant genes associated with complex disorders.

PMID:42374457 | DOI:10.1186/s13059-026-04176-x