Category: Nevin Manimala

J Imaging Inform Med. 2026 Jan 30. doi: 10.1007/s10278-026-01843-0. Online ahead of print.

ABSTRACT

Otosclerosis is a disease affecting the middle and inner ear, characterized by abnormal bone remodeling that leads to stapes fixation and progressive hearing loss. Although high-resolution computed tomography (HRCT) is the standard imaging modality for diagnosis, its sensitivity is limited, with a high false-negative rate (FNR). This study investigates the use of radiomics and machine learning (ML) to improve diagnostic accuracy. HRCT scans from 99 subjects (48 otosclerosis, 51 controls) were analyzed, focusing on the stapes, antefenestral region (AF), and oval window (OW). From each scan, 6048 radiomic features were extracted and reduced to 1317 through feature selection. Statistical analyses and ML modeling were performed using the selected features. Sixty-seven biomarkers showed significant differences between cases and controls, primarily in the AF (56) and stapes (11); none were found in the OW. Both the AF and stapes exhibited increased heterogeneity in otosclerosis, reflecting the bone remodeling process. A reduction in the stapes’ major axis was also observed, possibly related to torsional deformation. Image transformation filters enhanced disease visibility. Among several ML classifiers tested, L2-regularized logistic regression performed best, achieving an AUC of 0.90 ± 0.06, thereby enhancing the diagnostic accuracy reported in some studies for radiologists. Hierarchical clustering of the most predictive features further confirmed their strong discriminative power. Our findings highlight the potential of radiomics and ML to standardize otosclerosis diagnosis, reduce FNR, and support surgical decision-making. Future studies should validate these results using larger cohorts and advanced imaging technologies such as Photon-Counting CT.

PMID:41615634 | DOI:10.1007/s10278-026-01843-0

Odontology. 2026 Jan 30. doi: 10.1007/s10266-026-01328-0. Online ahead of print.

ABSTRACT

This in vitro study aimed to evaluate the effects of office and home bleaching agents containing nano-hydroxyapatite (n-HAP) on the surface roughness, microhardness, and micromorphology of sound and demineralized enamel. A total of 120 enamel specimens were obtained from extracted human third molars, half of which underwent a demineralization cycle to simulate initial enamel demineralization. The specimens were divided into five subgroups (n = 12) based on the bleaching agent applied: no bleaching (control), 40% hydrogen peroxide (HP), 16% carbamide peroxide (CP), 40% HP + n-HAP, and 6% HP + n-HAP. Surface roughness was measured using non-contact optical profilometry, and microhardness was assessed via the Vickers hardness test. Micromorphological changes were examined by scanning electron microscopy (SEM) at × 1,000 and × 4,000 magnifications. Statistical analyses were performed using the Shapiro-Wilk, Mann-Whitney U, Kruskal-Wallis H, and Bonferroni post hoc tests (p < 0.05). In the demineralized groups, surface roughness significantly increased while microhardness decreased (p < 0.05). The highest surface roughness was observed in the demineralized group treated with 16% CP, whereas microhardness significantly increased in the group treated with 6% HP + n-HAP. SEM findings revealed pronounced structural degradation in groups treated with high-concentration HP, while n-HAP-containing groups exhibited mineral deposition and preservation of the prismatic enamel structure. Although no remineralization protocol was used before bleaching, the findings indicate that low-concentration HP agents containing n-HAP may protect enamel with initial demineralization. These results highlight the potential clinical benefit of such formulations in reducing bleaching-related enamel damage.

PMID:41615631 | DOI:10.1007/s10266-026-01328-0

Acta Neurol Belg. 2026 Jan 30. doi: 10.1007/s13760-025-02984-9. Online ahead of print.

ABSTRACT

BACKGROUND: Relapsing-remitting multiple sclerosis (RRMS) often necessitates treatment changes due to safety concerns, inadequate efficacy, or patient-specific factors. While second-line therapies (e.g., natalizumab, ocrelizumab) are effective, real-world evidence on outcomes after switching or discontinuing these therapies are limited, particularly in diverse healthcare settings.

OBJECTIVE: This study aimed to evaluate treatment transition patterns, reasons for discontinuation, and six-month clinical/MRI outcomes in patients with RRMS switching between second-line therapies or discontinuing treatment.

METHODS: A retrospective cohort study was conducted at Sina Hospital, Tehran, Iran, including 338 RRMS patients who switched or discontinued second-line therapies including fingolimod, natalizumab, ocrelizumab and rituximab. Clinical and MRI data were collected at baseline (therapy change/discontinuation) and six-month follow-up. Outcomes included relapse frequency, disability progression (Expanded Disability Status Scale [EDSS]), and MRI lesion activity. Statistical analysis was done using paired t-tests and descriptive statistics.

RESULTS: Among 338 patients (83.1% female, mean age 33.9 years), treatment transitions occurred most frequently to ocrelizumab (42.3%) or rituximab (33.4%). Safety concerns (32.0%), inadequate efficacy (29.9%), tolerability issues (13.6%), and pregnancy planning (8.9%) were primary reasons for therapy changes. Overall paired analyses of EDSS scores showed a strong correlation between pre- and post-switch measurements (r = 0.944, p < 0.001), although the average change for the entire cohort was minimal and not statistically significant. Notably, the subgroup of patients who switched from fingolimod to ocrelizumab demonstrated a statistically significant reduction in EDSS scores, with a mean difference of 0.19 (p = 0.019). Furthermore, among 110 patients whose treatment change was driven solely by inadequate efficacy (e.g., ongoing relapses or poor symptom control), the mean EDSS improved significantly from 2.41 (± 1.74) at baseline to 2.16 (± 1.80) at six months, with a mean difference of 0.25 (p < 0.001) and a strong correlation between baseline and follow-up scores (r = 0.92, p < 0.001).

CONCLUSION: B-cell-depleting therapies, particularly ocrelizumab, may help lower disability in active RRMS, but longer follow-up is needed to confirm sustained benefits. Personalized strategies that balance efficacy, safety, and patient-specific factors (e.g., PML risk, pregnancy) are essential. Although most patients had low baseline disability, which may limit generalizability, these findings still offer real-world insight into treatment transitions. Longer prospective studies are needed to confirm long-term outcomes.

PMID:41615580 | DOI:10.1007/s13760-025-02984-9

Cardiovasc Drugs Ther. 2026 Jan 30. doi: 10.1007/s10557-026-07846-x. Online ahead of print.

NO ABSTRACT

PMID:41615573 | DOI:10.1007/s10557-026-07846-x

Discov Oncol. 2026 Jan 30. doi: 10.1007/s12672-026-04506-2. Online ahead of print.

ABSTRACT

BACKGROUND: The detection rate of early-stage gastric cancer remains relatively low. Early detection is beneficial for improving prognosis. We aim to explore the risk factors for lymph node metastasis(LNM) in elderly patients with early gastric cancer (EGC), and to construct a nomogram prediction model for validation.

METHODS: 136 patients diagnosed with elderly EGC accompanied by LNM in Cangzhou Central Hospital and Cangzhou People’s Hospital from January 2021 to June 2024 were selected as the training cohort. The new gastric cancer screening score (GCSS), regenerated-protein 4(REG4), tumor abnormal protein(TAP) levels and clinicopathologic characteristics were compared in elderly EGC, gastric precancerous disease and control groups. Lasso-Logistic regression was used to identify risk factors affecting LNM, and the nomogram model was established and verified. The clinical decision curve analysis (DCA) and clinical impact curve (CIC) were performed to evaluate the model. In addition, the clinical data of 72 patients with elderly EGC who met the inclusion criteria in two hospitals from July 2024 to June 2025 were selected as the validation cohort to verify the nomogram model.

RESULTS: There was no statistically significant difference in general clinical data between the training cohort and the validation cohort (P > 0.05). The incidence of LNM in the training cohort was 22.79% (31/136), while that in the validation cohort was 23.61% (17/72). GCSS, REG4, and TAP levels in EGC group were higher than gastric precancerous disease group and control group. Lasso-Logistic regression showed that REG4, TAP, vascular invasion, undifferentiated type, infiltrate into the submucosa, and diameter ≥ 2 cm were independent risk factors for LNM in elderly EGC. The Nomogram model was constructed based on the independent risk factors screened out, which showed that the predicted values were in good agreement with the measured values, The area under the receiver operating characteristic curve (ROC) (AUC) of the training cohort and the validation cohort was 0.853 and 0.878, respectively. The goodness-of-fit test was conducted using the Hosmer-Lemeshow method, and the result was P = 0.751. The DCA and CIC of the training and validation cohort both indicate that the model had good clinical application value.

CONCLUSION: The results of this study indicate that REG4, TAP, vascular invasion, undifferentiated type, infiltrate into the submucosa and diameter ≥ 2 cm are at a higher risk for LNM in elderly EGC. A nomogram model can be helpful for early prediction of LNM in elderly EGC, It provides certain references for the treatment strategies of elderly EGC.

PMID:41615557 | DOI:10.1007/s12672-026-04506-2

Environ Monit Assess. 2026 Jan 30;198(2):188. doi: 10.1007/s10661-026-14996-w.

ABSTRACT

Vegetation phenology needs to be considered in the assessment of agricultural drought severity, especially in drylands such as Botswana. Using Remote Sensing time-series data (2000 – 2020), this study evaluated vegetation productivity using the annual sum of the Enhanced Vegetation Index (EVI_sum) and computed changes as trends (EVIsum_trend) in agricultural lands comprising grasslands and croplands. To assess agricultural drought severity, a weighted linear combination was applied to the EVI-based Vegetation Condition Index (VCI_wlc) and compared to the conventional Standardized Precipitation Index. To detect how agricultural drought has impacted vegetation phenology, we identified dynamics in vegetation greenup, maturity, peak, senescence and dormancy and correlated these to the EVI_sum and VCI_wlc. Differentiating between croplands and grasslands, vegetation productivity in grasslands was consistently lower than in croplands during droughts. The seasonal agriculture-related phenology, such as late vegetation greenup – the start of the season – is correlated with reduced vegetation productivity and severe agricultural droughts as evidenced by lower EVI_sum and VCI_wlc values, respectively. Notable phenology patterns include delayed greenup in grasslands compared to croplands, while the peak period often overlaps between grasslands and croplands. Overall, phenological shifts detected over agricultural lands in Botswana were about 58 days delayed greenup between the earliest and latest detection, whereas for peak, senescence and dormancy, delays were between 60 and 61 days. Findings provide valuable insights into how vegetation responds over time to changing environmental stressors such as drought. Understanding and monitoring how drought impacts agriculture-related phenology in dryland ecosystems is essential to informing national drought policies.

PMID:41615550 | DOI:10.1007/s10661-026-14996-w

J Gen Intern Med. 2026 Jan 30. doi: 10.1007/s11606-025-10161-0. Online ahead of print.

ABSTRACT

BACKGROUND: The use of antibiotics in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) with clear evidence of pneumonia is considered standard practice. However, without radiographic bacterial pneumonia, the net impact of antibiotics is equivocal.

OBJECTIVE: To study physician-level practice variation in antibiotic prescribing and associated outcomes for patients hospitalized with AECOPD without pneumonia.

DESIGN: Retrospective cohort study.

PARTICIPANTS: Patients admitted to general internal medicine wards across seven hospitals in Ontario, Canada, between April 2010 and December 2020 with AECOPD without pneumonia. Each hospitalization was attributed to the admitting physician.

EXPOSURE: To avoid indication bias (sicker patients are more likely to receive antibiotics), the main exposure was the propensity of a patient’s physician to prescribe antibiotics in AECOPD, measured by the proportion of their AECOPD patients treated with antibiotics.

MAIN MEASURES: We studied four outcomes using multivariable regression to adjust for patient baseline characteristics: in-patient mortality, intensive care unit (ICU) transfer, 30-day hospital readmission, and hospital length of stay (LOS).

KEY RESULTS: The cohort included 2043 hospitalizations cared for by 106 physicians. Overall, 52.1% of patients were treated with antibiotics. Physician antibiotic prescribing ranged from 15.2 to 96.2% (median 69.2%, IQR 50.9 to 76.5). Physician propensity to prescribe antibiotics was not significantly associated with patient-level clinical outcomes, including in-patient mortality (adjusted odds ratio [aOR] 1.05, 95% confidence intervals [CI] = 1.00 to 1.10), ICU transfer (aOR 1.04, 95%CI = 1.00 to 1.09), 30-day readmission (aOR 1.01, 95%CI = 0.99 to 1.02), and hospital LOS (adjusted risk ratio 1.00, 95%CI = 0.99 to 1.00) (all not statistically significant).

CONCLUSIONS: More than half of patients hospitalized to a medical ward with AECOPD without pneumonia were treated with antibiotics. Antibiotic prescribing varied widely across physicians, and greater prescribing was not associated with better outcomes.

PMID:41615524 | DOI:10.1007/s11606-025-10161-0

Cancer Metastasis Rev. 2026 Jan 30;45(1):7. doi: 10.1007/s10555-026-10314-5.

ABSTRACT

Efforts to translate advances in immunology into anti-cancer immunotherapies have progressed rapidly in recent years. Six antibodies acting on programmed death ligand 1 or programmed death 1 pathways were approved in 75 cancer indications between 2015 and 2021. Several of these therapies were granted accelerated approval for specific cancer indications based on evidence from single-arm phase II clinical trials. In the absence of randomization, however, patient prognosis for progression-free and overall survival may not have been studied under standard chemotherapies for PD-1 and PD-L1 biomarker subpopulations. In 2021, two immunotherapies were withdrawn from accelerated approval applications for treatment of metastatic urothelial carcinoma after randomized phase III trials failed to demonstrate evidence for survival advantage over standard of care. This re-analysis uses digitized data to quantify PD-L1 heterogeneity in chemotherapy response, extending prior meta-analyses by incorporating digitized data and design simulation. The findings of the IMvigor210 (NCT02108652) and IMvigor211 (NCT02302807) trials of atezolizumab are reviewed to elucidate the statistical implications of PD-L1 subpopulation heterogeneity. To place the findings into the context of external evidence, digitization software is used to combine results from journal articles of eleven trials that assigned metastatic urothelial carcinoma patients to the same chemotherapy agents administered in the IMvigor211 control arm. This article defines the extent to which PD-L1 IC2/3 subpopulations appeared to outperform historical expectations in the IMvigor211 study based on external evidence from digitized data. Given the extent of PD-L1 heterogeneity suggested by this analysis, trial simulation is applied to define the probability that IMvigor211 would have resulted in a positive trial based on its actual design and alternative designs that enrolled more IC2/3 patients or had longer durations.

PMID:41615520 | DOI:10.1007/s10555-026-10314-5

Int Ophthalmol. 2026 Jan 30;46(1):89. doi: 10.1007/s10792-026-03948-5.

ABSTRACT

PURPOSE: Prospective randomized single-blinded study of 261 cataract patients to investigate the influence of different instruments and techniques in continuous curvilinear capsulorhexis (CCC) on the stability of the anterior chamber using intraoperative rebound tonometry.

METHODS: The study included 261 eyes allocated to six groups according to three ophthalmic viscoelastic device (OVD) conditions-hyaluronic acid (HA), hydroxypropylmethylcellulose (HPMC), and their combination via the soft-shell technique (SST)-and two instruments (Utrata forceps UF and a 26-G cystotome RN). Intraocular pressure (IOP) was measured before and after CCC using rebound tonometry with sterilized probes.

RESULTS: IOP reached 78.6 mmHg in the RN group and 76.5 mmHg in the UF group after OVD instillation and after the creation of the CCC. The mean IOP drop during capsulorhexis was significantly greater with UF (67.1 ± 12.3 mmHg; n = 117) compared to RN (56.5 ± 11.6 mmHg; n = 144) (P < 0.001).

CONCLUSION: The results of this study showed a statistically significant difference in the stability of the anterior chamber depending on the instrument used. The use of different OVDs had no statistically significant influence on anterior chamber stability. Maintaining a more stable IOP with a 26-gauge cystotome may be advantageous in complex cases, such as increased posterior vitreous pressure, zonular weakness or heightened intracapsular pressure.

PMID:41615516 | DOI:10.1007/s10792-026-03948-5

World J Urol. 2026 Jan 30;44(1):139. doi: 10.1007/s00345-025-05923-8.

ABSTRACT

OBJECTIVE: To describe the demographic profile and risk factors for kidney stone formation in patients with sarcoidosis.

MATERIAL AND METHODS: 158 sarcoidosis patients were analyzed, comparing groups with and without kidney stones evaluating clinical and metabolic factors and medication use. Statistical analysis was carried out using R software (p < 0.05).

RESULTS: The sample consisted of 138 patients (87.34%), with a majority of females (67.4%) and a median age of 54. Frequent comorbidities included hypertension (38.4%), diabetes (18.1%), and dyslipidemia (6.5%). Nephrolithiasis was reported by 11.9% of patients. Laboratory tests showed hypercalcemia in 9.4% and hypercalciuria in 17.4%. Kidney stones were found in 15.9% of patients, three of whom were bilateral. The comparative analysis revealed a significant association with a previous history of nephrolithiasis (40% vs. 6.6%). There was no statistical correlation with laboratory tests, except for uric acid, which was lower in the group with stones. Hydroxychloroquine was more frequent in the group with stones but without statistical significance. Logistic regression did not identify any significant associations.

CONCLUSION: Nephrolithiasis occurred in 16% of sarcoidosis patients and was more prevalent in women and adults. Calcium disturbances persist, requiring continuous monitoring. A history of renal lithiasis should be valued in diagnosis and follow-up.

PMID:41615515 | DOI:10.1007/s00345-025-05923-8