Category: Nevin Manimala

J Gastrointest Cancer. 2025 Sep 20;56(1):190. doi: 10.1007/s12029-025-01313-w.

ABSTRACT

PURPOSE: Small bowel (SB) capsule endoscopy (CE) is a well-established investigation for suspected SB pathology, but little research has evaluated the diagnostic miss rate of SB cancer. This Australian study sought to assess the risk of developing SB cancer within 36 months of a cancer-negative CE (PCSBC-3Y) using a novel root-cause analysis (RCA) method.

METHODS: Using a prospective CE database and data linkage with a population-based state cancer registry, the PCSBC-3Y rate was evaluated in consecutive patients undergoing CE between 2007 and 2019. SB cancers diagnosed or suspected from CE were defined as ‘detected cancers’, whilst those diagnosed within 36 months of a negative CE were defined as ‘missed cancers’. Descriptive statistics summarised characteristics for all diagnosed SB cancers. All PCSBC-3Y cases were evaluated by RCA.

RESULTS: A total of 20 patients were diagnosed with SB cancer within 36 months of CE, comprising of 18 detected cancers and two missed cancers. The overall PCSBC-3Y rate was 10% (95% CI 2.6-28.7%). The two missed cancers included one jejunal gastrointestinal stromal tumour and one duodenal adenocarcinoma. RCA revealed both missed cancers to be unavoidable, as the SB was normal on two retrospective reviews of the CE video recordings.

CONCLUSION: This study introduces the concept of measuring the PCSBC-3Y rate and a novel algorithm of RCA. In our quaternary referral CE cohort, the PCSBC-3Y rate was 10%. A subsequent RCA suggested that the two missed cancers were unavoidable.

PMID:40974481 | DOI:10.1007/s12029-025-01313-w

Biodegradation. 2025 Sep 20;36(5):89. doi: 10.1007/s10532-025-10185-7.

ABSTRACT

Sanitary landfilling remains a cost-effective waste management strategy, employing engineered liners and leachate collection systems to mitigate environmental pollution. However, long-term degradation of compacted clay baseliners (CCLs) poses risks to environmental safety and groundwater quality. This study investigated seasonal and habitat-specific microbial communities within CCLs and leachate from the Pulau Burung Sanitary Landfill, Pinang, Malaysia, utilizing 16S rRNA gene amplicon sequencing and functional prediction via PICRUSt2. Triplicate samples were collected from leachate and baseliner layers (0-30 cm depth) during both rainy and dry seasons, alongside assessments of physicochemical properties and permeability. Significant seasonal differences (p < 0.05) were observed in the physicochemical profiles of leachate and baseliner samples. Baseliner microbiomes exhibited greater compositional stability and smaller beta-diversity shifts compared to the more dynamic leachate communities. Alpha diversity increased in both matrices during the dry season, although changes in baseliner richness were not statistically significant (p > 0.05). Microbial community shifts were primarily driven by seasonal variations in environmental parameters. Core phyla shared across both habitats included Pseudomonadota (31.15-45.88%), Bacillota (8.58-31.15%), Actinobacteriota (6.22-19.58%), Acidobacteriota (0.16-15.85%), Chloroflexota (0.85-13.84%), and Bacteroidota (1.38-12.74%). Additional phyla such as Patescibacteria (0.77-2.06%), Cyanobacteria (0.12-6.16%), Desulfobacterota (0.77-5.38%), and Verrucomicrobiota (0.59-2.33%) showed matrix-specific enrichment. Functional prediction revealed distinct enzyme profiles and metabolic pathway enrichment. Anaerobic genera such as Geobacter, Desulfuromonas, Desulfuromusa, Pseudopelobacter, Desulfotomaculum, Clostridium, Desulfitobacterium, Telmatospirillum, and Dethiobacter were associated with redox cycling and mineral-transforming processes, suggesting potential contributions to increased clay porosity and reduced structural integrity. These findings demonstrate the ecological and functional complexity of landfill microbiomes and their potential role in compromising barrier performance. The study recommends routine monitoring of microbial functional genes and the development of biogeochemically resilient clay blends or in situ biobarriers to enhance long-term containment efficacy.

PMID:40974475 | DOI:10.1007/s10532-025-10185-7

Clin Transl Allergy. 2025 Sep;15(9):e70103. doi: 10.1002/clt2.70103.

ABSTRACT

BACKGROUND: Cefaclor is a commonly prescribed β-lactam antibiotic and a known major cause of immediate-type drug hypersensitivity in Korea. However, its genetic risk factors remain poorly understood. We aimed to identify genetic variants associated with cefaclor-induced anaphylaxis and evaluate their potential clinical implications.

METHODS: Whole-exome sequencing and HLA genotyping were performed in 33 patients with cefaclor-induced anaphylaxis and 41 drug-tolerant controls. Associations were assessed using logistic regression. Selected variants were validated in an independent Korean population. Gene set enrichment analysis (GSEA) was performed using association statistics from all variants to investigate relevant biological pathways.

RESULTS: A rare missense variant, rs765144578 in TPSAB1 was strongly associated with anaphylaxis and remained significant in the validation control group. It was found in 90.91% of patients with hypotension, suggesting a link to reaction severity. Rs192498095 in HLA-DRB5 showed a significant association in the discovery cohort. However, it was not detected in the replication set, likely due to its rarity and polymorphic nature. Co-occurrence of rs765144578 in TPSAB1 and rs192498095 in HLA-DRB5 markedly increased risk. GSEA revealed significant enrichment of the TNF-α signaling via NF-κB pathway, reflecting pathway-level immune activation.

CONCLUSION: Genetic variants in TPSAB1 and HLA-DRB5 may contribute to the risk of cefaclor-induced anaphylaxis, and TPSAB1 may also be associated with severity. These findings may support the development of future screening strategies or individualized risk prediction models in β-lactam allergy.

PMID:40974473 | DOI:10.1002/clt2.70103

J Assist Reprod Genet. 2025 Sep 20. doi: 10.1007/s10815-025-03675-3. Online ahead of print.

ABSTRACT

PURPOSE: To investigate whether re-biopsy and re-vitrification affect embryo developmental potential and clinical outcomes.

METHODS: Embryos that underwent preimplantation genetic testing for aneuploidy (PGT-A) and single embryo transfer between December 2017 and April 2024 were studied. All embryos were categorized into three groups: fresh biopsy and vitrification (BV group; n = 346); thawed, biopsied, and subsequently vitrified (VBV group; n = 12); fresh biopsied, vitrified, further thawed and biopsied again due to inconclusive results from the previous biopsy (BVBV group; n = 19). The live birth rate and miscarriage rate will be evaluated after embryo transfer in each group.

RESULTS: Live birth rate (LBR) was not statistically significant among the BV group (50.00%), VBV group [41.67%; adjusted relative risks (aRR) 0.96; 95% confidence interval (95% CI): 0.81-1.14], and BVBV group (42.11%; aRR 0.97, 95% CI: 0.83-1.13). The miscarriage rate was not statistically significant: BV group (11.27%); VBV group (25%; aRR 1.09, 95% CI: 0.95-1.25), and BVBV group (5.26%; aRR 0.97, 95% CI: 0.91-1.02).

CONCLUSIONS: The differences in LBR and miscarriage rates among the groups were not statistically significant. However, the limited sample sizes of the VBV and BVBV groups cannot rule out the possibility of moderate differences. Some embryos can be successfully salvaged, leading to live births. To minimize inconclusive results, the laboratory should refine the procedural details.

PMID:40974472 | DOI:10.1007/s10815-025-03675-3

Eur J Pediatr. 2025 Sep 20;184(10):627. doi: 10.1007/s00431-025-06416-x.

ABSTRACT

Tenosynovial giant cell tumour (TGCT) is a benign fibrohistiocytic proliferation that can lead to intraarticular inflammation causing secondary degenerative arthropathy. Surgery is the preferred treatment to avoid complications. Paediatric TGCT is rarely reported, mostly in case studies. This revision presents the largest paediatric series. This observational study involved 24 paediatric patients reported between 1998 and 2023 with confirmed histological diagnosis of TGCT. Descriptive statistics were used for analysis. Twenty-four patients (mean age 12.25 years, SD 3.78; 1:1 gender ratio) were included with the anatomopathological diagnosis of TGCT. The knee was the most affected joint (75%), with localized nodular presentation (66.7%). Initial symptoms were mechanical pain in all patients, joint effusion in 79.1%, and limp in 25%. Mean duration of symptom duration before diagnosis was 9 months (range 4-15). Magnetic Resonance Imaging (MRI) findings were consistent with TGCT in all cases, and alter confirmed by arthroscopic biopsy. Radiographs showed soft tissue changes in five patients. Treatment included arthroscopic synovectomy (70.8%) or open surgery (29.2%). Over a mean follow-up of 98 months (range 6-288), six recurrences occurred, all with diffuse presentation at the knee.

CONCLUSION: MRI is the preferred method for diagnosis and follow-up. Surgery is the main treatment, with low recurrence if nodular lesions are accurately removed. Outcomes and recurrence depend on diffuse presentation. We recommend open surgery for recurrences and local adjuvant treatment.

WHAT IS KNOWN: • Tenosynovial Giant Cell Tumour (TGCT) is an uncommon benign synovial lesion usually described as isolated case reports in children. • MRI is the preferred imaging technique due its superior tissue contrast and ability to differentiate diffuse and localized forms.

WHAT IS NEW: • We present the largest known pediatric series of TGCT including 24 histolgically confirmed cases and with outcome data. • The study provides insight into recurrence patterns and supports a tailored surgical approach based on lesion type.

PMID:40974423 | DOI:10.1007/s00431-025-06416-x

Int Arch Occup Environ Health. 2025 Sep 20. doi: 10.1007/s00420-025-02170-7. Online ahead of print.

ABSTRACT

PURPOSE: After vision, hearing is the most important sensory mechanism for obtaining essential and critical information during flight operations. Pilots are at risk of hearing loss due to exposure to excessive noise which usually causes permanent and incurable hearing damage. This study investigated the hearing status of Iranian pilots and explored the relationship between the severity of their impairment, age, work experience and flight hours.

METHODS: In this cross-sectional study, eligible pilots were selected. Demographic information, job characteristics, flight hours and auditory complaints were collected. Subsequently, the pilots underwent hearing tests (Pure tone Audiometry) and the hearing threshold was measured at different frequencies.

RESULTS: the study involved 100 pilots (57 fixed-wing pilots and 43 helicopter pilots) with the mean age of 47.77 ± 7.53 years (28-64 years). The average and standard deviation of work experience in all the studied subjects was equal to 24.84 ± 8.44 years. 55 pilots had no auditory impairments, while 45 were diagnosed with some form of hearing impairment. The findings indicate that older age, longer work experience, and more flight hours are significantly associated with greater hearing impairments. Individuals with any level of hearing impairment (slight to mild) had higher age, more work experience, and flight hours compared to those with normal hearing. Helicopter pilots exhibited higher hearing loss severity across frequencies compared to fixed-wing pilots, with statistically significant differences at 2000 Hz for the left ear and 1000, 2000, and 3000 Hz for the right ear. The comparison between the two ears showed that the hearing threshold in any of the flight devices (fixed wing or helicopter), in any of the investigated frequencies, has no significant difference between the left and right ears.

CONCLUSION: Exposure to loud noise during flights can significantly impact the hearing of pilots. The severity of hearing loss in helicopter pilots is higher across all frequencies compared to fixed-wing pilots. Increased age, work experience, and flight hours are significantly associated with higher severity of hearing loss in both ears. Regular auditory assessments for pilots, especially helicopter pilots, are essential for early detection and monitoring of noise-induced hearing loss.

PMID:40974421 | DOI:10.1007/s00420-025-02170-7

Lasers Med Sci. 2025 Sep 20;40(1):376. doi: 10.1007/s10103-025-04650-1.

ABSTRACT

The introduction of diode semiconductor lasers operating in the infrared spectrum has significantly advanced dental practice, elevating it to a new level of clinical efficiency. These technologies enable treatment methods that markedly reduce patient recovery time. Laser wavelengths of 810 ± 10 nm and 980 ± 10 nm are widely utilized in laser surgery and photobiomodulation. Of growing interest is the potential use of laser irradiation at a wavelength of 445 nm for photobiomodulation of oral mucosal tissues in cases of periodontal diseases and stomatitis. Using laser Doppler flowmetry, we demonstrated the effectiveness of non-ablative blue laser application to the gingival area in 20 healthy volunteers aged 22.9 ± 0.8 years. A statistical analysis was conducted to assess gingival microcirculation parameters, including peripheral blood flow, peripheral lymphatic flow, tissue fluorescence amplitude at 460 nm (NADH coenzyme), and at 515 nm (FAD coenzyme). Oxidative metabolism index was calculated using a specific formula. Following a 1-minute low-level laser irradiation session, a statistically significant average increase of 3.07 perfusion units in microcirculation was observed. Lymphatic perfusion values decreased by an average of 0.04 perfusion units. The oxidative metabolism index increased by an average of 0.16 perfusion units post-procedure. The observed enhancement in blood flow velocity and oxidative metabolism index in gingival tissues after exposure to 445 nm wavelength laser irradiation at 0.1 W confirms the therapeutic potential of blue laser technology.

PMID:40974420 | DOI:10.1007/s10103-025-04650-1

Support Care Cancer. 2025 Sep 20;33(10):867. doi: 10.1007/s00520-025-09922-8.

ABSTRACT

PURPOSE: Second opinions are increasingly sought by patients, particularly in complex and life-altering conditions such as gastrointestinal (GI) cancers, to ensure confidence in their diagnosis and treatment plans or to seek therapeutic trials.

METHODS: This retrospective study analyzed second-opinion requests handled by the GI oncology team in our institution between January and March 2024, examining the types of questions raised, patient characteristics, and their impact on clinical decision-making.

RESULTS: Of 261 eligible patients, 259 were included in this analysis. Most patients had metastatic disease (86%), and 51% had received at least two lines of prior treatment. Requests were predominantly submitted by oncologists (63%), with a significant proportion (41%) coming from outside academic centers. General practitioners (GPs) accounted for 37% of the submissions, often with incomplete records (86% completeness vs. 99% for oncologists; p < 0.01). The median age at diagnosis was 60 years, with younger patients being more frequently referred by oncologists (57.0 vs. 62.5 years, p < 0.001). The most common diagnoses were pancreatic (29%) and colorectal (27%) cancers. Second-opinion requests focused on therapeutic management (73%) and access to clinical trials (60%). Therapeutic decisions were in line with the standard of care in 93% of the cases, while 15% received alternative recommendations, such as intrahepatic arterial infusion or targeted therapies. However, participation in therapeutic trials (1.2%) and molecular screening (2.7%) was seldom offered to patients, highlighting the need for better tools to access trials. Importantly, palliative care decisions were upheld in 95% of the specific requests.

CONCLUSION: This study demonstrates the potential value of structured second-opinion pathways in ensuring adherence to evidence-based care and addressing patient concerns. However, improving GP support, reducing referral delays, and optimizing access to trials remain critical for improving outcomes in patients with advanced GI cancer.

PMID:40974415 | DOI:10.1007/s00520-025-09922-8

Environ Monit Assess. 2025 Sep 20;197(10):1127. doi: 10.1007/s10661-025-14541-1.

ABSTRACT

Climate change has emerged as one of the most pressing issues of the twenty-first century. Its induced disasters have posed significant threats to social, economic and environmental systems on the planet earth. Thus, the understanding of implications of climate change is crucial for developing effective mitigation and adaptation strategies. Climate change-induced flood has caused significant economic and environmental losses. This review paper synthesises the state of knowledge on flood susceptibility, vulnerability and risk for identifying research gaps and recommending future research. We collected the articles on the research domains through Web of Science and Scopus search engines to create a coherent database for analysis. A total of 156 research articles were Analysed after the exclusion criteria for the state of research. A bibliometric and systematic analyses were carried out for examining the trend in the publication, frequency of keywords, scale and distribution of studies during 1990-2023. The major emphasis of the review was on conceptualisation, approaches and methods used for analysing flood susceptibility, vulnerability and risk. The findings of this study revealed that most of the reviewed research papers were focused on flood susceptibility, risk and vulnerability while less attempts have been made on flood perception, flood resilience and flood management. The effectiveness of flood resilience, community-based initiatives and policy frameworks for sustainable flood management has been explored for the holistic and interdisciplinary approach. This paper emphasises the necessity of collaboration between policymakers, scientists and local communities to develop adaptive and resilient flood management strategies for future research direction. The insights of this study may help to build more resilient communities in the face of increasing flood-related challenges.

PMID:40974414 | DOI:10.1007/s10661-025-14541-1

Neuroradiology. 2025 Sep 20. doi: 10.1007/s00234-025-03776-x. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the effectiveness of the Fast 3D wheel (Fast 3Dw) technique in cerebral magnetic resonance angiography (MRA) and compare it with the conventional parallel imaging (PI) technique. The primary objective was to determine whether Fast 3Dw could reduce the examination time while maintaining image quality and diagnostic accuracy in patients with cerebral aneurysms.

METHODS: This retrospective study included 50 patients with unruptured cerebral aneurysms who underwent 3D time-of-flight MRA using either PI or Fast 3Dw techniques on a 3T magnetic resonance imaging scanner. The image quality was quantitatively assessed using the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), aneurysm diameter, and vessel diameter. Qualitative image assessments included vascular clarity, artifacts, and diagnostic confidence level and were evaluated using a 5-point scale. Statistical comparisons were performed using t-tests, Wilcoxon signed-rank tests, and weighted kappa statistics.

RESULTS: The mean examination time for Fast 3Dw (171.5 ± 4.9 s) was significantly shorter than that for PI (383.8 ± 13.2 s; p < 0.05). Fast 3Dw exhibited a significantly higher SNR (50.0 ± 14.2) than PI (46.6 ± 12.9; p < 0.05), while CNR showed no significant difference between the two techniques. No significant differences in aneurysm diameters and vessel diameters were observed between the two methods. Qualitative evaluations demonstrated no significant differences in vascular clarity, artifacts, and diagnostic confidence levels between the two methods.

CONCLUSION: The Fast 3Dw technique significantly reduces examination time while maintaining image quality and diagnostic accuracy in cerebral MRA compared to PI. This method may be a viable alternative for routine cerebral MRA in clinical practice.

PMID:40974398 | DOI:10.1007/s00234-025-03776-x