Category: Nevin Manimala

Cancer Med. 2026 Jun;15(6):e72042. doi: 10.1002/cam4.72042.

ABSTRACT

BACKGROUND: Many testicular cancer patients of reproductive age experience reproductive concerns. Metacognitions may alleviate patients’ fear of progression and reproductive concerns. However, this relationship has not been well established in testicular cancer patients of reproductive age.

OBJECTIVE: This study examines the level of reproductive concerns and explores how fear of progression mediates the relationship between metacognitions and reproductive concerns in testicular cancer patients of reproductive age in China.

METHODS: This study employed a quantitative cross-sectional design and was reported in accordance with the STROBE guidelines for observational research. A convenience sample of 192 testicular cancer patients of reproductive age was recruited from a tertiary specialized oncology hospital in Guangzhou, Guangdong, China. Data were collected through the WeChat mini program “Questionnaire Star” using “the general data questionnaire”, the Metacognitions Questionnaire-30 (MCQ-30), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and the Reproductive Concerns After Cancer-Male scale (RCAC-M) instruments. The data were analyzed using descriptive statistics, Pearson correlation analyses, and simple mediation effect analysis via the PROCESS macro program.

RESULTS: Reproductive concerns were at a moderate level (57.86 ± 10.93), and positively associated with metacognitions (r = 0.358, p < 0.001) and fear of progression (r = 0.523, p < 0.001). Mediation analysis revealed that metacognitions had a total effect path coefficient of 0.317 on reproductive concerns (bootstrap 95% CI: 0.202-0.432). The direct effect path coefficient was 0.152 (bootstrap 95% CI: 0.026-0.277), while the mediating effect through fear of progression was 0.166 (bootstrap 95% CI: 0.094-0.239), representing 52.4% of the total effect.

CONCLUSIONS: In testicular cancer patients of reproductive age, metacognitions are significantly associated with reproductive concerns, and fear of progression acts as a mediating factor. Interventions aimed at improving metacognition levels and reducing fear of progression may help alleviate reproductive concerns in this population.

PMID:42298302 | DOI:10.1002/cam4.72042

J Am Med Inform Assoc. 2026 Jun 16:ocag083. doi: 10.1093/jamia/ocag083. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop privacy-enhancing statistical methods for estimating disease risk parameters across multiple electronic health record (EHR) sites with heterogeneous selection mechanisms, avoiding individual-level data sharing. We illustrate their utility via a cross-biobank analysis of smoking and 97 cancer subtypes using NIH All of Us (AOU) and Michigan Genomics Initiative (MGI) data sites.

MATERIALS AND METHODS: Distributed health platforms often render centralized algorithms infeasible due to patient privacy protection. We propose Sequential Pseudo-Likelihood (SPL) and Sequential Augmented Inverse Probability Weighting (SAIPW) to adjust for selection bias using summary statistics shared across sites and external population information. SAIPW employs flexible auxiliary models for multiple robustness. We compared SPL and SAIPW against unweighted and centralized/meta-learning benchmarks in simulations, applying them to harmonized MGI (n = 50 935) and AOU (n = 241 563) data.

RESULTS: Unweighted estimators exhibited substantial bias. SPL and SAIPW yielded unbiased estimates with valid coverage, with SAIPW remaining robust to selection model misspecification. Both approaches showed negligible efficiency loss relative to centralized methods. Meta-learning methods proved unstable for rare outcomes. Real-data analyses consistently identified strong associations between smoking and lung, bladder, and larynx cancers.

DISCUSSION: These findings highlight the necessity of adjusting for site-specific selection biases in distributed health networks. SPL and SAIPW offer practical, scalable solutions that bypass the instability of meta-analysis for rare events, successfully harmonizing diverse biobanks while strictly enhancing patient privacy.

CONCLUSION: Our framework enables valid, privacy-enhancing inference across EHR sites subject to heterogeneous selection, facilitating scalable, distributed research using real-world data.

PMID:42298300 | DOI:10.1093/jamia/ocag083

J Robot Surg. 2026 Jun 16;20(1):588. doi: 10.1007/s11701-026-03607-y.

ABSTRACT

To compare textbook outcome (TO) and postoperative pain trajectories between reduced-port robotic distal gastrectomy (rpRDG) and conventional robotic distal gastrectomy (cRDG) for gastric cancer (GC). This retrospective cohort study analyzed patients who underwent robotic distal gastrectomy for GC between September 2022 and March 2026 at a single tertiary center. Cumulative sum (CUSUM) analysis was applied to exclude 30 cases representing the initial learning curve, yielding 107 patients (cRDG, n = 60; rpRDG, n = 47). Following 1:1 propensity score matching (PSM), 39 matched pairs were analyzed. The primary endpoint was TO achievement; secondary endpoints included operative time, estimated blood loss (EBL), retrieved lymph nodes, and postoperative pain assessed by numeric rating scale (NRS) from postoperative day (POD) 1 to 3. The two groups were well-balanced after PSM (all absolute standardized mean differences < 0.1). TO achievement rates were comparable between groups (cRDG: 79.49% vs. rpRDG: 87.18%, p = 0.3621), with no significant differences in operative time (264.97 vs. 246.23 min, p = 0.0808), EBL (47.05 vs. 43.21mL, p = 0.7088), or retrieved lymph nodes (34.67 vs. 38.92, p = 0.2686). A linear mixed-effects model revealed a significant group-by-time interaction in pain scores (p = 0.0044), and the rpRDG group reported significantly lower NRS scores on POD 1 (2.62 vs. 3.13, p = 0.0155). rpRDG demonstrated comparable surgical and oncologic outcomes to cRDG, with statistically significant reduction in early postoperative pain on POD 1, representing a meaningful marginal gain within an ERAS-optimized setting. These findings support rpRDG as a feasible, patient-centered alternative warranting further multicenter validation.

PMID:42298275 | DOI:10.1007/s11701-026-03607-y

Biol Trace Elem Res. 2026 Jun 15. doi: 10.1007/s12011-026-05174-7. Online ahead of print.

ABSTRACT

Maize flour is widely consumed in Turkey and may contain trace elements originating from agricultural practices and environmental contamination during cultivation, processing, and storage. This study aimed to determine the concentrations of Fe, Zn, Cu, Ni, Mn, Cd, and Cr in 20 commercially available maize flour samples using Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES). In addition, potential non-carcinogenic health risks associated with maize flour consumption were evaluated. The accuracy and reliability of the analytical procedure were verified using certified reference material analysis and quality control procedures. The mean concentrations of Fe, Zn, Cu, Ni, and Mn in the analyzed samples were found to be 18.5, 13.1, 1.7, 0.2, and 3.9 mg/kg, respectively, while Cd and Cr concentrations were below the detection limits. The obtained concentrations were evaluated according to international regulatory limits and previously reported literature data. Non-carcinogenic health risk assessment was conducted using hazard quotient (HQ) and hazard index (HI) values, and the results indicated that the detected trace element concentrations are unlikely to pose significant non-carcinogenic health risks to consumers. In addition, descriptive statistical analysis, Spearman’s rank correlation analysis, and Principal Component Analysis (PCA) were performed to evaluate the distribution characteristics of the analyzed elements, investigate relationships among trace elements, and identify possible common sources. These findings may provide baseline data for future studies on trace element levels and dietary exposure assessment of maize flour consumed in Turkey.

PMID:42298271 | DOI:10.1007/s12011-026-05174-7

Neurosurg Rev. 2026 Jun 16;49(1):448. doi: 10.1007/s10143-026-04365-z.

ABSTRACT

Glioblastoma is an aggressive form of brain cancer and poses a challenge in treatment due to its profound heterogeneity and capacity for extensive infiltration into the brain parenchyma. Research has shown glioblastomas near the ependyma have poorer survival rates. Therefore, our aim was to identify distinct molecular features of glioblastoma invading the ependyma of lateral ventricles and neural stem cell region and the survival prognosis of these patients. A retrospective review of 170 patients with a new histologically confirmed diagnosis of glioblastoma between 2018 and 2019. Patients were excluded if they were less than 18-years-old, did not have a histological diagnosis, or had missing data. Overall survival (OS) data was analysed. Statistical analysis included Kaplan-Meier survival curves, log rank tests and Cox regression. A total of 170 patients were included (mean age 61 ± 11.3 years; 54% male). Tumours contacted the ependyma in 69 patients and did not in 101. The most common tumour locations were temporal (31%), frontal (29%), and parietal (21%) lobes. Preoperatively, 65% had a performance status of 0-1. Biopsy alone was performed in 19%, subtotal resection (STR) in 48%, and gross total resection (GTR) in 32%; GTR was more common in non-ependyma contacting tumours (40% vs. 20%). MGMT promoter was unmethylated in 64% of patients. Mean overall survival was significantly lower in patients with ependymal contact compared with non-contacting tumours (11.9 vs. 17.4 months, p = 0.004). On multivariable analysis, ependymal contact remained independently associated with poorer survival. No significant association was found between MGMT status and ependymal contact or tumour epicentre distance. Overall, our study reinforces the prognostic relevance of glioblastoma contact with the ependymal and subventricular zones. Tumours involving these regions were associated with poorer overall survival.

PMID:42298219 | DOI:10.1007/s10143-026-04365-z

Environ Monit Assess. 2026 Jun 15;198(7):727. doi: 10.1007/s10661-026-15577-7.

ABSTRACT

This study investigates the combined effects of precipitation and landfill age on leachate characteristics using one-way ANOVA to identify statistically significant differences among impact groups. The primary objective is to evaluate how climatic conditions and landfill age jointly influence both organic and inorganic leachate constituents. The results indicate that precipitation acts as a dominant controlling factor, although its influence is strongly modulated by landfill age and site-specific conditions. In low-precipitation climates, statistically significant temporal variations were observed in organic parameters (COD, BOD, and BOD/COD), particularly during the early stages of landfilling. In contrast, no statistically significant age-related differences were detected in high-precipitation regions, suggesting that dilution and wash-out mechanisms dominate over time-dependent biological processes. For inorganic constituents, chloride and ammonia exhibit weak or inconsistent statistical differences, while calcium and selected metals show more complex, non-linear behavior. These findings demonstrate that one-way ANOVA is an effective tool for identifying parameters sensitive to climatic and temporal factors, while also revealing parameters that are statistically unaffected by such influences. Overall, the results confirm that landfill age plays a significant role in shaping leachate composition in dry climates, whereas hydrological processes are the dominant controlling factors in wet climates.

PMID:42298217 | DOI:10.1007/s10661-026-15577-7

Aesthetic Plast Surg. 2026 Jun 15. doi: 10.1007/s00266-026-05984-z. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative hypertrophic scarring represents a prevalent clinical challenge, with current therapeutic approaches demonstrating limited efficacy. Previous studies have confirmed the scar-inhibitory properties of Botulinum toxin type A (BTA), though its precise molecular mechanisms require further elucidation. This study aims to explore the molecular pathways through which BTA attenuates hypertrophic scar formation using an established auricular cicatricial model in rabbits.

METHODS: Sixteen healthy New Zealand white rabbits underwent hypertrophic scar modeling. Post-modeling, therapeutic interventions were administered as follows: BTA (4U) was injected at the edge of the wound in the BTA group and the combined group, whereas, decorin (50 µg) was injected at the edge of the wound in the decorin group and the combined group. Decorin administration was repeated following a seven-day interval. The control group was administered an equivalent volume of normal saline. The scar height, collagen deposition and TGF-β1 expression level were measured by histological examination. Protein expression profiles were evaluated through immunoblotting techniques.

RESULTS: Our results revealed that hypertrophic scars were reduced in all treatment groups compared with the control group. BTA- and/or decorin-treated group had lower scar height, collagen deposition and TGF-β1 expression level at week 4 and week 8. BTA and/or decorin effectively suppressed the Smad2/3 phosphorylation cascade, inhibited MMP2 enzymatic activity, and reduced the protein expression of α-SMA and collagen I.

CONCLUSION: BTA improves the appearance of scar, reduces collagen deposition, and decreases the degree of scar formation by inhibiting the TGF-β1/Smad signaling pathway in a rabbit ear model.

NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:42298167 | DOI:10.1007/s00266-026-05984-z

Aesthetic Plast Surg. 2026 Jun 15. doi: 10.1007/s00266-026-06068-8. Online ahead of print.

ABSTRACT

BACKGROUND: Regional fascial plane blocks are widely used in breast surgery for postoperative analgesia. While analgesic benefits are established, their impact on early complications after reduction mammaplasty remains unclear.

OBJECTIVE: To evaluate the association between regional fascial plane block use and early postoperative complications following superior pedicle reduction mammaplasty.

METHODS: This retrospective cohort study included 144 consecutive patients undergoing primary bilateral superior pedicle reduction mammaplasty at a single tertiary center. Patients were grouped as block (n=64) or no-block (n=80). All blocks were performed postoperatively at the end of surgery. The primary outcome was a 30-day composite complication, defined as hematoma requiring reoperation, wound dehiscence, or surgical site infection. Multivariable logistic regression assessed the independent association between block use and complications.

RESULTS: Overall, 55 patients (38.2%) developed at least one early postoperative complication. The composite complication rate was higher in the block group than in the no-block group (46.9% vs. 31.3%); however, this difference did not reach statistical significance (p=0.060). In multivariable analysis, block use was not independently associated with complications, whereas total excision weight was the only significant predictor. Hematomas occurred only in the block group (7.8% vs. 0%, p=0.016).

CONCLUSIONS: Regional fascial plane block use was not independently associated with overall postoperative morbidity after adjustment. Although hematomas were observed only in the block group, the low event rate and non-randomized design preclude causal inference. However, a relevant increase in overall complication risk cannot be ruled out; therefore, further prospective studies are needed to clarify this relationship.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:42298165 | DOI:10.1007/s00266-026-06068-8

Aesthetic Plast Surg. 2026 Jun 15. doi: 10.1007/s00266-026-05991-0. Online ahead of print.

ABSTRACT

BACKGROUND: Brazilian Butt Lift (BBL), liposuction, and abdominoplasty are increasingly being performed in combination to enhance esthetic results and reduce recovery time. However, this approach may lead to prolonged surgical times, complex anesthesia management, and an increased risk of potential complications. This study aims to evaluate the relationship between intraoperative variables and postoperative complications in patients undergoing combined body contouring surgery.

METHODS: A total of 1120 patients who underwent esthetic surgery between 2020 and 2025 were included in this retrospective cohort study. Patients were divided into two groups: Group 1 (n = 550) underwent BBL, liposuction, and abdominoplasty; Group 2 (n = 570) underwent only BBL and liposuction. Demographic data, intraoperative parameters, laboratory values, and postoperative complications were analyzed. Multivariate logistic regression and ROC analyses were performed to identify factors predicting complications.

RESULTS: In Group 1, the duration of surgery, amount of crystalloid fluid administered, volume of aspirate removed by liposuction, amount of fat injected, and urine output were significantly higher (p < 0.001). The total complication rate was 0.8%, with postoperative complications developing in only 9 patients. Three of these patients (33.3%) had a history of bariatric surgery. In the logistic regression analysis, prolonged surgical duration (OR = 2.12) and a history of surgery (OR = 1.87) were associated with the development of complications; however, neither reached statistical significance (p > 0.05). In the ROC analysis (multivariate), the model’s discriminatory power was high (AUC = 0.94).

CONCLUSIONS: Combined esthetic surgeries appear to be safe when performed by an experienced surgical-anesthesia team with close intraoperative monitoring. Surgical duration and previous surgical history may be associated with complications; however, larger prospective studies are needed to confirm these findings.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:42298152 | DOI:10.1007/s00266-026-05991-0

Eur Radiol. 2026 Jun 16. doi: 10.1007/s00330-026-12688-0. Online ahead of print.

NO ABSTRACT

PMID:42298150 | DOI:10.1007/s00330-026-12688-0