Nevin Manimala

J Cancer Surviv. 2025 Jun 19. doi: 10.1007/s11764-025-01850-0. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to explore the integration of American Society of Clinical Oncology (ASCO) guidelines for fertility discussion in clinical practice.

METHODS: A concurrent triangulation mixed methods design was used. We recruited oncologists from an NCI-designated Comprehensive Cancer Center who treat adolescents and young adults (AYAs) at risk for infertility to participate in a semi-structured qualitative interview and conducted a thematic analysis. Simultaneously, self-report fertility-related data were collected from AYAs (age 18-39) diagnosed at the same institution via self-report survey and were analyzed using descriptive statistics.

RESULTS: Themes reported by oncologists (N = 12; 66.7% female, on average in practice for 14.3 years) included a lack of oncofertility-related training and limited knowledge surrounding fertility discussion guidelines. Those who were aware of guidelines stated that they informed their discussions. Oncologists’ perceptions of fertility discussion guidelines were largely positive, though reservations were expressed. Discussions were primarily informed by patient needs and research/literature, but seldom by oncologists’ explicit training or experience in oncofertility. Among AYAs (N = 58; 53.5% female, 35.1% Hispanic, on average 32.0 years at diagnosis), 82.3% had a fertility discussion, 62.6% of which occurred with their oncologist. Fertility discussions occurred at some visits (66.7%), and AYAs were very (39.4%) or moderately (27.3%) satisfied with counseling received. Components of ASCO guidelines most often discussed were the timing of preservation and consideration of individual factors in fertility preservation (66.7% each). Patient advocacy resources (33.3%) and informing them that their cancer history does not increase risk of cancer or birth defects in a child (30.3%) were least often discussed.

CONCLUSION: Awareness of fertility discussion guidelines among oncologists was low, and more than half of AYAs reported only two components of ASCO guidelines were included in fertility discussions with their oncologists. Despite this, AYAs’ overall satisfaction with discussions was moderate to high, suggesting adherence to all guideline components may not be necessary for AYAs to derive benefit. While oncologists reported largely positive perceptions of fertility discussion guidelines, several shared that the guidelines themselves may hinder implementation if they do not capture diverse patient scenarios and/or are outdated.

IMPLICATIONS FOR CANCER SURVIVORS: Findings suggest a need to improve oncologists’ knowledge surrounding guidelines, refine recommendations to optimize oncofertility counseling, and subsequently improve their integration in practice to ensure AYAs are provided with desired and actionable information to support goal-concordant reproductive decisions.

PMID:40536662 | DOI:10.1007/s11764-025-01850-0

Neurol Sci. 2025 Jun 19. doi: 10.1007/s10072-025-08305-5. Online ahead of print.

ABSTRACT

PURPOSE: Sensory impairments are significant contributors to cognitive dysfunction, but the relationship between cognitive decline and various forms of neurosensory degeneration remains poorly understood. This study aimed to evaluate retinal layer neurodegeneration and hearing impairment in the general Korean population using cognitive assessments.

METHODS: This cross-sectional, retrospective study included participants who underwent Optical Coherence Tomography (OCT), Pure Tone Audiometry (PTA), and the Mini-Mental State Examination (MMSE). Participants were categorized into three groups based on MMSE scores: control group (MMSE > 27), mild cognitive impairment (MCI, MMSE 23-27), and dementia group (MMSE < 23). PTA thresholds were computed using the weighted four-frequency average formula (0.5 kHz, 1 kHz, 2 kHz, and 4 kHz). OCT images were analyzed to measure the Ganglion Cell Inner Plexiform Layer (GC-IPL), Peripapillary Retinal Nerve Fiber Layer (ppRNFL), and total macular thickness. These sensory parameters were compared across the three groups.

RESULTS: A total of 196 participants were included, with a mean age of 67.0 ± 10.4 years. MMSE scores showed an inverse correlation with both age and PTA thresholds, and a positive correlation with OCT parameters (all P <.05). After adjusting for age, significant differences in PTA thresholds were observed across all groups. However, significant reductions in OCT parameters and best-corrected visual acuity were only seen in the dementia group compared to the control and MCI groups (all P <.05).

CONCLUSIONS: Sensory assessments are reliable indicators of cognitive function, with hearing loss emerging as a more consistent and sensitive predictor of early functional decline than retinal thickness measurements. Advanced stages of cognitive impairment are closely linked to retinal neurodegeneration and visual impairment, underscoring the importance of careful monitoring and early intervention.

PMID:40536657 | DOI:10.1007/s10072-025-08305-5

Int J Clin Oncol. 2025 Jun 19. doi: 10.1007/s10147-025-02802-5. Online ahead of print.

ABSTRACT

BACKGROUND: Comprehensive genomic profiling (CGP) is essential for precision medicine, but early mortality remains a concern for patients undergoing CGP. This study aimed to identify risk factors for early mortality and develop a prediction model for gastrointestinal (GI) malignancies on the basis of data from the Japanese C-CAT database.

METHODS: Data from 18,657 patients with pancreatic, biliary, colorectal, and upper GI cancers were collected from the C-CAT database and retrospectively analyzed. Early mortality was defined as mortality within 90 days after CGP submission. A prediction model was constructed via weighted scoring of clinical factors, and the model was subsequently validated. Survival analysis was conducted to assess the utility of this model for prognostic stratification.

RESULTS: The early mortality rate was 14.2%. Independent predictors of early mortality included cancer type (pancreatic/biliary), Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥2, metastases, disease progression, and male sex. The prediction model stratified patients into low- (6.1%), intermediate- (17.6%), high-risk (39.2%), and very high-risk (75.6%) groups with a moderate level of discrimination (C statistic: 0.70-0.73). Survival analysis revealed that the median survival times after CGP submission for each group were 384.0 days, 199.0 days, 114.0 days, and 48.0 days, respectively. We developed a web-based application for the prediction of early mortality via the link: https://mortality-within-90days-cgp.shinyapps.io/mortality_treatment_20250130/ .

CONCLUSIONS: The prediction model effectively stratified patients on the basis of the risk of early mortality, thus supporting better patient selection and CGP timing.

PMID:40536622 | DOI:10.1007/s10147-025-02802-5

J Nephrol. 2025 Jun 19. doi: 10.1007/s40620-025-02286-6. Online ahead of print.

ABSTRACT

BACKGROUND: The Kidney Failure Risk Equation (KFRE) estimates the risk of kidney replacement therapy (KRT) at 5 years. Patients with diabetes mellitus are at high risk of KRT and death, a competing event. This study assesses the performance of the 5-year KFRE in patients with diabetes mellitus, compared to non-diabetic patients and considering age, in a cohort of patients evaluated by a nephrologist at a tertiary care center.

METHODS: The CKD-CAREMEAU cohort included all patients who visited a nephrologist for chronic kidney disease (CKD) before KRT between 2008 and 2017. The 5-year KFRE was calculated for each patient, based on their baseline characteristics. The study evaluated performance regarding discrimination and calibration, taking the patient’s diabetic status and age into account.

RESULTS: The study included 2935 patients with a median age of 73 [65-80] years, 1800 of whom were men (61%), and 1249 (43%) who were affected by diabetes. The incidence of KRT was higher in diabetic patients (167 (13%)) than in non-diabetic patients (184 (11%))(p = 0.04). Additionally, the death rate within five years after inclusion was not statistically higher for diabetic patients (351 (28%)) than non-diabetic patients (443 (26%))(p = 0.3). Diabetic status affected neither discrimination nor calibration. However, the equation overestimated the risk for higher-risk patients, especially among the elderly.

CONCLUSIONS: Our study found no difference in the 5-year KFRE performance between diabetic and non-diabetic patients. However, performance was worse for patients over 75 years old.

PMID:40536612 | DOI:10.1007/s40620-025-02286-6

Environ Monit Assess. 2025 Jun 19;197(7):774. doi: 10.1007/s10661-025-14220-1.

ABSTRACT

This study utilizes geospatial tools to assess the climate change vulnerability of the Ratnapura District, Sri Lanka, by examining three key dimensions: exposure, sensitivity, and adaptive capacity. Ratnapura is particularly prone to climate-related hazards, such as floods, landslides, and droughts, which pose significant threats to its socio-economic stability and environmental health. The assessment employs historical climate data and geographic information to develop exposure maps, while sensitivity is evaluated through an analysis of socio-economic and environmental conditions. Adaptive capacity is measured by examining local institutional frameworks and resource availability. The findings reveal high vulnerability levels, particularly in the Ratnapura and Kalawana Divisional Secretariat (DS) divisions, highlighting the urgent need for targeted adaptation strategies. This study demonstrates the effectiveness of geospatial analysis tools in conducting comprehensive climate vulnerability assessments, providing valuable insights for developing climate-sensitive policies, and enhancing disaster risk reduction efforts. The results offer a foundation for local and regional authorities to implement proactive measures to build resilience against climate change impacts.

PMID:40536594 | DOI:10.1007/s10661-025-14220-1

Mol Neurobiol. 2025 Jun 19. doi: 10.1007/s12035-025-05153-4. Online ahead of print.

ABSTRACT

Parkinson’s disease (PD) is the second most prevalent neurodegenerative disease, and previous research has shown that T cell-mediated immunity plays a key role in PD pathology. Programmed cell death protein 1 (PD-1) is a type I transmembrane protein that inhibits T lymphocyte inflammatory activity, and PD-1 deletion can reduce dopamine levels in mouse brains. However, the clinical status of PD-1 in PD patients remains obscure. To understand the clinical role of PD-1, flow cytometry (FCM) was used to assess peripheral blood mononuclear cells (PBMCs) from 16 patients with Parkinson’s disease and 16 controls in our study. With respect to PD-1 expression on peripheral T lymphocytes, we found a statistically greater proportion of PD-1 on CD8⁺ T, CD4⁺ T, and T helper (Th) 1 cells in the PD group compared to the control group (p < 0.05), and the proportion of CD4⁺ PD-1⁺ T cells was positively correlated with Parkinson’s Disease Sleep Scale (PDSS) scores (r = 0.5277, p = 0.0454). Moreover, the PD patients had a lower percentage of CD3⁺ T cells (p = 0.0007) among PBMCs. Furthermore, the expression level of PD-1 was positively correlated with the expression of interferon-gamma (IFN-γ) in CD4⁺ T cell subsets from patients with PD (r = 0.6765, p = 0.0051) and total subjects (r = 0.4674, p = 0.0070), while there was no relationship between PD-1 and regulatory T (Treg) cells in the PD group. In conclusion, our results indicated that the PD-1 expression on peripheral T lymphocytes may be involved in the pathogenesis of PD.

PMID:40536591 | DOI:10.1007/s12035-025-05153-4

Clin Oral Investig. 2025 Jun 19;29(7):344. doi: 10.1007/s00784-025-06373-7.

ABSTRACT

INTRODUCTION: The objective of this study was to compare the quality of obturation in the mesial roots of mandibular molars with isthmuses, using Er, Cr: YSGG laser and sonic-activated irrigation, assessed by micro-CT scanning.

METHODS: Mesial canals of extracted mandibular molars were instrumented to a master apical file size of 20/V06. The final irrigation protocol included 2.5% NaOCl, 17% EDTA, and a final rinse with 2.5% NaOCl, applied with either sonic-activated or laser-activated irrigation using the WaterLase iPlus (BIOLASE, Inc, Foothill Ranch, CA). Canals were obturated with Bioceramic Sealer HiFlow (Brasseler, Savannah, GA) and gutta-percha cones. Micro-computed tomography scans were obtained before and after obturation to evaluate the quality of obturation, determined by the percentage of unfilled spaces in each irrigation group.

RESULTS: There was no statistically significant difference in baseline canal characteristics, including isthmus width, canal volume, root curvature, and Weine classification between the groups (p > 0.05). In the post-obturation evaluation with micro-CT, the mean percentage of unfilled spaces was higher in the sonic group (17.24%) than in the laser group (10.73%), showing a statistically significant difference (p < 0.05).

CONCLUSIONS: This study suggests that laser-activated irrigation may improve the quality of obturation in mandibular molars with isthmuses compared to sonic-activated irrigation.

CLINICAL SIGNIFICANCE: This study demonstrates that laser-activated irrigation can lead to a higher quality of obturation in conservatively instrumented canals by reducing the percentage of unfilled spaces. However, these findings should be cautiously interpreted, as the improved obturation quality observed may not directly translate to clinical outcomes. Further research is needed to determine if this advanteg influence long-term treatment success.

PMID:40536580 | DOI:10.1007/s00784-025-06373-7

Environ Monit Assess. 2025 Jun 19;197(7):770. doi: 10.1007/s10661-025-14260-7.

ABSTRACT

Plastic waste pollution poses a critical challenge for environmental sustainability and socioeconomic well-being and is a severe environmental problem that has a significant impact not only on the natural ecosystem but also on socio-economic issues. To solve problems related to plastic waste pollution, we must clearly understand the current situation and related issues arising from plastic pollution in the research area. In this study, plastic input and leakage were examined during pre- and post-monsoon periods in the coastal regions of Can Gio District. Fifty-seven transects with differing ambient population densities in the study area were investigated for litter leakage, along with evaluations of single-use plastic consumer goods at the point of sale. The results showed that population density and pre- and post-monsoon periods did not affect litter densities. The CEI values representing 75% of the study area were classified as “clean,” and the litter density values representing 75% of the survey area were below 0.16 items/100 m. Most single-use plastic consumer items are produced domestically, facilitating the implementation of extended producer responsibility regulations.

PMID:40536579 | DOI:10.1007/s10661-025-14260-7

Dent Traumatol. 2025 Jun 19. doi: 10.1111/edt.13072. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: Insufficient motor coordination can predispose children to falls and, consequently, the occurrence of traumatic dental injuries (TDIs). The present study investigated the association between psychomotor development and TDI in preschool children.

MATERIALS AND METHODS: A cross-sectional study was conducted with 189 children aged three to six years in Diamantina, Brazil. Psychomotor development was assessed using the Test of Gross Motor Development-Second Edition (motor assessment) and a validated preschool version of the Mini-Mental State Examination (cognitive assessment). Parents/guardians answered a socioeconomic questionnaire. Anthropometric measures were determined using WHO growth curves to obtain the body mass index (BMI). Intraoral examinations were performed by a single examiner trained and calibrated for diagnosing TDI based on the criteria proposed by Andreasen, with radiographic evaluations conducted when necessary. Lip coverage, anterior open bite, arch shape, and overjet were also recorded. Descriptive statistics, the chi-square test, and Poisson regression (bivariate and multivariate) analyses were performed (95% CI, p < 0.05).

RESULTS: The prevalence of TDI was 50.3%. Delayed motor development (PR = 1.66; 95% CI: 1.25-2.22) and obesity (PR = 1.64; 95% CI: 1.10-2.45) were significantly associated with TDI in the adjusted model.

CONCLUSION: Delayed motor development and obesity were associated with TDI in preschool children.

PMID:40536023 | DOI:10.1111/edt.13072

Strabismus. 2025 Jun 19:1-5. doi: 10.1080/09273972.2025.2518296. Online ahead of print.

ABSTRACT

INTRODUCTION: Inferior rectus (IR) recession surgery is commonly performed for vertical strabismus, yet overcorrection risk remains high (21-50%) due to factors like lower lid retractors, suture dissolution, and muscle tension in thyroid eye disease (TED). This study aims to contribute novel insights by comparing clinical outcomes of IR recession using absorbable and non-absorbable sutures.

METHODS: A retrospective study (01/12/20-31/01/23) was conducted at a tertiary referral center on patients undergoing IR recession with absorbable or non-absorbable sutures. The following data were collected: absorbable vs non-absorbable suture use, age at operation, sex, date of operation, surgical indication, presence of TED, adjustable vs non-adjustable suture technique, surgeon training level, number of muscles recessed, IR distance recessed, and time from surgery to final follow-up.

RESULTS: Thirty-two IR recession procedures were evaluated (26 absorbable, 6 non-absorbable cases) with a mean follow-up of 3.6 months. Both groups achieved similar success in vertical deviation control with no significant difference in success rates for distance (p = .48) or near fixation (p = .21). Overcorrection occurred in 23.1% (absorbable) and 16.7% (non-absorbable) cases, with no statistical difference (p = .61). Logistic regression analysis was performed, which showed that TED (p = .99), surgeon training level (p = .20), adjustable sutures (p = .89) and number of muscles operated on (p = .28) did not significantly impact success for absorbable sutures.

CONCLUSION: This study demonstrates that IR recession surgeries using absorbable sutures yield outcomes comparable to those using non-absorbable sutures, with no significant difference in success rates and overcorrection rates consistent with existing literature. These findings suggest that absorbable sutures are equally viable in use for IR recession surgeries.

PMID:40536018 | DOI:10.1080/09273972.2025.2518296