Nevin Manimala

Pediatr Blood Cancer. 2025 Jan 25:e31568. doi: 10.1002/pbc.31568. Online ahead of print.

ABSTRACT

PURPOSE: To explore the potential relationship between social media (SoMe) and burnout or overall wellbeing within the field of oncology.

DESIGN: A cross-sectional study of adult and pediatric oncology professionals conducted using an anonymous electronic survey. The survey was disseminated through the Children’s Oncology Group (COG) and the SWOG Cancer Research Network (SWOG) member listservs.

RESULTS: The majority of pediatric and adult oncology professionals are not engaging on, with only 873/3000 (29%) using SoMe professionally. Use of SoMe was associated with statistically significant higher incidence of self-reported burnout and poorer self-reported work‒life integration (WLI). However, both groups reported the same degree of career satisfaction and choosing the same career/job again. SoMe users and non-users reported similar overall psychological distress, although the use of SoMe was associated with less severe psychological distress.

CONCLUSION: While SoMe users reported higher rates of burnout and poorer WLI compared to non-users, it was not accompanied by higher levels of psychological distress. Furthermore, there were no differences in career satisfaction. These misalignments require further study.

PMID:39865348 | DOI:10.1002/pbc.31568

Immunol Cell Biol. 2025 Jan 25. doi: 10.1111/imcb.12848. Online ahead of print.

ABSTRACT

Natural killer (NK) cells are emerging agents for cancer therapy. Several different cytokines are used to generate NK cells for adoptive immunotherapy including interleukin (IL)-2, IL-12, IL-15 and IL-18 in solution, and membrane-bound IL-21. These cytokines drive NK cell activation through the integration of signal transducers and activators of transcription (STAT) and nuclear factor-kappa B (NF-κB) pathways, which overlap and synergize, making it challenging to predict optimal cytokine combinations for both proliferation and cytotoxicity. We integrated functional assays for NK cells cultured in a variety of cytokine combinations with mathematical modeling using feature selection and mechanistic regression models. Our regression model successfully predicts NK cell proliferation for different cytokine combinations and indicates synergy of activated STATs and NF-κB transcription factors between priming and post-priming phases. The use of IL-21 in solution in the priming of NK cell culture resulted in an improved NK cell proliferation, without compromising cytotoxicity potential or interferon gamma secretion against hepatocellular carcinoma cell lines. Our work provides an integrative framework for interrogating NK cell proliferation and activation for cancer immunotherapy.

PMID:39865344 | DOI:10.1111/imcb.12848

J Esthet Restor Dent. 2025 Jan 25. doi: 10.1111/jerd.13420. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the color stability of a one-shade resin-based composite material (RC) and a glass-ionomer cement (GIC) after staining with plaque detectors (PDs) with different formulations and delivery forms.

MATERIALS AND METHODS: Rectangular-shaped specimens (7 × 3 × 2 mm) were produced with RC (Venus Diamond One, Kulzer) and GIC (Fujy IX GP, GC) (n = 30). Further, the following PDs were used on the specimens: (1) tablets (T; Plaq-Search, TePe); (2) mouthwash (M; Plaque Agent, Miradent); and (3) light-curing liquid (L; Plaque test, Ivoclar). The PDs were removed with dedicated toothbrushes (T₁) and the specimens were repolished (T₂). The protocol was repeated after 1 week of storage in artificial saliva (staining-T₃ and repolishing-T₄). Color measurement were performed at baseline (T₀) and all testing times (T₁-T₄) using a recently introduced digital colorimeter (SmartColor, Smart Vision). Color changes (ΔE_ab) compared to T₀ were automatically recorded by the digital instrument. The data were statistically analyzed (p < 0.05).

RESULTS: The type of PD, the polishing procedure and their interactions influenced the color stability of both restorative materials (p < 0.05). Particularly, after the second PDs application, M and L produced the highest color changes (p < 0.05), with GIC showing higher color variability than RC. Although repolishing reduced the color changes of RC (p < 0.05), it could not reestablish the initial color of GIC, irrespective of the PD used (p < 0.05). Except for RC associated with T, all materials exhibited discoloration above the clinical perceptibility (1.77) and acceptability (2.66) thresholds.

CONCLUSIONS: The influence of PDs on the color stability of RC and GIC was material-dependent. GIC showed higher color instability than RC. Repolishing could not reestablish the original color of GIC and only attenuated the color changes of the one-shade RC. The newly introduced digital colorimeter was an important tool to standardize and simplify color measurement evaluations.

CLINICAL SIGNIFICANCE: PDs can pose a potential risk to the color stability of restorative materials. Dental practitioners should be careful when recommending the frequency of at-home application of PDs, taking into consideration the material properties and the position of the restorations of each patient.

PMID:39865343 | DOI:10.1111/jerd.13420

Cancer. 2025 Feb 1;131(3):e35723. doi: 10.1002/cncr.35723.

ABSTRACT

BACKGROUND: There is much concern that opioids administered as intravenous (iv) bolus for pain relief may inadvertently increase their risk for abuse. However, there is insufficient data to support this. The authors compared the abuse liability potential, analgesic efficacy, and adverse effect profile of fast (iv push) versus slow (iv piggyback) administration of iv hydromorphone among hospitalized patients requiring iv opioids for pain.

METHODS: In this double-blind, double dummy, randomized, 2 × 2 crossover trial, patients with ≥4 cancer-related pain were randomly assigned to receive either iv hydromorphone 1 mg administered over 2 minutes (fast iv push) or 15 minutes (slow iv piggyback) during the first treatment period. Participants crossed over to receive the alternate treatments during the second period after a 6-hour washout period.

RESULTS: Eighty-three eligible patients were allocated to slow-fast (42, 51%) or fast-slow (41, 49%). Both treatments produced low abuse potential scores with no difference between them (mean peak Drug Effect Questionnaire “drug liking” subscale of fast [24.00] vs. slow [24.34], p = .82). A total of 92% and 94% of slow and fast iv hydromorphone recipients, respectively, had similar improvements in pain scores over 120 minutes (odds ratio, 0.67; 95% confidence interval, 0.06-5.82, p = .65). Drowsiness was more frequent with the fast than the slow rate (50% vs. 29% at 15 minutes [p = .03] and 52% vs. 31% at 60 minutes [p = .03]).

CONCLUSIONS: Slow iv hydromorphone infusion resulted in similar abuse liability potential and pain improvement but less sedation than fast injection. These findings, taken together, suggest that the slow infusion may be considered as a first-line modality for iv opioid administration in hospitalized patients requiring intermittent opioids for pain.

PMID:39865340 | DOI:10.1002/cncr.35723

Infect Dis (Lond). 2025 Jan 26:1-7. doi: 10.1080/23744235.2025.2456902. Online ahead of print.

ABSTRACT

BACKGROUND: Whether a detected virus or bacteria is a pathogen that may require treatment, or is merely a commensal ‘passenger’, remains confusing for many infections. This confusion is likely to increase with the wider use of multi-pathogen PCR.

OBJECTIVES: To propose a new statistical procedure to analyse and present data from case-control studies clarifying the probability of causality.

METHODS: We conducted a case-control study in US outpatient settings that enrolled patients aged 18 to 75 years with acute lower respiratory tract infection and controls without respiratory symptoms. Patients underwent multi-pathogen PCR testing. The positive etiologic predictive value was calculated to estimate the probability that each potential pathogen was the cause of symptoms. The outcome was illustrated using a modified forest plot and by classifying pathogens into five categories clarifying the probability for causality.

RESULTS: We enrolled 618 adult cases and 497 asymptomatic controls. The modified forest plot and the classification of risk for causality aimed to facilitate understanding. Pathogens likely to be causative when present included influenza A and B, SARS-CoV-2, rhinovirus, and parainfluenza viruses, while Staphylococcus aureus is almost always commensal. Broad confidence intervals for the positive etiologic predictive value made it difficult to draw conclusions for potential pathogens with low prevalence.

CONCLUSION: This pilot study shows that the proposed statistical approach is likely to be practical for analysing larger case-control studies or for a meta-analysis of multiple studies. This method may help when interpreting the results from multi-pathogen PCR.

PMID:39864052 | DOI:10.1080/23744235.2025.2456902

J Ultrasound. 2025 Jan 26. doi: 10.1007/s40477-025-00986-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Post-stroke cognitive impairment (PSCI) and dementia affect short- and long-term outcome after stroke and can persist even after recover from a physical handicap. The process underlying PSCI is not yet fully understood. Transcranial Doppler ultrasound (TCD) is a feasible method to investigate cerebrovascular aging or dementia, through the pulsatility index (PI), the cerebrovascular reactivity (e.g. the Breath-Holding Index (BHI)) and the functional Transcranial Doppler sonography (fTCD). Aim of the study was to assess the usefulness of PI, BHI, Resistance Index (RI) and fTCD in evaluating the risk of cognitive impairment evolution in patients with minor stroke (MS), compared to patients with transient ischemic attack (TIA) and to healthy controls (HC).

MATERIAL AND METHODS: PI, RI, BHI and fTCD were evaluated in the middle cerebral artery (MCA) of MS patients, TIA and HC. Patients with MS and TIA were enrolled within six days from the cerebrovascular event (acute phase) and the tests were repeated after 180±15 days from t0 (control phase). During the TCD recording, particular sections of MoCA test and FAB test were performed.

RESULTS: 43 subjects were enrolled: 13 MS, 16 TIA and 14 HC. MFV analysis in the acute phase demonstrated no difference between MFVs at rest vs MFVs during MoCA/FAB tests in TIA and MS (acute phase), a significant increase of MFVs during MoCA/FAB tests vs MFVs at rest in HC (p<0.01), a statistically significant difference in the PI of MS vs HC at rest (p=0.048) and in BHI between HC vs MS (p<0.001) and HC vs TIA (p<0.01). In the control phase the absence of a statistically significant difference in MFVs was observed only in MS patients (MFVs at rest vs MFVs during MoCA) and PI and BHI values were in the normal range both in MS and TIA. No correlation was observed between MoCA test results and MFV, PI or RI, in any of the three groups.

CONCLUSION: A different cerebral vasoreactivity, in terms of no increase in MFV, was found when performing cognitive tasks in patients with MS and TIA compared to HC in the acute phase. TCD is a fundamental tool to study cerebral vasoreactivity.

PMID:39864049 | DOI:10.1007/s40477-025-00986-0

Endocrine. 2025 Jan 26. doi: 10.1007/s12020-025-04170-6. Online ahead of print.

ABSTRACT

PURPOSE: Our study evaluated skeletal muscle mass, function and quality among mild autonomous cortisol secretion (MACS) patients and non-functioning adrenal incidentaloma (NFAI) patients in comparison with the control group without adrenal mass.

METHODS: 63 NFAI (49 female, 14 male) and 31 MACS (24 female, 7 male) patients were included in the study. As the control group, 44 patients (31 women, 13 men) who were known to have no radiological adrenal pathology on computed tomography or magnetic resonance imaging performed for other reasons were selected. After recording the laboratory parameters of the patients, anthropometric measurements, handgrip strength test with dynamometer, SARC-F survey and bioelectrical impedance analysis (BIA) measurements were performed.

RESULTS: There was no statistical difference among the groups in terms of age, gender, and BMI parameters. Handgrip strength (HGS), skeletal muscle mass (SMM) index (SMM/BMI), and skeletal muscle quality (HGS/SMM), values used to evaluate muscle strength and quality, were found to be significantly lower in both the MACS and NFAI groups compared to the control group (p = 0.004, p = 0.012 and p = 0.034 respectively). This significance was also present in women subgroup analyses (p = 0.002, p = 0.037 and p = 0.039 respectively), but these parameters lost their statistical significance in men. In the correlation analysis of the female subgroup, 24-h free urine cortisol value was inversely proportional to skeletal muscle quality (r_s = -0.417, p = 0.008).

CONCLUSION: Our study showed that there is a decrease in muscle mass and function in female AI patients, and this decrease is more severe in MACS patients. These results may suggest that mild cortisol excess also has negative effects on skeletal muscle metabolism.

PMID:39864048 | DOI:10.1007/s12020-025-04170-6

Pediatr Surg Int. 2025 Jan 26;41(1):73. doi: 10.1007/s00383-024-05948-x.

ABSTRACT

OBJECTIVE: To review and compare robot-assisted ipsilateral ureteroureterostomy (RALUU) and laparoscopic ipsilateral uretero-ureterostomy (LUU) in terms of efficacy and outcomes.

METHODS: Clinical data of 65 children with complete renal ureteral duplication deformity admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2022 were collected. Among these, 42 patients underwent laparoscopic ureteroureterostomy (LUU), designated as the LUU group, while 23 patients received robot-assisted laparoscopic ureteroureterostomy (RALUU), designated as the RALUU group. We compared the two groups regarding surgical duration, intraoperative blood loss, postoperative drainage duration, length of hospital stay, changes in anterior-posterior diameter (APD) of the affected renal pelvis pre- and postoperatively, changes in ureteral diameter, and alterations in renal function.

RESULTS: The postoperative drainage duration (Z = 2.375, P = 0.024) and length of hospital stay (t = 2.142, P = 0.038) were shorter in the RALUU group compared to the LUU group, with statistically significant differences. However, there were no statistically significant differences in surgical duration (t = – 1.465, P = 0.153) and intraoperative blood loss (Z = 1.679, P = 0.097) between the two groups. Complications occurred in three patients in the LUU group (two cases of anastomotic stricture and one case of stump syndrome), while no long-term complications were reported in the RALUU group, with no significant difference between the groups (χ² = 0.482, P = 0.488). Both groups exhibited a tendency for improvement in APD, ureteral diameter (UD), and differential renal function (DRF) pre- and postoperatively. However, further analysis revealed that changes in APD (ΔAPD, t = – 1.132, P = 0.284), DRF (ΔDRF, Z = 1.865, P = 0.073), and UD (ΔUD, t = 1.562, P = 0.064) did not show statistically significant differences between the two groups.

CONCLUSION: Both RALUU and LUU are safe and effective treatments for children with complete renal ureteral duplication anomalies. Compared to LUU, RALUU is associated with shorter postoperative drainage duration and hospital stay.

PMID:39864036 | DOI:10.1007/s00383-024-05948-x

Radiol Med. 2025 Jan 26. doi: 10.1007/s11547-025-01957-5. Online ahead of print.

ABSTRACT

PURPOSE: To develop an artificial intelligence (AI) algorithm for automated measurements of spinopelvic parameters on lateral radiographs and compare its performance to multiple experienced radiologists and surgeons.

METHODS: On lateral full-spine radiographs of 295 consecutive patients, a two-staged region-based convolutional neural network (R-CNN) was trained to detect anatomical landmarks and calculate thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), and sagittal vertical axis (SVA). Performance was evaluated on 65 radiographs not used for training, which were measured independently by 6 readers (3 radiologists, 3 surgeons), and the median per measurement was set as the reference standard. Intraclass correlation coefficient (ICC), mean absolute error (MAE), and standard deviation (SD) were used for statistical analysis; while, ANOVA was used to search for significant differences between the AI and human readers.

RESULTS: Automatic measurements (AI) showed excellent correlation with the reference standard, with all ICCs within the range of the readers (TK: 0.92 [AI] vs. 0.85-0.96 [readers]; LL: 0.95 vs. 0.87-0.98; SS: 0.93 vs. 0.89-0.98; SVA: 1.00 vs. 0.99-1.00; all p < 0.001). Analysis of the MAE (± SD) revealed comparable results to the six readers (TK: 3.71° (± 4.24) [AI] v.s 1.86-5.88° (± 3.48-6.17) [readers]; LL: 4.53° ± 4.68 vs. 2.21-5.34° (± 2.60-7.38); SS: 4.56° (± 6.10) vs. 2.20-4.76° (± 3.15-7.37); SVA: 2.44 mm (± 3.93) vs. 1.22-2.79 mm (± 2.42-7.11)); while, ANOVA confirmed no significant difference between the errors of the AI and any human reader (all p > 0.05). Human reading time was on average 139 s per case (range: 86-231 s).

CONCLUSION: Our AI algorithm provides spinopelvic measurements accurate within the variability of experienced readers, but with the potential to save time and increase reproducibility.

PMID:39864034 | DOI:10.1007/s11547-025-01957-5

Pediatr Surg Int. 2025 Jan 26;41(1):74. doi: 10.1007/s00383-025-05972-5.

ABSTRACT

PURPOSE: Initial recommendations for ECMO had relative contraindications for low birth weight (BW) or low gestational age (GA) babies. However, more recent literature has demonstrated improved and acceptable outcomes of ECMO in smaller neonates. The purpose of this study was to understand both utilization and survival in patients with lower GA and BW.

METHODS: All neonates captured in the Extracorporeal Life Support Organization (ELSO) registry who underwent a single ECMO run from 2009 to 2019 were included. The primary outcome measure was mortality and the secondary outcome measure was major adverse outcomes, defined as a composite outcome variable any severe ECMO complications. Univariate and multivariable statistical tests were performed to estimate the association between GA and BW with both outcome variables.

RESULTS: A total of 14,167 cases met inclusion criteria. Univariate analysis noted that birth weight, gestational age, ECMO mode, pulmonary support type, pH and ventilator settings were highly significant predictors of survival. Multivariable assessment noted significant linear relationship of mortality rates with increasing GA and BW (p < 0.001, OR = 0.82 GA, 0.51 BW). The highest ECMO-related mortality was observed in neonates with GA 30-31 weeks and BW 1.5-2.0 kg, with a 70-75% in-hospital mortality rate.

CONCLUSIONS: Decreasing GA and BW were strongly correlated with increasing odds of mortality and/or ECMO-related complications. However, even in low GA or BW neonates, survival may be possible in up to a quarter of patients put on ECMO.

PMID:39864029 | DOI:10.1007/s00383-025-05972-5