Nevin Manimala

Environ Sci Pollut Res Int. 2025 Nov 23. doi: 10.1007/s11356-025-37240-3. Online ahead of print.

ABSTRACT

Diatom-based monitoring offers a cost-effective and reliable tool for assessing water quality in developing countries. As natural bio-indicators, diatoms respond sensitively to environmental changes, making them ideal for long-term ecological monitoring. The current paper aims to examine the potential use of a diatom-based tool at the genus level (generic diatom index (GDI)), when flora at the species level is poorly known, for water quality assessment in the Cambodian river systems. Nineteen monitoring sites within the Sangker River catchment have been chosen for the study, while eleven physicochemical parameters and trophic diatom index (TDI) values have been used to predict the response of GDI values. Basic statistical tests and linear regression (LM) were used to describe the spatio-temporal variation of water quality based on GDI classification. A total of 78 diatom genera were recorded, dominated by biraphid taxa (67%), and 13 genera accounted for ~ 90% of total abundance. GDI classification indicated that 10% of sites were of good quality, 53% moderate, and 37% poor, with water quality declining downstream and in areas influenced by urban and agricultural activities. The linear model revealed that GDI was significantly associated with nutrient- and oxygen-related parameters (orthophosphate, dissolved oxygen, and chloride) and correlated strongly with TDI (adjusted R² = 0.96). Seasonal variation was also significant, highlighting the importance of temporal dynamics in tropical rivers. The current findings provided clear evidence of potential uses of diatom indices to assess the water quality in the Sangker River and other Cambodian river networks even at the genus level of determination. More importantly, diatom indices could be potential tools for long-term biomonitoring in developing countries like Cambodia, where the data and resources are limited. Consequently, the study suggested further investigation on the ecological sensitivity of diatom flora to localize their values, improving GDI classification performance within the tropical environment.

PMID:41275459 | DOI:10.1007/s11356-025-37240-3

Eur J Nucl Med Mol Imaging. 2025 Nov 23. doi: 10.1007/s00259-025-07570-y. Online ahead of print.

ABSTRACT

PURPOSE: [¹⁸F] fluoroestradiol (FES) is an FDA-approved tracer that measures functional estrogen receptor (ER) expression and can estimate the likelihood of response to ER-targeted therapy. In this exploratory analysis, we tested a novel radiomics based analysis of dynamic volumetric FES PET images to predict outcomes in patients with metastatic ER positive breast cancer treated with endocrine therapy.

METHODS: We utilized the Rad-Fit method, previously tested in an FDG PET data set, to identify and characterize intratumor subregions of heterogeneous time-activity through an unsupervised clustering approach. A scaled silhouette score was implemented to determine the optimal number of intratumor subregions on a per-tumor basis. Summary statistics of sum of squared error (SSE) and distance between sub regions as well as the total number of intratumor subregions were used to build prognostic models of overall survival (OS) and progression free survival (PFS). We employed Kaplan-Meyer analysis to determine model performance.

RESULTS: The radiomic phenotype differentiated between a high and low risk group for progression free survival (C = 0.67, p = 0.025) in the single tumor scenario. Radiomic features of subregion distance classified a high and low risk group for OS in a single tumor (C = 0.67, p = 0.008) and average tumor (C = 0.65, p = 0.017) scenario.

CONCLUSIONS: In this exploratory study, 4D radiomic features extracted from dynamic FES PET images can improve the prediction of outcomes in metastatic ER positive breast cancer. Metrics of tumor subregion distance and radiomic phenotype appear to perform as the best radiomic predictors for risk stratification of OS and PFS respectively by potentially reflecting characteristics of the overall tumor heterogeneity in FES PET images.

CLINICAL TRIAL NUMBER: not applicable.

PMID:41275453 | DOI:10.1007/s00259-025-07570-y

Clin Transl Oncol. 2025 Nov 23. doi: 10.1007/s12094-025-04127-1. Online ahead of print.

ABSTRACT

OBJECTIVES: The primary objective of this study is to identify opportunities to improve clinical and comprehensive support of patients diagnosed with gynaecological cancers in Spain. Secondary objectives included identifying the unmet needs regarding awareness and access to screening strategies of gynaecological cancers in Spain.

METHODS: A mixed-methods design was used, combining qualitative and quantitative research in 235 participants. The qualitative component comprised semi-structured interviews and focus groups with 12 patients with gynaecological cancer, 6 caregivers, and 11 healthcare professionals. The quantitative component included anonymous surveys from 44 women with gynaecological cancer and 162 women from the general population. Descriptive statistics were applied.

RESULTS: The qualitative study revealed needs in prevention, early diagnosis, emotional support, nutrition, physical activity, and sexual health. Among surveyed patients, the mean knowledge of gynaecological cancer before diagnosis was low (2.3/6). Substantial limitations were reported after diagnosis in physical activity (59%), diet (43%), and sexual life (70%), and 55% experienced psychological consequences. Fifty-six percent reported insufficient non-pharmacological information from their healthcare team, and 59% sought support from patient associations. In the general population, 40% of women had never received information on gynaecological cancer.

CONCLUSIONS: Improving care for women with gynaecological cancers in Spain requires action at two levels: (1) strengthened early detection through awareness and screening strategies, and (2) expanded supportive services including nutrition, psycho-oncology, physical activity programmes, and sexual health interventions. Addressing taboos around women’s sexuality and leveraging patient associations and preferred communication channels should be priorities.

PMID:41275447 | DOI:10.1007/s12094-025-04127-1

Aesthetic Plast Surg. 2025 Nov 23. doi: 10.1007/s00266-025-05465-9. Online ahead of print.

ABSTRACT

BACKGROUND: The supraclavicular lateral incision approach offers a promising alternative to the conventional median incision in thyroid surgery, prioritizing cosmetic outcomes and quality of life (QoL) without compromising safety. This study evaluated its efficacy and impact on thyroid-specific QoL in patients undergoing thyroid lobectomy for unilateral papillary thyroid carcinoma (PTC).

METHODS: A prospective, nonrandomized study was conducted on 197 PTC patients, including 98 treated with the supraclavicular approach and 99 with the conventional approach. Demographic, clinicopathologic, operative, and postoperative data were collected. Cosmetic satisfaction was assessed at six months post-surgery using visual analog scales, while thyroid-specific QoL was evaluated with the validated T-QoL questionnaire. Statistical analyses compared outcomes between the two groups.

RESULTS: Both approaches achieved comparable surgical outcomes, with no significant differences in operation time, blood loss, or complication rates. The supraclavicular approach demonstrated superior cosmetic satisfaction scores for incision scars (median 9 vs. 6, P = 0.001). Although overall T-QoL scores were similar, psychological well-being was significantly better in the supraclavicular group (P = 0.036), with a trend toward improved social well-being (P = 0.066). No recurrences were observed during a median follow-up of 28 months.

CONCLUSIONS: The supraclavicular lateral incision approach offers enhanced cosmetic outcomes and mitigates QoL decline without increasing surgical risks. It serves as a feasible, cost-effective alternative to conventional and remote-access techniques, aligning with contemporary trends in minimally invasive thyroid surgery.

LEVEL OF EVIDENCE II: 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:41275446 | DOI:10.1007/s00266-025-05465-9

J Cancer Surviv. 2025 Nov 23. doi: 10.1007/s11764-025-01940-z. Online ahead of print.

ABSTRACT

PURPOSE: To examine labor force participation and employment income during early adulthood among childhood cancer survivors and matched cancer-free individuals in Canada.

METHODS: Children aged 0-14 diagnosed with cancer from 2000 to 2017 in Canada were identified from the Canadian Cancer Registry and matched to cancer-free individuals by birth year, sex, and region of Canada at age 18. Matched cohorts were generated for all cancers combined, by cancer type (hematologic/central nervous system [CNS]/solid), and age at cancer diagnosis (0-4, 5-9, 10-14 years). Using linked national tax records, we examined labor force participation (declared employment income of > $0) and employment income (2017 CAD) annually during adulthood (≥ 18 years) until 2017. Absolute and relative differences in outcomes between groups were investigated using generalized estimating equations.

RESULTS: Overall, 3635 childhood cancer survivors and 1,032,090 cancer-free individuals were included (median age by maximum follow-up: 22 years). During follow-up, survivors were 5% less likely to be employed (risk ratio [RR], 0.95; 95% CI 0.94, 0.96) and earned 6% lower income annually (ratio of income, 0.94; 95% CI 0.89, 0.98), after adjusting for age and period effects. The largest effect sizes were observed among CNS survivors (RR for, 0.89; 95% CI 0.87, 0.92; ratio of income, 0.77; 95% CI 0.67, 0.89).

CONCLUSIONS: In this pan-Canadian longitudinal matched cohort study, we observed differences in socioeconomic outcomes between adult-aged childhood cancer survivors and cancer-free individuals. Given the cohort’s young age, additional studies incorporating education data are warranted.

IMPLICATIONS FOR CANCER SURVIVORS: Childhood cancer can impact a survivor’s career path. This study provides insight into the financial trajectory of survivors in Canada.

PMID:41275443 | DOI:10.1007/s11764-025-01940-z

Ophthalmol Ther. 2025 Nov 23. doi: 10.1007/s40123-025-01275-z. Online ahead of print.

ABSTRACT

INTRODUCTION: Pediatric patients with noninfectious uveitis refractory to standard therapies have limited options. Efficacy and safety of systemic tacrolimus, a calcineurin inhibitor used successfully in adult noninfectious uveitis as an adjuvant immunomodulatory treatment, was investigated in the pediatric population at our institution.

METHODS: This was a retrospective chart review of patients ≤ 18 years old diagnosed with noninfectious uveitis who were intolerant to or failed conventional systemic immunosuppressants between January 2014 and June 2025 at a tertiary referral center. The primary outcome was treatment success, defined as two or more of the following: ≤ 0.5+ anterior chamber cell, ≤ 2 drops of topical steroids per day per eye, improvement or resolution of vitritis, macular edema, papillitis, and angiographic leakage without addition of systemic therapy at 6 and 12 months after tacrolimus initiation. Secondary outcomes included need for dose reduction or discontinuation owing to adverse effects. Descriptive statistics were used to analyze the data.

RESULTS: Data from 11 patients, with median age of 10 years, were analyzed. Treatment success was achieved in 88.9% and 63.6% of patients at 6 and 12 months, respectively. Although seven patients experienced laboratory abnormalities, tacrolimus was not discontinued. An average tacrolimus dose of 0.16 mg/kg/day divided every 12 h achieved therapeutic tacrolimus levels. Median duration (range) of tacrolimus therapy was 24 months (4-93 months).

CONCLUSIONS: Tacrolimus may potentially be a well-tolerated, safe, and effective option for refractory cases of pediatric noninfectious uveitis.

PMID:41275437 | DOI:10.1007/s40123-025-01275-z

Eur J Pediatr. 2025 Nov 23;184(12):782. doi: 10.1007/s00431-025-06639-y.

ABSTRACT

The aim of this study was to assess the socio-economic burden on families of children diagnosed with inflammatory bowel diseases (IBD), particularly ulcerative colitis (UC), and Crohn’s disease (CD). The study was conducted at the 2nd Clinic of Paediatrics, Gastroenterology and Nutrition of Wroclaw Medical University. Anonymous questionnaires were completed by parents of paediatric IBD patients. The survey collected demographic, socio-economic, and treatment-related data. The study identified both material and non-material costs associated with IBD care. These included frequent private medical visits, medication, diet modifications, and transportation. Average monthly travel expenses were PLN 215.9 for UC and PLN 302.3 for CD (PLN = Polish zloty, 1 PLN = 0.25 euro). Limited access to paediatric gastroenterologists, especially in remote areas, led many families to seek private care, with associated monthly costs averaging PLN 312.3 for UC and PLN 513.3 for CD. Additionally, parents reported frequent work absences due to caregiving responsibilities, further impacting income and quality of life.

CONCLUSION: Childhood IBD imposes a considerable financial and psychosocial burden on families. The findings underscore the need for improved access to public healthcare services and financial support mechanisms to reduce the strain on affected families.

WHAT IS KNOWN: • Families of children with IBD (ulcerative colitis, Crohn’s disease) face significant costs related to medical care and lifestyle changes. • Limited access to specialised paediatric gastroenterologists and frequent absences from work add to the overall family burden.

WHAT IS NEW: • This study quantifies the monthly out-of-pocket travel and private care costs for paediatric IBD in Poland (PLN 215.9-513.3), previously rarely documented. • The findings highlight significant non-material impacts, such as caregiver work absences, further reducing family quality of life.

PMID:41275433 | DOI:10.1007/s00431-025-06639-y

Cancer Med. 2025 Nov;14(22):e71400. doi: 10.1002/cam4.71400.

ABSTRACT

OBJECTIVE: To examine the association between adverse childhood events (ACEs) and cannabis use among adult cancer survivors in the United States.

METHODS: We conducted a cross-sectional study of cancer survivors ≥ 18 years old using 2020 Behavioral Risk Factor Surveillance System data. ACEs were categorized as 0, 1, 2-3, and ≥ 4. Weighted multivariable logistic regression estimated the odds of cannabis use by ACE category.

RESULTS: Among 7896 cancer survivors, cannabis use prevalence was 6.0%. ACE distribution was 44.1% (0), 22.7% (1), 20.2% (2-3), and 13.0% (≥ 4). Cannabis use was more common among younger adults, Hispanics, never-married individuals, smokers, and those reporting fair/poor health. Compared to those with 0 ACEs, cancer survivors with 2-3 ACEs (aOR: 2.56, 95% CI: 1.57-4.27) and ≥ 4 ACEs (aOR: 4.10, 95% CI: 2.54-6.64) had significantly higher odds of cannabis use.

CONCLUSIONS: Cancer survivors with a higher number of ACEs reported increased odds of cannabis use. These findings support further study of ACEs and substance use in cancer survivors and may inform trauma-informed survivorship care.

PMID:41275428 | DOI:10.1002/cam4.71400

Cancer Med. 2025 Nov;14(22):e71380. doi: 10.1002/cam4.71380.

ABSTRACT

OBJECTIVE: This study examined all-cause and cause-specific cancer mortality among older migrants and non-migrants in Finland and the role of socioeconomic status in mortality differences.

METHODS: We used the Finnish Causes of Death Register on all deaths (2002-2020) among individuals aged ≥ 70 (N = 718,717) and the corresponding population-at-risk data (N = 13,241,620 person years). Poisson regression was used with two sequential models adjusting for age at death, calendar year, and region of residence in Finland (M1), and personal annual disposable income (M2).

RESULTS: We found an overall cancer mortality advantage for both migrant men (IRR in the full model 0.83, 95% CI: 0.78-0.89) and migrant women (IRR: 0.89, 95% CI: 0.83-0.95) and lung cancer mortality advantage for migrant men (IRR: 0.77, 95% CI: 0.67-0.89) and women (IRR: 0.67, 95% CI: 0.53-0.85). For migrant men, advantage was found in pancreatic cancer (IRR: 0.76, 95% CI: 0.58-0.99), prostate cancer (IRR: 0.78, 95% CI: 0.66-0.93), and leukaemia and lymphoma (IRR: 0.73, 95% CI: 0.58-0.93), and for women in genital cancers (IRR: 0.69, 95% CI: 0.55-0.86). Notable variations were observed by region of origin and in certain cases, migrants’ lower income obscured the full extent of their cancer mortality advantage. A mortality disadvantage was observed in stomach cancer among men (IRR: 2.76, 95% CI: 2.08-3.65) and women (IRR: 2.32, 95% CI: 1.79-3.00) born in the former USSR. Liver cancer mortality disadvantage was found for men from the Global South and East (IRR: 2.00, 95% CI: 1.10-3.61), and this association was attenuated after adjustment for personal disposable income. In cancers of the urinary tract, men born in Sweden had elevated mortality (IRR: 2.09, 95% CI: 1.14-3.81).

CONCLUSION: Finings underscore the need for targeted cancer prevention and screening programmes that account for the diverse backgrounds, sex, socioeconomic status, and health risks of migrant populations, particularly those from higher-risk regions.

PMID:41275426 | DOI:10.1002/cam4.71380

Ann Saudi Med. 2025 Nov-Dec;45(6):381-387. doi: 10.5144/0256-4947.2025.381. Epub 2025 Nov 20.

ABSTRACT

BACKGROUND: Errors in clinical laboratory tests can have a detrimental effect on healthcare delivery. The pre-analytical phase accounts for most laboratory errors, known as pre-analytical errors (PAEs).

OBJECTIVE: This study investigated the causes and frequencies of PAEs occurring within a laboratory of a tertiary care hospital.

DESIGN: A single-center, retrospective, observational study.

SETTING: King Abdul-Aziz Specialist Hospital, Taif, Saudi Arabia.

MATERIALS AND METHODS: All laboratory test orders and repeated or rejected specimens in the Laboratory Information System (LIS) during 2021. The data consisted of the types of PAEs, their distribution across laboratory sections, the patient source among hospital departments, and the working shift during which PAEs were recorded.

MAIN OUTCOME MEASURES: The causes and frequencies of PAEs across laboratory sections, hospital departments, and work shifts were analyzed.

SAMPLE SIZE: 2104 PAEs from a total of 3 346 199 test orders.

RESULTS: Of the 3 346 199 test orders, 3137 were recorded as either repeated or rejected. Of these, 2104 (67.1%) were attributed to PAEs, representing a rate of 0.063% (95% CI: 0.060-0.066%) of the total test orders. ‘Clotted specimens’ (32%) and ‘insufficient quantity’ (31%) were the most frequent PAEs. Significant differences were identified in the error rate and type of PAEs across laboratory sections, hospital departments, and working shifts (P<.001 for each). The highest error rate was in the blood bank (0.4%). The hematology section accounted for the largest proportion of errors (48.4%). Most PAEs were test orders from the inpatient department (47.3%), with a majority occurring in the morning shift (58.2%).

CONCLUSION: Our study revealed a low overall PAE rate of 0.063%. ‘Clotted specimens’ and ‘insufficient quantity’ were the most frequent errors. Importantly, we identified significant differences in the types of PAEs across laboratory sections, hospital departments, and working shifts, indicating their multifaceted and context-dependent nature.

LIMITATIONS: A retrospective, single-center study.

PMID:41275351 | DOI:10.5144/0256-4947.2025.381