Nevin Manimala

BMC Cancer. 2026 Jan 19. doi: 10.1186/s12885-026-15598-y. Online ahead of print.

ABSTRACT

BACKGROUND: Testicular germ cell tumors (TGCTs) are the most common solid malignancies among young men. Although overall survival exceeds 95%, a subset of patients still present with advanced disease or relapse. Identifying clinicopathological and modifiable lifestyle factors associated with advanced-stage presentation may improve risk stratification and guide management.

METHODS: This retrospective study included 96 patients with TGCTs treated at a single tertiary center. Data on smoking status, body mass index (BMI), lymphovascular invasion (LVI), and tumor size were analyzed. Associations between these parameters and stage at diagnosis were assessed using chi-square tests and multivariable logistic regression. Recurrence-free survival (RFS) was evaluated by the Kaplan-Meier method.

RESULTS: Among 96 patients (median age, 31 years), 59.4% had early-stage and 40.6% had advanced-stage disease. Smoking (OR = 8.17; p = 0.014), LVI (OR = 70.23; p < 0.001), and tumor size ≥ 4 cm (OR = 12.00; p = 0.009) were independently associated with advanced-stage presentation, whereas BMI showed no significant association. Recurrence occurred in 13.5% of patients, more frequently among smokers and LVI-positive cases, though not statistically significant.

CONCLUSION: Smoking, lymphovascular invasion, and tumor size ≥ 4 cm were independently associated with advanced-stage presentation in TGCTs, whereas obesity showed no significant association. The combined evaluation of pathological and lifestyle factors may enhance individualized risk stratification and inform future risk-adapted management strategies.

PMID:41555284 | DOI:10.1186/s12885-026-15598-y

J Matern Fetal Neonatal Med. 2026 Dec;39(1):2614840. doi: 10.1080/14767058.2026.2614840. Epub 2026 Jan 19.

ABSTRACT

INTRODUCTION: The importance of prenatal determination of chorionicity for the management of twin pregnancies is well recognized. However, research on the contribution of prenatal evaluation of zygosity to the management of twins is limited. We assessed the utility of adding SNP-based cell-free DNA (cfDNA) zygosity testing to ultrasound chorionicity assessment for the clinical management of twin pregnancies.

METHODS: Prospective observational study involving 13 United States practices with proficiency in prenatal ultrasound. Patients diagnosed by ultrasound with twins in the first trimester were assessed with cfDNA screening for zygosity. Ultrasound assessment of chorionicity was performed prior to cfDNA results. Placental pathology was used as the gold standard for chorionicity assessment. Gestational age at delivery and standardized birthweights were compared, based on chorionicity and zygosity.

RESULTS: 110 twin pregnancies were included. Among 79 dichorionic (DC) cases confirmed by placental pathology, one (1.3%) was misclassified as monochorionic (MC) by ultrasound, but was dizygous (DZ) by cfDNA, consistent with DC. Of 31 monozygotic (MZ) twins by cfDNA, confirmed as MC by pathology, ultrasound misclassified one (3.6%) as DC. Median gestational age at delivery was earlier for MZ twin pregnancies (35.0 weeks) compared to DZ (36.9 weeks, p = 0.02). After adjusting for fetal sex and gestational age at birth, MZDC twins had significantly lower birthweights (p = 0.006) and birthweight percentiles (p = 0.004) than DZDC twins.

CONCLUSIONS: Based on postpartum placental pathology as the reference standard for determining MC versus DC, cfDNA zygosity testing appears to aid in the prenatal assignment of chorionicity. Larger studies are needed to confirm the value of zygosity testing in the management of twin pregnancies.

PMID:41555214 | DOI:10.1080/14767058.2026.2614840

Pediatr Dent. 2025 Nov 15;47(6):408-448.

ABSTRACT

Purpose: Evaluate and compare the accuracy and completeness of responses provided by ScholarGPT and ChatGPT-4 Omni (ChatGPT-4o) to clinical questions in pediatric dentistry. Methods: Thirty clinical questions across six clinical topics were developed. Responses were collected from ScholarGPT and ChatGPT-4o and independently evaluated by six experienced pediatric dentists. The evaluators used a five-point Likert scale for accuracy and three-point scale for completeness. Accuracy was rated for factual correctness, relevance, and coherence, while completeness reflected how fully the response addressed the question. Statistical analysis was performed using non-parametric tests, including the Wilcoxon signed-rank and Kruskal-Wallis tests. Results: ScholarGPT received significantly higher median accuracy scores (five, interquartile range [IQR] equals zero) compared to ChatGPT-4o (four, IQR equals one) across all topics (P<0.001). In completeness scores, ScholarGPT (three, IQR equals one) also out-performed ChatGPT-4o (two, IQR equals zero; P<0.001). ScholarGPT showed the highest accuracy in the “fissure sealants” (five, IQR equals zero), while the lowest was observed in “development of dentition and occlusion” (five, IQR equals one). ChatGPT-4o yielded the lowest accuracy in “development of dentition and occlusion” (four, IQR equals two) and the highest in “fluoride” (four, IQR equals one). Accuracy scores varied significantly across topics for both ChatGPT-4o (P=0.012) and ScholarGPT (P=0.001). However, differences in completeness across topics were observed only for ScholarGPT (P=0.008). Conclusions: ScholarGPT provided more accurate and complete responses to pediatric dentistry questions than ChatGPT-4o, suggesting that domain-specific artificial intelligence tools can aid dental education and clinical support, though further refinement is needed.

PMID:41555199

Nurs Health Sci. 2026 Mar;28(1):e70291. doi: 10.1111/nhs.70291.

ABSTRACT

Nurses play a key role in medication review. This study explores nursing students’ awareness and understanding of concepts (pharmacology, medication review, polypharmacy, and deprescribing) and gives insight into their preparedness to engage with these in clinical settings. This cross-sectional survey was conducted at a London higher education institution. The sample comprised 127 third-year undergraduate adult and paediatric nursing students. Data were collected using a structured questionnaire, which included free-text items to capture qualitative insights. Quantitative data were analyzed using descriptive statistics, while thematic analysis explored qualitative responses. Respondents were familiar with the terms medication review (94%, 118/125) and polypharmacy (76%, 96/126), but not deprescribing (37%, 46/125). Although respondents could identify triggers for initiating a medication review, their understanding of the collaborative nature of the process for healthcare professionals and patients was inconsistent. Respondents were able to identify medications that may warrant review and potential deprescribing. Core concepts related to medication review were generally understood by respondents. However, understanding of deprescribing, as well as the nurse’s role in advocating for patients during medication review, was less consistent.

PMID:41555163 | DOI:10.1111/nhs.70291

Dermatol Ther (Heidelb). 2026 Jan 19. doi: 10.1007/s13555-025-01646-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Switching biologics within or across classes can improve outcomes for patients with psoriasis who failed to meet their treatment goals on their original therapy. The objective of this study was to identify real-world baseline features which are associated with switching psoriasis therapies following sustained use of a biologic therapy.

METHODS: The study was a retrospective analysis of the prospective, multicenter, non-interventional PPD™ CorEvitas™ Psoriasis Registry cohort. Patient sociodemographics, comorbidities, treatment history, disease activity, and patient-reported outcome measures were assessed at baseline visits, along with changes in disease activity and treatment at follow-up visits. Patients were classified at each follow-up visit as either switchers from one biologic therapy to another or non-switchers. Three analytic strategies-logistic regression, random forest, and decision trees-were used to identify features associated with switching.

RESULTS: Patients contributed 14,729 follow-up visits, of which 995 episodes (6.8%) reflected a switch in biologic therapy. In logistic regression models, statistically significant associations with switching were seen for features including body surface area (BSA) involvement at baseline, change in BSA involvement from baseline to follow-up, and addition of at least one non-biologic systemic medication to treatment between baseline and follow-up. In random forest estimations, these three variables along with patient-reported fatigue and quality of life were determined to be most important. Finally, in the decision tree analysis, four subgroups of patients with moderate/severe BSA involvement at baseline in combination with other specific variables were identified as having a > 50% likelihood of switching.

CONCLUSION: Identification and recognition of these features and combinations thereof can facilitate shared decision-making between clinicians and patients to improve both outcomes of and patient satisfaction with biologic therapy.

PMID:41555153 | DOI:10.1007/s13555-025-01646-1

J Autism Dev Disord. 2026 Jan 20. doi: 10.1007/s10803-025-07211-1. Online ahead of print.

ABSTRACT

PURPOSE: Social skill interventions are frequently used to support the development of social competence in children with autism spectrum disorder (ASD). The Superheroes Social Skills program (SSS), a multicomponent social skills curriculum, has shown promise in supporting social skill acquisition and use in autistic children. The present exploratory pilot study evaluated the effectiveness of a brief version of SSS on social skill accuracy and quality of skill use of five young children with ASD.

METHOD: Single-case design (multiple probe design across skills, replicated across participants) was used to evaluate the effect of a brief SSS intervention implemented in a series of weekly 20-minute sessions. Five young autistic children participated in the study. Social skill accuracy and quality of skill use were measured to assess the impact of the intervention.

RESULTS: Results of the study indicated that participants increased in social skill accuracy and quality of skill use following participation in the intervention, with statistical analysis of data also supporting the effectiveness of the brief intervention.

CONCLUSION: Although preliminary, findings of this pilot study suggest that a brief variation of SSS may have utility as a strategy to address social skill needs in young children with ASD. Given the small sample included in the study, further replication is necessary to address limitations to external validity.

PMID:41555143 | DOI:10.1007/s10803-025-07211-1

Mem Cognit. 2026 Jan 19. doi: 10.3758/s13421-025-01841-7. Online ahead of print.

ABSTRACT

Event-files are a central concept in human action control as they integrate perception and action. The basic idea is that event-files comprise internal representations of stimuli, motor programs, and sensory effects of actions that are bound together, maintained for some time, and then ultimately decay. Yet the exact nature of the decay of event-files remains elusive. Most previous studies analyzed the decay only on a very coarse-grained scale typically with only two or three different response-stimulus intervals (RSI). Because available data are inconsistent, the decay function could as yet not be delineated, particularly whether it is linear or resembles a typical forgetting curve. In the present study, we analyzed the decay of event-files using nine different RSIs between 400 ms and 2,000 ms in a large sample (N = 156) of neurotypical participants. If event-file decay mimics the typical forgetting curve, the concept of event-files can be better connected to the memory literature. Using unsupervised cluster analysis, the results showed, however, a more complex pattern. In fact, there were different decay functions across participants with only a subset showing a forgetting curve suggesting that (i) event-file decay functions are modulated by interindividual differences and (ii) that the previously observed power function might be a statistical artifact due to averaging. At least in the time range investigated in this study, event-files decay only for a subset of participants. Possible underlying processes are discussed.

PMID:41555140 | DOI:10.3758/s13421-025-01841-7

Updates Surg. 2026 Jan 19. doi: 10.1007/s13304-026-02532-x. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Statistical cure occurs when the mortality of a specific population returns to mortality values of the general population. Whether antiviral therapy is associated with achievement of statistical cure of patients with hepatocellular carcinoma (HCC) undergoing liver resection (LR) remains unknown. We aimed to clarify this issue.

METHODS: We enrolled 1004 patients with HCC who underwent LR. We evaluated overall survival (OS) as the primary survival measure for estimating cure fractions through a mixture model.

RESULTS: The probability of resection enabling patients with HCC to achieve the same life expectancy as that of the general population was 48.6%. The multivariable cure model revealed that age ≤ 65 years, 7th edition pathological American Joint Committee on Cancer (AJCC) stage 1, no cirrhosis, receipt of antiviral therapy, and a Model for End-Stage Liver Disease (MELD) score of ≤ 9 were predictors of cure after LR.

CONCLUSIONS: About five in 10 patients could be considered cured after LR for HCC. In addition to tumor- and liver-related variables, receipt of antiviral therapy was associated with achievement of statistical cure. We highlight the importance of antiviral therapy for maximizing outcomes of resection for HCC.

PMID:41555128 | DOI:10.1007/s13304-026-02532-x

Saudi Dent J. 2026 Jan 20;38(2):6. doi: 10.1007/s44445-025-00098-9.

ABSTRACT

This study aimed to evaluate the effects of photobiomodulation therapy (PBM) on post-operative pain and wound healing following the extraction of mandibular third molars. A split-mouth, double-blind, placebo-controlled, randomized clinical trial was conducted at the Faculty of Dentistry, José Antonio Páez University. Patients requiring bilateral surgical extraction of impacted and retained mandibular third molars in comparable anatomical positions were enrolled. Individuals with soft or hard tissue pathologies or systemic inflammatory conditions that could interfere with healing were excluded. One side of the jaw was randomly assigned as the treatment side, whereas the contralateral side served as the control. The treatment side received photobiomodulation (PBM) via a 980 nm diode laser (SOLASE PRO LASER, LAZON®) immediately after surgery and at 24, 48, and 72 h postoperatively. The primary outcome variables were wound healing and pain intensity. Pain was assessed via a visual analog scale (VAS) at 24, 48, 72, and 168 h. Wound healing was clinically evaluated on postoperative days 3, 7, and 14. Comparative analysis was performed via two-way ANOVA and repeated-measures ANOVA. A p value < 0.05 was considered statistically significant. Thirty-seven patients (32.4% male and 67.6% female) aged 22.8 ± 3.6 years participated in this study. VAS results revealed that PBM controlled pain at 24 h (4 ± 3) in comparison with the control group (6 ± 3) (p = 0.002), at 48 h (4 ± 3 and 5 ± 2, respectively) (p = 0.003), and at 72 h (2 ± 2 and 4 ± 2, respectively) (p = 0.004). Wound healing was significantly better on the PBM-treated side on day 3 (2,1 ± 0,2) than on the control side (3,2 ± 0,6) (p = 0.00), at 7 days (1,5 ± 0,5 and 2,5 ± 0,8, respectively) (p = 0.00), and at 14 days (1 ± 0 and 1,8 ± 0,8), respectively (p = 0.00). No adverse effects were reported. PBM with a 980 nm diode laser significantly reduced postoperative pain and enhanced wound healing compared to the contralateral control side, supporting its use as a safe and effective adjunct in third molar surgery.

PMID:41555111 | DOI:10.1007/s44445-025-00098-9

Int Urol Nephrol. 2026 Jan 19. doi: 10.1007/s11255-026-05001-x. Online ahead of print.

ABSTRACT

BACKGROUND: Globally, Chronic kidney disease (CKD) has emerged as one of the major public health concerns impacting 10 to 15% of the world population. However, relatively very few studies have presented the comprehensive data on burden of disease particularly in developing countries like Nepal. Chronic kidney disease leads to declining kidney function, often progressing to end stage renal disease or death, imposing significant economic burdens. We aim to describe the ethology of end stage renal disease patients undergoing maintenance haemodialysis.

METHODOLOGY: A cross-sectional, descriptive study was conducted at a dedicated transplant centre in Nepal to assess a comprehensive understanding of the causes of chronic kidney disease. Data was collected from the individual’s undergoing haemodialysis at the Shahid Dharma Bhakta National Transplant Centre, approximately 175 individuals meeting the inclusion criteria. SPSS was used for descriptive and inferential statistics.

RESULTS: Among 175 patients, the mean age was 47.2 years (SD ± 14.97), with 115 (65.7%) males, and the majority were aged between 40 and 64 years. Hypertensive nephropathy was the most common cause, accounting for 39.4%, followed by both hypertension and diabetes mellitus in 12.6% of cases, while isolated diabetes mellitus accounted for 10.9%. Chronic glomerulonephritis (9.1%), chronic pyelonephritis (8%), and obstructive uropathy (7.4%) were also major contributors, with smaller proportions linked to conditions like urate nephropathy, renal tuberculosis, systemic lupus erythematosus, preeclampsia, and solitary kidney.

CONCLUSION: This study identified the primary causes of end stage renal disease in Nepal, where chronic kidney disease prevalence is increasing but under-researched. Hypertension and diabetes mellitus are key risk factors for chronic kidney disease, yet awareness of these conditions and their complications is often limited in Nepal. The etiological spectrum data is crucial for targeted screening programs for the general population and high-risk groups, follow-up and treatment, improving patient outcomes and reducing the economic burden of end stage renal disease.

PMID:41555102 | DOI:10.1007/s11255-026-05001-x