Nevin Manimala

Cancer Treat Res Commun. 2025 Aug 26;45:100983. doi: 10.1016/j.ctarc.2025.100983. Online ahead of print.

ABSTRACT

BACKGROUND: Nasopharyngeal carcinoma (NPC) is located near critical structures like the hippocampus, essential for memory and cognitive function. While Volumetric Modulated Arc Therapy (VMAT) has improved dose conformity in NPC treatment, the integration of hippocampal-sparing (HS) approaches remains underexplored. This study evaluates the dosimetric feasibility and effectiveness of hippocampal-sparing VMAT (HS-VMAT) in NPC, focusing on reducing radiation exposure to the hippocampus while maintaining target volume coverage.

METHODS: We conducted a retrospective cohort study of 20 NPC patients treated at Cheikh Khalifa International University Hospital between 2020 and 2023. Each patient underwent two radiotherapy plans: one with hippocampal sparing and one without. Dosimetric parameters for planning target volumes (PTVs) and organs at risk (OARs) were analyzed. Independent samples t-tests were used for statistical analysis with a significance level of p < 0.05.

RESULTS: For the high-risk PTV (PTV HR), there were no significant differences in maximum dose (D2 %) between HS and non-HS groups (71.71 ± 0.23 Gy vs. 71.65 ± 0.11 Gy; p = 0.298). The minimum doses (D95 %, D98 %) and mean dose (Dmean) were slightly lower in the HS group, though not statistically significant. For intermediate- and low-risk PTVs, dose metrics remained similar across groups. Hippocampal sparing significantly reduced doses to the hippocampus. The minimum dose (Dmin) decreased from 5.87 ± 2.06 Gy to 3.93 ± 0.45 Gy (p = 0.001), and the maximum dose (Dmax) decreased from 10.73 ± 3.62 Gy to 7.40 ± 1.25 Gy (p = 0.001). Radiation doses to critical structures were also reduced. The brainstem Dmax decreased from 35.68 ± 5.31 Gy to 30.12 ± 4.71 Gy (p = 0.001), and the left parotid gland Dmoy decreased from 21.38 ± 5.38 Gy to 18.32 ± 2.53 Gy (p = 0.029).

CONCLUSION: HS-VMAT for NPC effectively reduces hippocampal and critical structure radiation doses without compromising target volume coverage. This technique offers a feasible approach to minimize neurocognitive risks while maintaining treatment efficacy.

PMID:40897082 | DOI:10.1016/j.ctarc.2025.100983

Clin Oncol (R Coll Radiol). 2025 Aug 8;46:103907. doi: 10.1016/j.clon.2025.103907. Online ahead of print.

ABSTRACT

AIMS: To compare the safety and efficacy of hypofractionated chemoradiation (HYPO) regimen with a conventional fractionation (CVRT) for locally advanced cervical cancer (LACC).

MATERIALS AND METHODS: A single-centre, open-label, randomised controlled trial enrolled patients with LACC to receive either HYPO (44 Gy/20 fractions) or CVRT (45 Gy/25 fractions) with intensity-modulated radiotherapy, image-guided adaptive brachytherapy, and concurrent weekly cisplatin. The primary outcome was the incidence of acute and late gastrointestinal (GI) and genitourinary (GU) toxicity assessed using the Common Terminology Criteria for Adverse Events version 5.0. Secondary outcomes included health-related quality of life (HRQoL), disease control, and survival.

RESULTS: Forty patients with a median follow-up of 19 months were enrolled (HYPO: n=21; CVRT: n=19). The HYPO achieved a significantly shorter overall treatment time (OTT) compared with CVRT (39 vs 47 days, P < .001). GI and GU toxicities were manageable, with a trend towards higher rates in the HYPO compared with CVRT for both acute (grading [Gr]≥3 CTCAE/patient-reported outcome 43%/29% vs 32%/11%, P=.53/0.24) and actuarial 18-month late GI toxicity (Gr≥2/Gr≥3 26.2%/21.2% vs 20.6%/14.4%, P=.537/0.438), although not statistically significant. No Gr≥3 GU toxicity was observed. HRQoL scores during treatment were lower in the HYPO compared with CVRT; however, recovering within the 3-month post-radiotherapy period. A trend toward superior locoregional control was observed in the HYPO. Notably, para-aortic control at 24 months was significantly higher in the HYPO (100% vs 71.2%, P=.003). No significant differences were observed in local control or overall survival at the time of analysis.

CONCLUSION: HYPO with modern techniques is feasible for LACC, significantly reducing OTT. A trend towards higher yet tolerable acute and late GI toxicity warrants further investigation. Encouragingly, HYPO showed promising locoregional control.

REGISTRATION NUMBER: thaiclinicaltrials.org (TCTR20210812003).

PMID:40897075 | DOI:10.1016/j.clon.2025.103907

Eval Program Plann. 2025 Aug 25;113:102689. doi: 10.1016/j.evalprogplan.2025.102689. Online ahead of print.

ABSTRACT

This study presents a data-driven analysis of academic performance, demographic disparities, and predictive modeling among more than 23,000 first-time freshmen at a US public University. We examine multiple factors influencing student outcomes, including GPA, credit accumulation, unit workload, Pell Grant eligibility, minority status, and parent education levels. Our analysis reveals several statistically significant disparities: non-minority students earn more units than minority students in their first two years, and Pell-eligible students accumulate fewer credits than their non-eligible peers. First-generation college students also exhibit lower credit accumulation compared to peers. GPA distributions show that minority students have a lower average GPA compared to non-minority students, with broader variation. Clustering analysis identifies three distinct academic engagement profiles based on GPA and unit load, highlighting heterogeneous performance patterns and the need for differentiated support. We develop and tune predictive models to forecast sophomore credit accumulation and GPA, achieving strong performance using deep learning. These models enable proactive risk identification and support strategic interventions. Our findings set the stage for actionable insights for institutional decision-makers aiming to enhance student retention, success, and academic momentum.

PMID:40897068 | DOI:10.1016/j.evalprogplan.2025.102689

Int J Med Inform. 2025 Aug 31;205:106103. doi: 10.1016/j.ijmedinf.2025.106103. Online ahead of print.

ABSTRACT

BACKGROUND: The development and use of artificial intelligence and machine learning technologies in healthcare have increased, prompting a need for evidence on their safety and value. Economic evaluations support healthcare decision-making and resource allocation. This scoping review aimed to map and synthesize current approaches to evaluating the economic aspects of machine learning based technologies implemented in healthcare.

METHODS: Following the updated JBI guidance for scoping reviews, six databases (PubMed, CINAHL, Cochrane Library, Embase, Scopus, and IEEE Xplore) were searched for studies evaluating the economic aspects of machine learning-based technologies within healthcare. No exclusions were applied to healthcare settings, healthcare professionals or used economic evaluation methods. The results of data extraction were analyzed using descriptive statistics and inductive coding. The reporting of the studies was compared against the CHEERS-AI statement.

RESULTS: A total of 6332 references were retrieved, with 18 studies included in the review. The studies comprised economic evaluations (n = 9), impact evaluations (n = 5), and performance evaluations (n = 4), with cost-effectiveness analysis being the most frequently used economic evaluation method (n = 8). The comparison of the studies to the reporting guidelines revealed gaps in the reporting of details from economic evaluations and the artificial intelligence nature of the technologies. Overall, the study alignment with the CHEERS-AI items on average was 39.6 %, with 64.1 % alignment with economic evaluation details, and 21.3 % alignment with key details related to the artificial intelligence nature of the evaluated technologies.

CONCLUSIONS: The current literature evaluating the economic aspects of machine learning-based technologies implemented in healthcare reveals gaps in coherence and coverage. Frameworks guiding artificial intelligence development should be refined to incorporate components related to system evaluation and post-implementation considerations. Further, multidisciplinary collaboration should be enhanced and promoted.

PMID:40897062 | DOI:10.1016/j.ijmedinf.2025.106103

Ecotoxicol Environ Saf. 2025 Sep 1;303:118962. doi: 10.1016/j.ecoenv.2025.118962. Online ahead of print.

ABSTRACT

BACKGROUND: Hormonal disruption evidence of metal exposure is lacking and contradictory.

OBJECTIVES: To elucidate the association of multiple metals exposure with a comprehensive panel of sex hormones in women across the lifespan.

METHODS: 5492 women aged 3-80 from a national survey were included. Multivariable linear regression, restricted cubic splines, and receiver operating characteristic curves were employed to assess individual metal exposure with sex hormones. Quantile-based g computation was used to explore mixture exposure association. Vitamin D and folate were examined as the modifiers. Integrative bioinformatics analysis was conducted leveraging a network of databases to reveal underlying mechanisms.

RESULTS: Exposure to cadmium, lead (Pb), mercury (Hg), selenium, and manganese was associated with sex hormones. For example, in young adult (20-49 years), Pb was associated with androstenedione [3.89 %, 95 % CI: 0.81, 7.06], estrone sulfate [8.14 %, 95 % CI: 1.54, 15.18], and luteinizing hormone [12.29 %, 95 % CI: 5.01, 20.07]; Hg was associated with estrone sulfate [4.84 %, 95 % CI: 0.62, 9.22]. Metals mixture was mainly associated with young adults’ increased sex hormones with effect ranging from 5.37 % (95 % CI: 1.77, 9.10) to 17.83 % (95 % CI: 9.04, 27.34). Folate modified such associations with hazardous effect appeared in high folate level in young adults, while in low folate level in other age groups. Inflammatory signaling pathways such as TNF and IL-17 may mediate metal-induced sex hormones disturbance.

CONCLUSIONS: Our findings highlight the significant associations, folate modifications, and potential pathways of metal exposure on female sex hormones, which provides insights for prevention avenues and mechanisms.

PMID:40897053 | DOI:10.1016/j.ecoenv.2025.118962

Ultrasonics. 2025 Aug 26;157:107803. doi: 10.1016/j.ultras.2025.107803. Online ahead of print.

ABSTRACT

This study aims to evaluate the clinical utility of quantitative ultrasound (QUS) envelope statistics imaging in predicting the risk of vertebral fractures (VFs) in postmenopausal women, compared to conventional dual-energy X-ray absorptiometry (DXA) measurements, including bone mineral density (BMD) and T-score. A total of 63 postmenopausal women were enrolled. QUS envelope statistics imaging was performed on the L3 vertebra, analyzing parameters including the Nakagami parameter (m), scatterer clustering parameter (α), coherent to diffuse signal ratio (k), and entropy (H) for comparisons with DXA. The data were divided into three tertiles: reference, early VF risk, and high-risk groups. Odds ratios (ORs) were calculated to evaluate the predictive abilities of each parameter for VF risk. Intraclass correlation coefficients (ICCs) and Bland-Altman plots were utilized to evaluate consistency both within subjects and across different operators. There were no significant differences in QUS parameters between subjects with and without VFs overall (p > 0.05). However, compared to DXA, the Nakagami parameter and entropy demonstrated a significant association with early VF risk, as subjects in the second tertile exhibited higher risks of VFs compared to those in the first tertile (ORs: 3.02 for m and 3.30 for H). Bland-Altman analysis indicated mean differences close to zero and ICCs exceeding 0.90 for all QUS parameters. QUS envelope statistics imaging could complement DXA in predicting VFs, particularly in detecting early fracture risk, offering a non-invasive, radiation-free alternative for osteoporosis screening.

PMID:40897038 | DOI:10.1016/j.ultras.2025.107803

J Biomech. 2025 Aug 16;191:112909. doi: 10.1016/j.jbiomech.2025.112909. Online ahead of print.

ABSTRACT

This study assessed the biomechanical effect of a counterforce brace on the common extensor origin (CEO) tendon at the elbow via the measurement of shear wave velocity (SWV) using ultrasound. The counterforce brace was hypothesised to reduce SWV, which is a proxy measure of tendon stiffness, whilst the wrist and finger extensors were contracting at different levels of maximum voluntary contraction (MVC). In this cross-sectional study, nineteen healthy participants (age±SD: 30±9) were included in the study. The counterforce brace was applied with either 0 or 80 mmHg pressure to the forearm. The SWV was measured under four different wrist extensors MVC levels: 0%, 20%, 30%, and 40%. The counterforce brace had no significant effect on CEO tendon SWV at rest (V-statistic = 86, p = 0.74), 20% (V-statistic = 105, p = 0.71), 30% (V-statistic = 87, p = 0.77), or 40% (V-statistic = 94, p = 0.98) of MVC. The Friedman test for repeated measures showed an increase in SWV with greater levels of wrist extension MVC (x² = 7.9, p = 0.048). In conclusion, the counterforce brace does not appear to have a biomechanical effect on the CEO of the elbow during resting conditions or whilst the wrist extensors are contracting. The SWV of the CEO, a proxy for tendon stiffness, increases with greater levels of MVC.

PMID:40897020 | DOI:10.1016/j.jbiomech.2025.112909

Environ Int. 2025 Aug 21;203:109739. doi: 10.1016/j.envint.2025.109739. Online ahead of print.

ABSTRACT

BACKGROUND: Early life exposure to environmental factors can impact skeletal development. We aimed to identify periods of susceptibility to air pollution in early life in relation to bone health outcomes at age six.

METHODS: Data were from the Generation R study, a population-based pregnancy cohort study, The Netherlands. We estimated daily concentrations of nitrogen dioxide (NO2) and particulate matter (PM10, PM2.5 and PM2.5 absorbance) at the home addresses during pregnancy and childhood, using land-use regression models. Bone mineral density and area-adjusted bone mineral content were measured by dual-energy x-ray absorptiometry at age six. We performed distributed lag modelling (DLM) adjusted for several socioeconomic characteristics to assess the associations between bone health and air pollution, using 28-day averaged exposure levels, and identify windows of susceptibility.

RESULTS: Among 5966 children, we identified windows of susceptibility from ∼ 1 to ∼ 4 years of age for PM2.5 and PM2.5 absorbance with bone mineral density (e.g., -10.3; 95 % CI -15.8 to -4.7 per 5 µg/m³ increase in PM2.5) and for all air pollutants with bone mineral content (e.g., -14.6; 95 % CI -20.7 to -8.4 per 5 µg/m³ increase in PM2.5). Also, we identified an association between NO2 and PM2.5 absorbance during pregnancy and higher bone mineral content (e.g., 4.0; 95 % CI 1.4 to 6.6 per 10^-5 m^-1 increase in PM2.5 absorbance). In the sex-stratified analyses, associations across all exposures and outcome measures were in the same direction for both sexes, and similar to the main analyses, but statistically significance was observed only in boys.

CONCLUSIONS: Our findings suggest that exposure to air pollutants during childhood may already lead to poorer bone health outcomes.

PMID:40897019 | DOI:10.1016/j.envint.2025.109739

Talanta. 2025 Aug 30;297(Pt B):128784. doi: 10.1016/j.talanta.2025.128784. Online ahead of print.

ABSTRACT

Tetracycline (TC) is a common antibiotic with broad antibacterial activity, yet its excessive abuse will leave antibiotic residues in animal-derived food, posing some threats to human health. Therefore, developing a simple and effective technology for TC trace analysis is immediately important for food safety. Herein, the sensitive PEC aptasensor within Z-scheme heterojunction, based on Bi/Bi₂MoO₆ and P-doped ultrathin porous g-C₃N₄ (PCN), was constructed by elemental doping strategy, hydrothermal method and surface plasmon resonance (SPR) effect. Benefiting from the Z-scheme electron transmission way, the Bi/Bi₂MoO₆@PCN heterojunction significantly improves both visible-light absorption and the mobility of photogenerated carriers. Thus, the fabricated PEC aptasensor based on Bi/Bi₂MoO₆@PCN heterojunction exhibited outstanding selectivity and stability for TC detection, which displayed a wider linear range of 0.05-350 nM and a lower detection limit of 0.036 nM. In addition, the proposed aptasensor showed the acceptable recoveries (98.41-104.76 %) for TC residue analysis in animal-derived food, including milk, honey and pork. Therefore, it demonstrates that the PEC sensing technology possesses the excellent feasibility and application potential in food analysis.

PMID:40897008 | DOI:10.1016/j.talanta.2025.128784

Arch Gerontol Geriatr. 2025 Aug 26;139:106003. doi: 10.1016/j.archger.2025.106003. Online ahead of print.

ABSTRACT

With growing recognition of psychosocial risks for cognitive impairment, research on social isolation (SI) and loneliness (LON) and their relationship to memory has increased over the past decade. However, most studies have examined SI and LON separately, leaving their combined influence on memory underexplored, particularly in qualitative research. This study presents the qualitative arm of a larger mixed-methods investigation, exploring how SI and LON, separately and together, shape memory in middle-aged and older adults. Ten individuals aged 47 – 81 were recruited through purposive and snowball sampling for semi-structured interviews, analyzed using thematic analysis informed by descriptive phenomenology. Participants generally viewed LON as more damaging to memory than SI, noting that mental stimulation is still possible during isolation, whereas LON often drains the motivation to engage in such activities. Some described SI positively (form of self-care), though extended SI was seen as detrimental due to increased social anxiety (further limits social engagement), disrupted routines, and diminished sense of purpose, all critical for memory. The combination of SI and LON was perceived as most harmful, creating a feedback loop that exacerbates both conditions and increases vulnerability to self-destructive behaviours (smoking, physical inactivity, poor diet). This research identifies distinctive indicators and psychosocial needs of those experiencing SI, LON, or both, supporting more precise screening and intervention triage in clinical and community settings. It underscores the value of targeted, multimodal brain health interventions addressing diverse contributing factors through strategies like social connection, purpose-driven living, cognitively stimulating activities, chronic disease management, and healthy lifestyle habits.

PMID:40896982 | DOI:10.1016/j.archger.2025.106003