Nevin Manimala

Br J Cancer. 2025 Oct 4. doi: 10.1038/s41416-025-03224-w. Online ahead of print.

ABSTRACT

BACKGROUND: Survival differences between socioeconomic groups in colorectal cancer have been studied for patients diagnosed in the 90s and 00s, but research on recent patients using individual measures of socioeconomic position is limited.

METHODS: CRCBaSe, a database of linked national registry data, was used to analyse stage I-III colorectal cancer patients diagnosed in Sweden between 2008 and 2021. The exposures of interest were income and education. Flexible parametric survival models were fitted and standardised survival probabilities and hazard ratios (HR) were calculated for cancer-specific survival, recurrence, and overall survival.

RESULTS: Analysis of 59,995 patients showed better 5-year standardised cancer-specific survival in the least deprived income group, 77.8% (95%CI 76.9-78.6) vs. 73.2% (95%CI 72.6-73.9) in the most deprived income group, HR 0.93 (95%CI 0.87-0.99). Time to recurrence was not statistically different between socioeconomic groups. Overall survival was better in the least deprived income group, with a 5-year standardised overall survival of 70.0% (95%CI 69.1-70.8) vs. 63.5% (95%CI 62.9-64.1) in the most deprived income group, HR 0.82 (95%CI 0.79-0.86).

CONCLUSION: We found large disparities in cancer-specific and overall survival between the highest and most deprived income and education groups, despite improvements in care and the introduction of guidelines.

PMID:41046246 | DOI:10.1038/s41416-025-03224-w

J Prosthet Dent. 2025 Oct 3:S0022-3913(25)00750-4. doi: 10.1016/j.prosdent.2025.09.019. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Grinding is often required for the clinical adjustments of zirconia restorations; nevertheless, the effects of following regeneration firing processes on additively manufactured zirconia are still unclear.

PURPOSE: The purpose of this in vitro study was to evaluate the effects of grinding and regeneration firing (RF) on the phase transformation and biaxial flexural strength (BFS) of additively or subtractively manufactured 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP).

MATERIAL AND METHODS: A total of 108 disk-shaped (Ø15×1.5 mm) 3Y-TZP specimens (n=54) were fabricated using either subtractive manufacturing (SM) or additive manufacturing (AM) techniques. Grinding was performed using a 150-μm-grit diamond rotary instrument with a high-speed handpiece, and RF was carried out at 1000 °C for 15 minutes in a sintering furnace. The crystalline phases were analyzed using X-ray powder diffraction (XRD). All specimens were loaded until fracture using a universal testing machine for a biaxial flexural strength test at a crosshead speed of 1 mm/minute. Microstructure and fracture surfaces were examined using scanning electron microscopy. BFS data were statistically analyzed using 1-way ANOVA, followed by the Tukey post hoc test for pairwise comparisons. (α=.05). The Weibull modulus and characteristic strength were calculated to assess the reliability of strength data.

RESULTS: Tetragonal-to-monoclinic phase transformation was detected in ground specimens of both AM and SM groups, whereas only the tetragonal phase was observed in their corresponding RF groups. The highest BFS (1427.2 MPa) was observed in ground AM specimens (P<.001). Grinding and RF did not significantly affect the BFS of SM zirconia (P=.927 and P=.999, respectively) but significantly increased the BFS of AM zirconia (P<.001). RF increased the Weibull modulus in both AM (from m=6.98 to 12.25) and SM (from m=5.91 to 8.35) zirconia.

CONCLUSIONS: The implementation of RF after grinding is crucial, particularly for AM zirconia, to improve mechanical strength and structural reliability.

PMID:41046229 | DOI:10.1016/j.prosdent.2025.09.019

J Prosthet Dent. 2025 Oct 3:S0022-3913(25)00751-6. doi: 10.1016/j.prosdent.2025.09.022. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: An efficient protocol for removing stains from 3-dimensionally (3D) printed artificial teeth must also preserve their surface properties.

PURPOSE: The purpose of this in vitro study was to evaluate methods of removing stains from a 3D printed resin (Bio Crown) for artificial teeth submitted to immersion in coffee by using spectrophotometric analysis (CIEDE2000) and analyzing surface roughness with a profilometer and topography with a scanning electron microscope (SEM).

MATERIAL AND METHODS: Disks (Ø10×1.2 mm) were 3D printed and stained in instant coffee simulating 1 year of consumption. Color data (L*, a*, b*) and roughness (Ra, µm) were obtained at T0 (baseline, before staining), T1 (after staining), and T2 (after each stain removal protocol, n=12). The stain removal groups used sodium perborate (SP), 0.25% sodium hypochlorite (SH), conventional polishing with brush and pumice stone + felt wheels and universal paste (CP), and polishing with 3-abrasive tip kit (AP); the control was storage in distilled water (DW). Mixed 2-way ANOVA followed by the Bonferroni test was performed to statistically analyzing data with α=.05.

RESULTS: Roughness increased in all groups between T1 and T2 (P<.05), except for SH. The AP (0.64 ±0.12 µm) and CP (0.52 ±0.17 µm) groups showed similar roughness and higher roughness compared with the other groups (SP 0.40 ±0.22 µm, SH 0.31 ±0.12 µm, and DW 0.34 ±0.11 µm). A significant color difference (ΔE₀₀) was observed between T0 (1.03 ±0.49) and T1 (1.36 ±0.77), (P<.001), and the color remained statistically similar between T1 and T2 (1.48 ±1.02).

CONCLUSIONS: No method was effective in removing coffee stains. The polishing methods resulted in greater roughness, followed by sodium perborate. The only protocol that did not increase the roughness of the 3D printed resin for artificial teeth was 0.25% sodium hypochlorite. Longer application periods of the staining removal protocols are suggested for future studies.

PMID:41046228 | DOI:10.1016/j.prosdent.2025.09.022

Clin Genitourin Cancer. 2025 Aug 28:102423. doi: 10.1016/j.clgc.2025.102423. Online ahead of print.

ABSTRACT

INTRODUCTION: The EV-302 trial demonstrated a very significant overall survival (OS) benefit for Enfortumab Vedotin plus Pembrolizumab (EVP) relative to standard chemotherapy (CHT) for patients with metastatic urothelial carcinoma. However, questions have been raised regarding the high rate of treatment discontinuation in the CHT arm for reasons unrelated to adverse events or progression (33% vs. 10% with EVP, P < .01), potentially resulting in loss of unaccounted information, or informative censoring, and affecting survival results interpretation.

MATERIALS AND METHODS: We performed a multistep analysis to assess the impact of differential dropout on trial outcomes. First, Kaplan-Meier (KM) curves were reconstructed from published data to estimate time-to-event outcomes. Second, a reverse KM analysis was conducted to evaluate censoring patterns in the overall population and key subgroups (PD-L1 expression; cisplatin eligibility). Third, simulation models were employed to test whether informative censoring could negatively impact survival benefit by EVP. Finally, we compared the CHT arm of EV-302 to those of other contemporary RCTs through reconstructed survival analyses and risk-of-bias assessments.

RESULTS: Overall, no significant imbalance in censoring between the treatment arms of EV-302 was found on reverse KM analysis when assessing OS (P = .73); however, a significant difference was noted for progression-free survival (PFS) (P = .002). Simulation analysis revealed that even under extreme assumptions of informative censoring, the OS benefit of EVP remained statistically significant. Comparison with historical RCTs confirmed that the CHT outcomes in EV-302 were not anomalously poor. Risk of bias was low overall, although deviations from intervention and outcome measurement were flagged for EV-302.

CONCLUSIONS: Despite the high discontinuation rate in the CHT arm, OS benefit with EVP remains robust. These findings support the reliability of EV-302 results and mitigate concerns about informative censoring, thus encouraging the use of EVP in clinical practice.

PMID:41046201 | DOI:10.1016/j.clgc.2025.102423

Urol Oncol. 2025 Oct 3:S1078-1439(25)00346-1. doi: 10.1016/j.urolonc.2025.08.027. Online ahead of print.

ABSTRACT

INTRODUCTION: Consistent urologic oncology follow-up after radical cystectomy (RC) improves survival. However, there is scarce literature describing postoperative communication. We aimed to identify differences in postoperative communication patterns and healthcare utilization among English-speaking patients (ESPs) and patients with limited English proficiency (LEP) following RC.

METHODS: We conducted a single-institution, retrospective cohort study, examining patients who underwent RC for bladder cancer. We used propensity score matching to match 50 ESPs and 50 patients with LEP on age and sex. We abstracted patient demographics, postoperative communication and healthcare utilization within 90 days of surgery. We fit multivariable linear regression to investigate factors associated with postoperative communication frequency.

RESULTS: Postoperative communication was common, with 82% of patients placing ≥1 phone call/message. ESPs communicated more than patients with LEP (6.04 vs. 3.80 average calls/messages), though this difference was not statistically significant (P = 0.08). ESPs were more likely to initiate the communication themselves and have postoperative communication result in reassurance from the surgical team (P = 0.03), while patients with LEP were more likely to have a family member communicate on their behalf (P < 0.001) and have postoperative communication result in outpatient evaluation/treatment (P = 0.01). Patients with a neobladder reconstruction placed an increased number of phone calls/messages. There were no differences in postoperative healthcare utilization between the 2 groups.

CONCLUSIONS: Postoperative communication is frequent following RC. ESPs communicated nearly twice as often as patients with LEP, suggesting a clinically relevant difference in patient communication following radical cystectomy. Primary language spoken is not associated with differences in postoperative healthcare utilization.

PMID:41046200 | DOI:10.1016/j.urolonc.2025.08.027

ISA Trans. 2025 Sep 26:S0019-0578(25)00527-0. doi: 10.1016/j.isatra.2025.09.022. Online ahead of print.

ABSTRACT

In this research paper, a state estimation framework for a class of descriptor linear systems with MIMO is provided by using auxiliary modulating dynamical systems. First, the considered model is transformed into a simpler form involving the derivatives of inputs and outputs, based on which the auxiliary systems are applied. Then, the state variables are expressed through modulating integrals without the need for initial conditions, guaranteeing non-asymptotic convergence within fixed-time. This framework does not require the calculation of the derivatives of noisy outputs in discrete cases, reducing sensitivity to high-frequency noise in the estimation. Finally, the performance of the proposed method is validated through numerical simulations, which provide practical insights into its effectiveness and enable a comparison with some observers.

PMID:41046198 | DOI:10.1016/j.isatra.2025.09.022

ISA Trans. 2025 Sep 17:S0019-0578(25)00509-9. doi: 10.1016/j.isatra.2025.09.004. Online ahead of print.

ABSTRACT

The malicious attack design helps to accurately assess the vulnerability of cyber-physical systems under attacks. Based on this, an off-line generated attack model with time-varying covariance is proposed under the energy constraint, which aims to maximize the system estimation error while satisfying the ϵ-stealthiness. Subsequently, the problem is equivalently transformed by quantifying the optimization objective based on the derivation of error covariance and deriving the stealthiness condition according to the statistical properties of mutual information and Kullback-Leibler divergence. Due to the coupling relationship between the designed covariance and scheduling, the covariance is derived as a function of the attack scheduling by the Lagrange multiplier method. Then, the optimal attack scheduling is proved to be fixed according to the uniqueness of the optimal parameters. Finally, some numerical simulations are given to validate the effectiveness of results.

PMID:41046197 | DOI:10.1016/j.isatra.2025.09.004

ISA Trans. 2025 Sep 25:S0019-0578(25)00530-0. doi: 10.1016/j.isatra.2025.09.025. Online ahead of print.

ABSTRACT

In this paper, we propose a novel event-triggered (ET) distributed neurodynamic (DND) approach that integrates a distributed controller to tackle distributed time-varying optimization problems (DTOP). The approach achieves optimization of a global cost function in real time while simultaneously steering agent states toward consensus. Two key features distinguish the proposed method from prior works. First, communication among agents is governed by ET schemes, allowing updates only at specific triggering moments, which helps conserve communication energy. Second, the ET distributed controller eliminates the computation of the inverse of the Hessian matrix of the local objective function, which effectively reduces the computational cost. Finally, a case study of the battery charging problem demonstrates the effectiveness of the proposed approach.

PMID:41046194 | DOI:10.1016/j.isatra.2025.09.025

Clin Breast Cancer. 2025 Sep 4:S1526-8209(25)00251-4. doi: 10.1016/j.clbc.2025.09.001. Online ahead of print.

ABSTRACT

INTRODUCTION/BACKGROUND: Breast cancer affects over 61,000 women annually in France. While only 5-10% of breast cancers are hereditary, BRCA1/2 mutations significantly increase the lifetime risk of breast and ovarian cancer, with cumulative invasive breast cancer risks of 72% (BRCA1) and 69% (BRCA2) by age 80. Surgical management in this population is crucial, as it directly impacts quality of life (QoL). However, prospective comparative data on surgical strategies are lacking.

MATERIALS AND METHODS: This prospective study analyzed data from the CANTO cohort to assess the impact of different surgical approaches on QoL in BRCA1/2 mutation carriers diagnosed with invasive breast cancer. Four surgical options were compared: breastconserving surgery (BCS), mastectomy, immediate breast reconstruction (IBR), and delayed breast reconstruction (DBR). Patient-reported outcomes were evaluated over time, focusing on body image, future perspective, sexual functioning, and physical symptoms.

RESULTS: BCS and IBR were associated with better preservation of body image throughout follow-up. DBR significantly improved body image, future perspective, and sexual functioning beginning at the time of surgery. Breast and arm symptoms were overall moderate, but mastectomy resulted in increased arm symptoms, likely due to the higher rate of axillary lymphadenectomy.

CONCLUSION: When feasible, BCS should be preferred for BRCA1/2 mutation carriers, as it best preserves QoL. For patients requiring mastectomy, IBR is a valuable option, while DBR offers long-term benefits in body image and psychosocial well-being. Psychological support and structured postsurgical rehabilitation are strongly recommended to alleviate symptoms and optimize patient quality of life.

PMID:41046190 | DOI:10.1016/j.clbc.2025.09.001

Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Aug 27:S2212-4403(25)01195-2. doi: 10.1016/j.oooo.2025.08.016. Online ahead of print.

ABSTRACT

OBJECTIVE: Oral submucous fibrosis (OSF) is a progressive disease with an increased risk of developing oral cancer. There exists a notable scarcity of evidence on treatments that can promote tissue regeneration in OSF. Autologous platelet-rich plasma (PRP) is an emerging therapy with limited applications in OSF.

STUDY DESIGN: A prospective case-series was conducted in 10 patients with a histopathologically confirmed diagnosis of OSF. Baseline data included sociodemographic and risk habits, self-reported burning sensation to food was recorded using a visual analogue scale, and inter incisor distance at maximum mouth opening was measured in cm. Autologous PRP was infiltrated into bilateral buccal mucosa, once a month, and measurements were repeated at 6 months. Thresholds for clinically significant improvement were defined at ≥ 50% change in burning sensation, and ≥ 25% change in mouth opening. Data analysis was done using a paired sample T test and effect size (Cohen’s D).

RESULTS: Patients were aged 31 to 69 years, female to male ratio was 1:4 with mild to moderate disease severity. Clinically significant change in mouth opening was reported in 60% of patients, whereas 100% reported significant reduction in burning sensation, no side effects were reported. There were statistically significant differences (P < .05) on mouth opening and burning sensation following PRP therapy.

CONCLUSIONS: Based on this exploratory evidence, we propose intralesional PRP therapy as a safe and clinically effective treatment for mild to moderate OSF. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

PMID:41046183 | DOI:10.1016/j.oooo.2025.08.016