Nevin Manimala

Esophagus. 2025 Jan 10. doi: 10.1007/s10388-025-01106-x. Online ahead of print.

ABSTRACT

BACKGROUND: Neoadjuvant chemotherapy is standard for advanced esophageal squamous cell carcinoma, though often ineffective. Therefore, predicting the response to chemotherapy before treatment is desirable. However, there is currently no established method for predicting response to neoadjuvant chemotherapy. This study aims to build a deep-learning model to predict the response of esophageal squamous cell carcinoma to preoperative chemotherapy by utilizing multimodal data integrating esophageal endoscopic images and clinical information.

METHODS: 170 patients with locally advanced esophageal squamous cell carcinoma were retrospectively studied, and endoscopic images and clinical information before neoadjuvant chemotherapy were collected. Endoscopic images alone and endoscopic images plus clinical information were each analyzed with a deep-learning model based on ResNet50. The clinical information alone was analyzed using logistic regression machine learning models, and the area under a receiver operating characteristic curve was calculated to compare the accuracy of each model. Gradient-weighted Class Activation Mapping was used on the endoscopic images to analyze the trend of the regions of interest in this model.

RESULTS: The area under the curve by clinical information alone, endoscopy alone, and both combined were 0.64, 0.55, and 0.77, respectively. The endoscopic image plus clinical information group was statistically more significant than the other models. This model focused more on the tumor when trained with clinical information.

CONCLUSIONS: The deep-learning model developed suggests that gastrointestinal endoscopic imaging, in combination with other clinical information, has the potential to predict the efficacy of neoadjuvant chemotherapy in locally advanced esophageal squamous cell carcinoma before treatment.

PMID:39792350 | DOI:10.1007/s10388-025-01106-x

Sports Med. 2025 Jan 10. doi: 10.1007/s40279-024-02152-8. Online ahead of print.

ABSTRACT

BACKGROUND: Aging is associated with sustained low-grade inflammation, which has been linked to age-related diseases and mortality. Long-term exercise programs have been shown to be effective to for attenuating this process; however, subsequent detraining might negate some of these benefits. Master athletes, as a model of lifelong consistent exercise practice, have been suggested to present similar inflammatory profiles to untrained young adults. Nonetheless, it is unclear whether maintaining training habits throughout life can completely counteract low-grade inflammation associated with aging.

OBJECTIVES: We aimed to systematically evaluate comparisons of baseline inflammatory profiles in Master athletes, untrained middle-aged and older adults, and untrained young individuals to elucidate whether lifelong exercise can counteract low-grade inflammation associated with aging.

METHODS: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and a protocol was prospectively registered in PROSPERO (CRD42024521339). Studies reporting baseline systemic levels of proinflammatory and anti-inflammatory markers in Master athletes and untrained controls were eligible for inclusion. A total of six databases (PubMed [MEDLINE], Embase, Cochrane Central Register of Controlled Trials [CENTRAL], Scopus, SPORTDiscus, and Web of Science [WoS]) were searched in September 2024, and studies were independently screened by two reviewers. Risk of bias was assessed using an adapted version of the Joanna Briggs Institute Critical Appraisal tool for cross-sectional trials, and random-effect meta-analyses of standardized mean differences (SMDs) of inflammatory markers were conducted to evaluate comparisons between Master athletes and age-matched untrained middle-aged and older adults as well as Master athletes and young untrained subjects. Subgroup analyses were performed based on exercise intensity and type, and participants’ sex.

RESULTS: A total of 17 studies (n = 649 participants) were included both in qualitative and quantitative synthesis. Lifelong exercise appears to attenuate increases in baseline C-reactive protein, and to elevate anti-inflammatory interleukin (IL)-10 levels compared with untrained middle-aged and older adults (C-reactive protein: SMD – 0.71, 95% confidence interval – 0.97, – 0.45, I² 0%, p = 0.78; IL-10: SMD 1.44, 95% confidence interval 0.55, 2.32, I² 87%, p < 0.00001). Statistical significance was maintained in C-reactive protein and IL-10 sub-analyses. No difference in tumor necrosis factor-α levels was observed between Master athletes and untrained middle-aged and older adults (SMD 0.40, 95% confidence interval – 0.15, 0.96, I² 72%, p = 0.0008). A trend towards decreased IL-6 levels in Master athletes was shown in pooled analyses comparing untrained middle-aged and older adults, and rendered statistically significant in sub-analyses. However, comparisons with young untrained adults indicated that Master athletes still present with elevated levels of tumor necrosis factor-α and IL-6, along with decreased IL-10.

CONCLUSIONS: Master athletes might exhibit a more anti-inflammatory profile denoted by decreased baseline circulating levels of C-reactive protein and, potentially, IL-6, along with increased IL-10 compared with healthy age-matched untrained peers. However, lifelong exercise might still be insufficient to completely counteract age-related changes in tumor necrosis factor-α, IL-6, and IL-10, as shown in comparisons with untrained young adults.

PMID:39792347 | DOI:10.1007/s40279-024-02152-8

Int J Legal Med. 2025 Jan 10. doi: 10.1007/s00414-024-03398-7. Online ahead of print.

ABSTRACT

The burnout phenomenon is a subject of considerable interest due to its impact on both employee well-being and scientific inquiry. Workplace factors, both intrinsic and extrinsic, play a pivotal role in its development, often leading to job dissatisfaction and heightened burnout risk. Chronic stress and burnout induce significant dysregulation in the autonomic nervous system and hormonal pathways, alongside structural brain changes. This paper presents a preliminary review of the literature on burnout syndrome among forensic science workers, focusing on the prevalence of this phenomenon and its triggers. This review aims to consolidate existing research on burnout among forensic medicine workers, highlight significant findings, and encourage further studies. Symptoms range from demoralization to somatic complaints. The Maslach Burnout Inventory (MBI) was the main tool in assessing burnout levels alongside measures of occupational stress, vicarious trauma and posttraumatic stress syndrome. Forensic medicine workers face unique stressors, with notable impacts on burnout levels. These workers experience challenges such as workplace conflicts and exposure to traumatic cases, leading to moderate or high burnout levels, particularly, emotional exhaustion, depersonalization or low personal accomplishment. Despite the prevalence of burnout, many forensic medicine workers lack access to support networks and perceive a disregard for their well-being from supervisors. There is a pressing need for further research to understand the biological mechanisms, susceptibility factors, and discover diagnostic markers of burnout syndrome, with the goal of its recognition as a psychiatric disorder in diagnostic manuals like the Diagnostic and Statistical Manual of Mental Disorders.

PMID:39792327 | DOI:10.1007/s00414-024-03398-7

Environ Monit Assess. 2025 Jan 10;197(2):155. doi: 10.1007/s10661-024-13431-2.

ABSTRACT

Recent advancements in satellite technology have greatly expanded data acquisition capabilities, making satellite imagery more accessible. Despite these strides, unlocking the full potential of satellite images necessitates efficient interpretation. Image classification, a widely adopted for extracting valuable information, has seen a surge in the application of deep learning methodologies due to their effectiveness. However, the success of deep learning is contingent upon the quality of the training data. In our study, we compared the efficiency of pixel-based and object-based classifications in Sentinel-2 satellite imagery using the Deeplabv3 deep learning method. The image sharpness was enhanced through a high-pass filter, aiding in data visualization and preparation. Deeplabv3 underwent training, leading to the development of classifiers following the extraction of training samples from the enhanced image. The majority zonal statistic method was implemented to assign class values to objects in the workflow. The accuracy of pixel-based and object-based classification was 83.1% and 83.5%, respectively, with corresponding kappa values of 0.786 and 0.791. These accuracies highlighted the efficient performance of the object-based method when integrated with a deep learning classifier. These results can serve as a valuable reference for future studies, aiding in the improvement of accuracy while potentially saving time and effort. By evaluating this nuanced impact pixel and object-based classification as well as on class-specific accuracy, this research contributes to the ongoing refinement of satellite image interpretation techniques in environmental applications.

PMID:39792312 | DOI:10.1007/s10661-024-13431-2

Sleep. 2025 Jan 10:zsaf007. doi: 10.1093/sleep/zsaf007. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Exploding head syndrome (EHS) is a parasomnia characterized by the perception of loud noises, or explosions inside the head during the sleep-to-wake transition. The prevalence of EHS remains unclear. This survey aimed to elucidate the prevalence of and factors associated with EHS in this cohort.

METHODS: As part of the Night in Japan Home Sleep Monitoring Study (NinjaSleep study), a cross-sectional survey was conducted among government employees in Koka City, Shiga Prefecture, Japan, in 2022. Participants were queried regarding their experiences with EHS as defined in the International Classification of Sleep Disorders, 3rd Edition, including sudden loud noises or sensations of explosions, subsequent abrupt awakenings and feelings of fright. Various standardized instruments were employed to evaluate depression, anxiety, insomnia, quality of life, and fatigue.

RESULTS: Of the 2081 employees invited to participate, 1878 completed the survey. After excluding respondents with epilepsy and incomplete responses, 1843 participants were deemed eligible for analysis. Among them, 46 (2.49%) reported experiencing sudden noises or sensations of explosions, with 23 (1.25%) meeting the diagnostic criteria for EHS. The EHS was significantly related to the scores on the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Athens Insomnia Scale, and Chalder Fatigue Scale, even after adjusting for age, sex, BMI and categorized mean sleep duration.

CONCLUSION: This study elucidates the prevalence of EHS among the Japanese population and underscores its potential association with insomnia symptoms and various psychological factors.

PMID:39792308 | DOI:10.1093/sleep/zsaf007

J Robot Surg. 2025 Jan 10;19(1):49. doi: 10.1007/s11701-024-02202-3.

ABSTRACT

This study applied cumulative sum (CUSUM) analysis to evaluate trends in operative time and blood loss, It aims to identify key milestones in mastering extraperitoneal single-site robotic-assisted radical prostatectomy (ss-RARP). A cohort of 100 patients who underwent ss-RARP, performed by a single surgeon at the First Affiliated Hospital of Guangzhou Medical University between March 2021 and June 2023, was retrospectively analyzed. To evaluate the learning curve, the CUSUM (Cumulative Sum Control Chart) technique was applied, revealing the progression and variability over time. A cubic polynomial model was utilised to fit the non-linear data trends accurately. Key perioperative outcomes, such as operative duration and estimated blood loss, were assessed and compared between distinct learning stages to identify improvements and transitions during the surgeon’s proficiency development. A total of 100 patients were included, with a mean age of 71.44 ± 5.46 years. The median operative time was 119.53 min (94, 144), and the best-fit equation for the CUSUM learning curve of operative time was y = 387.0373 – 3.4334x – 0.2982x² + 0.003x³ (R² = 0.898), reaching its peak at the 11th case. The median blood loss was 49.9 ml (20, 50), and the best-fit equation for the CUSUM learning curve of blood loss was y = 444.9362 + 23.6787x – 0.7719x² + 0.0049x³ (R² = 0.957), reaching its peak at the 27th case. The learning curve was divided into a learning phase (1-27 cases) and a proficient phase (28 cases onward). Intraoperative blood loss significantly decreased from 75.93 ± 79.19 mL to 40.27 ± 35.27 mL in the proficient phase (P < 0.05), while operative time remained similar between phases (P > 0.05).There were no statistically significant differences in pelvic drainage tube placement time, drainage volume, positive surgical margin rate, hospital stay duration, or postoperative pain scores (P > 0.05). The findings suggest that proficiency in ss-RARP is typically achieved after approximately 27 cases, indicating a manageable and safe learning curve. These insights can inform the design of surgical training programmes, optimising early learning and improving clinical outcomes for novice surgeons.

PMID:39792294 | DOI:10.1007/s11701-024-02202-3

Proc Natl Acad Sci U S A. 2025 Jan 14;122(2):e2411074122. doi: 10.1073/pnas.2411074122. Epub 2025 Jan 10.

ABSTRACT

Chemotaxis enables marine bacteria to increase encounters with phytoplankton cells by reducing their search times, provided that bacteria detect noisy chemical gradients around phytoplankton. Gradient detection depends on bacterial phenotypes and phytoplankton size: large phytoplankton produce spatially extended but shallow gradients, whereas small phytoplankton produce steeper but spatially more confined gradients. To date, it has remained unclear how phytoplankton size and bacterial swimming speed affect bacteria’s gradient detection ability and search times for phytoplankton. Here, we compute an upper bound on the increase in bacterial encounter rate with phytoplankton due to chemotaxis over random motility alone. We find that chemotaxis can substantially decrease search times for small phytoplankton, but this advantage is highly sensitive to variations in bacterial phenotypes or phytoplankton leakage rates. By contrast, chemotaxis toward large phytoplankton cells reduces the search time more modestly, but this benefit is more robust to variations in search or environmental parameters. Applying our findings to marine phytoplankton communities, we find that, in productive waters, chemotaxis toward phytoplankton smaller than 2 μm provides little to no benefit, but can decrease average search times for large phytoplankton (∼20 μm) from 2 wk to 2 d, an advantage that is robust to variations and favors bacteria with higher swimming speeds. By contrast, in oligotrophic waters, chemotaxis can reduce search times for picophytoplankton (∼1 μm) up to 10-fold, from a week to half a day, but only for bacteria with low swimming speeds and long sensory timescales. This asymmetry may promote the coexistence of diverse search phenotypes in marine bacterial populations.

PMID:39792290 | DOI:10.1073/pnas.2411074122

Mycopathologia. 2025 Jan 10;190(1):14. doi: 10.1007/s11046-024-00922-6.

ABSTRACT

Epidemiological studies combining taxonomic and clinical data have been limited globally, particularly Guiyang, the most under-developed economic provincial capital city in southwestern China. A retrospective analysis was performed of dermatophyte epidemiology involving all culture-positive cases received between May 2017 and May 2023 at the Affiliated Hospital of Guizhou Medical University. Phylogenetic analysis was conducted on 391 dermatophyte isolates collected from patients using the rDNA internal transcribed spacer sequences. Clinical relevance information was analyzed statistically using T-test, one-way ANOVA, Kruskal-Wallis H test, and Chi-square test. Eight species were recognized, and their identity was confirmed on the basis of phylogenetics. Trichophyton rubrum (n = 308, 78.77%) ranked first, followed by T. mentagrophytes (n = 39, 9.97%) and Microsporum canis (n = 32, 8.18%). Tinea unguium (48.56%) was the most common type of dermatophytosis in this study, rates of detection being impacted by the host population’s attention for dermatophyte infections. The hypothesized patterns of evolution in the M. canis series, T. mentagrophytes series and T. rubrum series, i.e. from zoophilic to a preponderantly anthropophilic nature, was reflected in clinical parameters such as host age, occupational background, infection pattern, degree of skin involvement and site preference. To the best of our knowledge, we provide the first detailed analysis of epidemiological characteristics and pathogenic patterns of dermatophytosis in Guiyang.

PMID:39792278 | DOI:10.1007/s11046-024-00922-6

Arch Dermatol Res. 2025 Jan 10;317(1):222. doi: 10.1007/s00403-024-03728-0.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a chronic, pruritic, and inflammatory dermatosis seen in individuals with an atopic predisposition. This study aimed to examine the immunoreactivity of spexin and TRPM2 in skin samples from patients with AD and MF lesions using immunohistochemical methods.

MATERIALS AND METHODS: The study utilized a total of 60 skin samples, comprising 20 from AD patients, 20 from MF patients, and 20 from control subjects. Skin samples from patients diagnosed with other dermatological diseases, malignancies, and diabetes mellitus were excluded from the study. During staining, the prevalence (0.1: <25%, 0.4: 26-50%, 0.6: 51-75%, 0.9: 76-100%) and intensity (0: none, + 0.5: very low, + 1: low, + 2: moderate, + 3: intense) of immunoreactivity were used as criteria to establish a histo-score. Calculations employed the formula histo-score = prevalence x intensity.

RESULTS: Statistically significant higher spexin histoscores were observed in both the AD and MF patient groups compared to the control group (1.30 ± 0.46, 1.04 ± 0.29, and 0.20 ± 0.07, respectively; p = 0.000). Similarly, TRPM2 histoscores were significantly higher in the AD and MF patient groups compared to the control group (1.12 ± 0.28, 1.02 ± 0.30, and 0.20 ± 0.07, respectively; p = 0.000).

CONCLUSION: It is hypothesized that the increase in the neuropeptide spexin in both AD and MF is triggered by inflammation and contributes to itching mechanisms via galanin receptors. TRPM2, an ion channel, is speculated to be a marker of Reactive Oxygen Species (ROS) in chronic inflammatory dermatoses like AD, but it may not serve as a potential biomarker for distinguishing chronic inflammatory dermatoses from MF.

PMID:39792277 | DOI:10.1007/s00403-024-03728-0

Neurosurg Rev. 2025 Jan 10;48(1):39. doi: 10.1007/s10143-025-03177-x.

ABSTRACT

Stereotactic radiosurgery (SRS) and radiotherapy (SRT) have gained prominence as both adjuvant and primary treatment options for patients with skull base tumors that are either inoperable or present as residual or recurrent lesions post-surgery. The object of the current study is to evaluate the safety and efficacy of robotic-assisted SRS and SRT across various skull base pathologies. The study was conducted under PRISMA guidelines and involved a comprehensive evaluation of databases, including PubMed, Scopus, Embase, Web-of-Science, and the Cochrane Library. The data collection period was extended up to 30 September. Statistical analyses were executed using Comprehensive Meta-Analysis software. Furthermore, Cochran’s Q test assessed statistical heterogeneity within the findings. From an initial pool of 1,792 articles, 69 studies were included in the systematic review, with 60 qualifying for meta-analysis, encompassing 3,046 participants. Meta-analysis revealed tumor control rates were significantly enhanced with the use of CyberKnife (95% CI: 0.901-0.928, p < 0.001) and robotic Gamma Knife radiosurgery (GKRS) (95% CI: 0.897-0.959, p < 0.001). Meningiomas and schwannomas exhibited higher treatment responsiveness (ES: 0.960 and 0.949, respectively), whereas chordomas displayed lower responsiveness (ES: 0.743). The overall major adverse event rate was between 5.6% and 8.3% (95% CI: 0.056-0.083, p < 0.001). Adverse events exhibited a higher incidence in patients with adenomas (95% CI: 0.122-0.217, p < 0.001), while they were least prevalent in those with schwannomas (95% CI: 0.019-0.041, p < 0.001). Robotic SRS and SRT, employing both gamma-knife and cyber-knife, have demonstrated promising outcomes characterized by high efficacy and safety in managing various skull base tumors.

PMID:39792270 | DOI:10.1007/s10143-025-03177-x