Tag: nevin manimala

Jpn J Ophthalmol. 2026 Aug 13. doi: 10.1007/s10384-026-01404-6. Online ahead of print.

ABSTRACT

PURPOSE: Basal cell carcinoma (BCC) is the most common malignancy of the eyelid, with a significant risk of local recurrence despite its low metastatic potential. Understanding prognostic factors for recurrence is essential for optimizing treatment and improving patient outcomes. This study aimed to analyze the clinical characteristics and prognostic factors associated with recurrence in periocular BCC in a Taiwanese population.

STUDY DESIGN: This was a retrospective, single-center cohort study conducted at a tertiary medical center in Taiwan.

METHODS: We reviewed 46 patients diagnosed with periocular BCC at National Taiwan University Hospital between 2000 and 2023. Data on demographics, tumor characteristics, surgical margins, and recurrence outcomes (both clinical and pathological) were collected. Recurrence-free survival was assessed using Kaplan-Meier analysis, and statistical analyses, including chi-square tests, Fisher’s exact tests, and multivariate logistic regression, were performed to identify significant prognostic factors.

RESULTS: The mean age at diagnosis was 72.3 years, with a slight female predominance (54.4%). Tumors predominantly affected the lower eyelid (84.8%). The study identified a clinical recurrence rate of 30.4% with a 10-year recurrence-free survival (RFS) of 67.4%. Upon strict histological confirmation, the pathological recurrence rate was 23.9%, corresponding to an RFS of 73.7%. Multivariate analysis identified two robust independent predictors across both definitions. Compromised surgical margins were strongly associated with recurrence (Clinical: OR = 5.70, p < 0.001; Pathological: OR = 15.56, p < 0.05). Similarly, delayed surgical intervention (>12 months) significantly increased recurrence risk (Clinical: OR = 5.21, p = 0.001; Pathological: OR = 14.21, p < 0.05). Tumor size and thickness were correlated with recurrence in univariate analysis but did not reach statistical significance in the multivariate models.

CONCLUSION: Compromised surgical margins and delayed treatment are robust, major risk factors for recurrence in periocular BCC, regardless of whether a clinical or pathological definition is applied. While the clinical recurrence rate highlights the burden of re-operation, the pathological recurrence rate underscores the biological aggressiveness in neglected cases. Notably, achieving free margins resulted in excellent long-term control. These findings emphasize the critical need for early diagnosis and complete excision to improve patient outcomes.

PMID:42593602 | DOI:10.1007/s10384-026-01404-6

J Robot Surg. 2026 Aug 13;20(1):836. doi: 10.1007/s11701-026-03821-8.

ABSTRACT

Redo fundoplication is technically challenging and associated with higher complication rates compared with primary procedures. Robotic platforms may offer technical advantages in reoperative foregut surgery; however, comparative outcomes with laparoscopy remain unclear. This meta-analysis aimed to compare perioperative outcomes between robotic and laparoscopic redo fundoplication. A systematic review and meta-analysis was conducted by searching five databases up to July 2026. Primary outcome was intraoperative complications, including leaks, gastric, esophageal, and bowel injuries. Secondary outcomes were postoperative complications (POC), operative time (OT) and length of stay (LOS). The random-effects model was used to calculate the pooled Odds Ratios (OR) and mean difference (MD) with 95% confidence intervals (CI). Heterogeneity was assessed using I² statistics. Of 269 studies screened, 4 cohort studies comprising 257 patients were included. Robotic cases accounted for 49% (n = 126). There was no difference between groups in terms of sex, age and preoperative BMI. Robotic cases had longer OT (MD = 26.36 min, p = 0.03) but shorter LOS (MD = – 0.16 days, p = 0.55), with a lower risk of intraoperative complications (6.3% vs. 9.1%; OR = 0.57, 95% CI = 0.22-1.47, I²: 0%). There were no differences in POC rates. In this meta-analysis, robotic redo fundoplication was as safe as the laparoscopic approach, in terms of intra- and postoperative complications. Higher-quality prospective evidence is needed before firm conclusions can be drawn.

PMID:42593598 | DOI:10.1007/s11701-026-03821-8

Saudi Dent J. 2026 Aug 13;38(8):109. doi: 10.1007/s44445-026-00223-2.

ABSTRACT

Accurate three-dimensional (3D) reproduction of facial soft-tissue geometry is a prerequisite for planning and fabricating maxillofacial epitheses. This single-subject pilot study compared the surface agreement of seven 3D facial scanning configurations available on the Ukrainian market against a cone-beam computed tomography (CBCT)-derived reference surface, reporting trueness-related surface-deviation metrics and acquisition time. Because only one participant was examined and no repeated acquisitions were obtained, the work is exploratory and does not establish device precision (repeatability) or population-level accuracy. A prospective comparative pilot acquisition was performed on one healthy adult volunteer at rest on a single day. Three radiopaque fiducial markers were placed over low-mobility sites (glabella, both temporal regions). A CBCT volume (Planmeca ProMax 3D Mid) was segmented in 3D Slicer (v5.10.0) to yield the reference soft-tissue surface. Seven configurations were assessed: Shining 3D MetiSmile, Creality CR-Scan Raptor Pro, Revopoint Miraco Pro, RAYFace Facial Scanner, Planmeca ProMax 3D ProFace, and Qlone Dental App (iPad and iPhone). In CloudCompare (v2.14.alpha), fiducial-based Point-Pairs registration was followed by Iterative Closest Point (ICP) alignment, and cloud-to-mesh (C2M) surface-deviation distances were computed. Only descriptive statistics were used. Across the evaluated low-mobility region, the structured-light devices showed sub-millimetre surface deviation, with Shining 3D MetiSmile and Creality CR-Scan Raptor Pro showing the smallest dispersion (RMSE 0.288 and 0.328 mm). RAYFace recorded the highest proportion of points within ≤ 2 mm (98.74%) and the shortest acquisition time (5 s). Revopoint Miraco Pro and Planmeca ProMax 3D ProFace showed larger but still sub-millimetre deviations. Qlone deviated markedly (iPad and iPhone), with its upper error range approaching the fixed computation limit, so its tail is under-represented. In this single volunteer and over rigid, low-mobility regions only, structured-light scanners showed closer agreement with the CBCT-derived surface than the smartphone photogrammetry application. Differences among the leading structured-light devices were within the expected uncertainty of the reference surface and should not be over-interpreted as a device ranking. These preliminary observations require confirmation in multi-subject, repeated-measures studies before any clinical recommendation.

PMID:42593589 | DOI:10.1007/s44445-026-00223-2

Breast Cancer Res Treat. 2026 Aug 13;218(3):43. doi: 10.1007/s10549-026-08056-7.

ABSTRACT

PURPOSE: Adjuvant cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) improve outcomes in hormone receptor-positive (HR+), HER2-negative early breast cancer, though trial results have been heterogeneous. Menopausal status and endocrine therapy backbone may contribute to variability in treatment effect. We performed a meta-analysis evaluating whether menopausal status influences the efficacy of adjuvant CDK 4/6 inhibition.

METHODS: A systematic review of phase III randomized trials evaluating adjuvant CDK4/6i in HR+/HER2- early-stage breast cancer was conducted. Trial-level hazard ratios (HRs) and 95% confidence intervals (CIs) for iDFS and OS were extracted separately for pre-/peri-menopausal and postmenopausal subgroups. HRs were pooled using random-effects modelling (DerSimonian-Laird method) with inverse-variance modeling. Heterogeneity was assessed using I² statistics. A sensitivity analysis limited to approved CDK4/6i (ribociclib and abemaciclib) was performed.

RESULTS: Four trials comprising 17,748 participants were included, of whom 45% were pre-/peri-menopausal and 55% were postmenopausal. Pooled iDFS HRs were 0.80 (95% CI 0.67-0.97, I²=64%) in pre-/peri-menopausal patients and 0.79 (95% CI 0.72-0.86, I²=0%) in postmenopausal patients. Pooled OS HRs were 1.02 (95% CI 0.67-1.54, I²=80%) in pre-/peri-menopausal and 0.89 (95% CI 0.78-1.03, I²=0%) in postmenopausal patients. No significant subgroup differences were observed for iDFS or OS. Compared to post-menopausal participants, those who were premenopausal had 3.0% fewer absolute iDFS events at 5-6 years. Sensitivity analyses yielded consistent findings.

CONCLUSIONS: Efficacy of adjuvant CDK4/6 inhibition in HR+/HER2-negative early breast cancer does not appear to be influenced by menopausal status as defined in individual trials. Greater heterogeneity among pre-/peri-menopausal patients may reflect differences in endocrine therapy backbone, tumor characteristics and patient risk.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42593586 | DOI:10.1007/s10549-026-08056-7

Antonie Van Leeuwenhoek. 2026 Aug 13;119(9):195. doi: 10.1007/s10482-026-02380-0.

ABSTRACT

Staphylococcus aureus (S. aureus) is a clinically significant opportunistic pathogen and a leading cause of healthcare-associated infections, particularly in surgical settings. This study aimed to investigate the antibiotic resistance patterns, biofilm-forming ability, and the distribution of selected virulence and resistance genes among S. aureus isolates collected from healthy orthopedic surgical personnel in Iran. A total of 63 S. aureus isolates, comprising 52 methicillin-resistant (MRSA) and 11 methicillin-susceptible (MSSA) isolates, were recovered from nasal and hand swabs. Antimicrobial susceptibility was determined by the Kirby-Bauer disk diffusion method or broth microdilution for oxacillin. Biofilm formation was quantified using the tissue culture plate assay, and resistance and virulence genes were detected by PCR. All isolates were biofilm producers, with nasal isolates representing the highest proportion of strong producers, although the difference was not statistically significant. High resistance rates were observed to penicillin and ampicillin, and erythromycin resistance was significantly associated with moderate biofilm formation. MRSA, identified by cefoxitin resistance, accounted for 82.5% of the isolates and produced significantly greater biofilm biomass compared to MSSA isolates. Among MRSA isolates, 40.4% exhibited an MDR phenotype and 1.9% were XDR, while all isolates remained susceptible to vancomycin and chloramphenicol. The mecA gene was present in all MRSA isolates, while icaA was exclusive to MRSA and strongly correlated with biofilm biomass. Three agr types were identified, with agrI predominating. The convergence of potent virulence determinants, multidrug resistance, and robust biofilm formation-particularly among MRSA isolates-underscores the potential for silent nosocomial transmission and highlights the need for enhanced infection-control practices and strengthened antimicrobial stewardship.

PMID:42593577 | DOI:10.1007/s10482-026-02380-0

World J Urol. 2026 Aug 13;44(1):563. doi: 10.1007/s00345-026-06696-4.

ABSTRACT

PURPOSE: to reassess the prognostic value of positive surgical margins (PSM) after partial nephrectomy (PN) in terms of relapse-free survival (RFS), progression-free survival (PFS), overall survival (OS) and cancer-specific mortality (CSM) within a large cohort spanning changing surgical eras, including the progressive adoption of minimally invasive approaches.

MATERIALS AND METHODS: We retrospectively analyzed 1441 patients who underwent PN for cM0 renal tumors between 2000 and 2024 at a tertiary referral center. Patients were stratified according to margin status (PSM vs. negative surgical margins, NSM). Kaplan-Meier analyses estimated RFS, PFS, and OS, while uni (UVA)- and multivariable (MVA) Cox regression models stratified by surgical era (2000-2011 vs. 2012-2024) tested the association between PSM and local relapse, progression, and all-cause mortality. Fine-Gray regression tested PSM impact on CSM. Then, exploratory interaction and subgroup analyses according to surgical approach were also performed.

RESULTS: Of 1441 included patients, 81 (5.6%) had PSM on final pathology. Apart from a higher proportion of females in the PSM group (42% vs. 31%, p = 0.03), no clinical or pathological differences were observed between PSM and NSM (all p > 0.1). At 5-year follow-up, RFS, PFS, and OS were 90.5% vs. 96.7% (p = 0.003), 94.9% vs. 94.4% (p = 0.7), and 91.3% versus 94.4% (p = 0.1) for PSM vs. NSM, respectively. After adjustment for the selected clinical variables, PSM were associated with higher hazard of local relapse (HR: 4.03, 95% CI: 1.64-9.87; p = 0.002). No statistically significant association was observed between PSM and systemic progression (HR: 1.15, 95% CI: 0.35-3.74; p = 0.8), all-cause mortality (HR: 1.96, 95% CI: 0.82-4.72; p = 0.1), or CSM on Fine-Gray analysis (SHR: 2.66, 95% CI: 0.58-12.1, p = 0.2). However, the number of progression and mortality events in the PSM group was limited, resulting in wide CIs.

CONCLUSIONS: PSM after PN were independently associated with a higher risk of local recurrence. No statistically significant association was observed with systemic progression, CSM, or OS; however, these analyses were limited by the small number of events, and clinically meaningful effects cannot be excluded. These findings support careful postoperative surveillance while larger contemporary studies are needed to better define the long-term prognostic impact of PSM.

PMID:42593572 | DOI:10.1007/s00345-026-06696-4

Psychol Res. 2026 Aug 13;90(4):148. doi: 10.1007/s00426-026-02360-z.

ABSTRACT

INTRODUCTION: Artificial faces are frequently used in research on perception, attention, working memory, and long-term memory. Although artificial faces offer advantages in terms of standardization, time, and cost, people tend to recognize real human faces more accurately than artificial faces in long-term memory tasks. However, there is no direct comparison of working memory performance between human and artificial faces. This study aims to examine the effect of artificial faces on working memory performance. Additionally, the study investigated the effects of the emotional valence of facial stimuli and the cognitive load of the task on working memory performance.

METHODS: Forty-five adults (18-36 years) completed an n-back task with two conditions: human faces and computer-generated versions of the same identities (artificial faces). Working-memory load was manipulated at two levels (1-back and 2-back), and emotional valence was varied across three levels (neutral, happy, and angry). Sensitivity (d’) and reaction times served as dependent measures to examine the effects of stimulus type, cognitive load, and emotional valence on working-memory performance.

RESULTS: Results showed that sensitivity was lower and reaction times were longer for artificial faces compared to the real faces. Moreover, performance decreased as cognitive load increased, whereas the effect of emotional valence was not statistically significant.

CONCLUSIONS: These findings suggest that artificial faces are processed less efficiently not only in long-term memory but also in working-memory. The results are discussed within the context of the face-space model and the other-race effect.

PMID:42593570 | DOI:10.1007/s00426-026-02360-z

Clin Oral Investig. 2026 Aug 13;30(9):389. doi: 10.1007/s00784-026-07066-5.

ABSTRACT

OBJECTIVES: This study evaluated dental caries experience in individuals with neurofibromatosis type 1 (NF1) compared with matched controls and investigated its associations with salivary parameters, behavioral factors, and socioeconomic characteristics.

MATERIALS AND METHODS: In this case-control study, 42 individuals with NF1 and 42 controls matched for age and sex were included. Caries were diagnosed according to World Health Organization criteria, and the decayed, missing, and filled teeth (DMFT) index was used to assess caries experience. Oral hygiene was evaluated through the Simplified Oral Hygiene Index (OHI-S), tongue coating was quantified from standardized photographs, and questionnaires were used to assess cariogenic diet frequency and socioeconomic variables (educational level, housing status, and family income). Salivary assessments included unstimulated whole saliva flow rate (UWSFR), chewing-stimulated whole saliva flow rate (CSWSFR), pH, buffering capacity, viscosity, and levels of calcium, phosphorus, potassium, magnesium, amylase, and lipase.

RESULTS: Participants with NF1 showed higher caries experience than matched controls (DMFT index: 18.5 ± 8.6 vs. 12.6 ± 7.4; p = 0.001). Hyposalivation (UWSFR: 57.1% vs. 2.4%; CSWSFR: 40.5% vs. 0%) and high salivary viscosity (71.4% vs. 11.9%) were significantly more frequent in NF1 (all p < 0.001). While bivariate analysis within the NF1 group showed no direct association between DMFT and salivary flow, post hoc power analysis indicated limited statistical power (20.4%) for this comparison. A significant positive correlation was found between DMFT and tongue coating index (ρ = 0.312; p = 0.044). In multivariable regression, NF1 was independently associated with higher DMFT compared to matched controls (p < 0.001). Additionally, lower family income (p < 0.001) and poorer oral hygiene (p = 0.016) were significantly associated with higher DMFT. A significant interaction between group and cariogenic diet (p < 0.001) was also observed, indicating that the association between dietary habits and DMFT differed between groups.

CONCLUSIONS: Individuals with NF1 present significantly higher DMFT compared to matched controls. Our findings suggest that this is a multifactorial process, characterized by an independent association between NF1 status and DMFT, even after adjusting for salivary flow, oral hygiene, socioeconomic status, and dietary habits. Notably, the high prevalence of hyposalivation and altered salivary viscosity-combined with the significant positive correlation between tongue coating and DMFT-highlight a complex and compromised oral environment in NF1.

CLINICAL RELEVANCE: These findings support that individuals with NF1 represent a high-risk group for dental caries and significant salivary impairment. This dual vulnerability necessitates specialized preventive protocols, including intensive biofilm control and regular dental monitoring, to reduce the high cumulative caries experience and its impact on oral health in this population.

PMID:42593558 | DOI:10.1007/s00784-026-07066-5

Lasers Med Sci. 2026 Aug 13;41(1):188. doi: 10.1007/s10103-026-04981-7.

ABSTRACT

Purpose the increasing demand for aesthetic dental treatments has made in-office tooth bleaching a popular and minimally invasive procedure. However, bleaching may alter enamel surface roughness, potentially increasing plaque retention and discoloration. Laser activation has been proposed as a safer alternative. This study compared the effects of conventional bleaching, LED activation, and different laser systems (Diode, KTP, Nd-YAG, and CO₂) on enamel surface roughness. Methods sixty freshly extracted human anterior teeth were selected. Samples were randomly assigned to conventional bleaching (without light activation), LED bleaching, and laser bleaching groups, including KTP, Diode, Nd-YAG, and CO2 lasers (n = 10). Pre-treatment surface roughness evaluation was done for all samples. Samples were treated with Opalescence Xtra Boost (Ultradent, USA) for the control group and JW Power Bleaching Gel (Heydent GmbH, Germany) for other groups. Surface roughness was evaluated after bleaching in all groups. Kruskal-Wallis test and Two-Way ANOVA were done to statistically analyze study data, using GraphPad Prism v9, and P-values lower than 0.05 were considered significant. Results LED caused significantly greater surface roughness change compared to bleaching without light (P = 0.0236). Laser-activated groups did not differ significantly from the conventional group or from each other. In the middle third, LED activation resulted in significantly higher roughness compared with the KTP laser (P = 0.029). Conclusion LED activation resulted in greater roughness changes, particularly in the middle third of enamel, while laser activation generally preserved enamel surface integrity, compared to the conventional group.

PMID:42593532 | DOI:10.1007/s10103-026-04981-7

Eur Spine J. 2026 Aug 13. doi: 10.1007/s00586-026-10247-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Osteoporotic vertebral fractures (OVF) present varying treatment challenges depending on fracture severity, stability, and patient characteristics. While the OF classification system guides treatment decisions, gender differences in OVF management and outcomes remain underexplored.

RESEARCH QUESTION: How do treatment strategies and clinical outcomes differ between genders?

METHODS: This secondary analysis utilized prospective data from the German multicenter EOFTT study, including 518 patients (390 females, 128 males) treated for thoracolumbar OVF. Outcomes assessed included adherence to OF score recommendations, pain levels, functional performance (Timed Up & Go test, Barthel Index, Oswestry Disability Index), and rates of anti-osteoporotic therapy (aoTh). Statistical analyses included generalized linear mixed models and repeated-measures general linear models, with therapy type as a covariate.

RESULTS: Gender did not influence overall treatment choice; however, men more frequently underwent instrumentation, while women received augmentation procedures. AoTh administration was significantly lower in men at discharge (72% vs. 82%, p = 0.017) and follow-up (71% vs. 89%, p < 0.001). Both genders showed significant improvements in pain, mobility, and functional outcomes over time (p < 0.001), with no gender-specific differences. Adherence to OF score recommendations was 61% with no gender disparity.

DISCUSSION AND CONCLUSION: Although gender had minimal influence on pain and functional recovery, marked differences in surgical strategies and the administration of anti-osteoporotic therapy underscore potential disparities in the surgical treatment of women and the management of osteoporosis in men. Addressing these disparities through tailored screening, optimized adherence to guidelines, and individualized treatment strategies may improve outcomes in OVF management.

PMID:42593510 | DOI:10.1007/s00586-026-10247-1