Tag: nevin manimala

J Neurooncol. 2025 Jun 25. doi: 10.1007/s11060-025-05140-8. Online ahead of print.

ABSTRACT

PURPOSE: Heritable genetic contributions to familial and sporadic pituitary tumorigenesis are poorly understood. There is emerging evidence that germline variants in classical cancer susceptibility genes may increase the risk of pituitary tumour development. We aimed to identify and assess the rate of pathogenic germline variants in breast and colorectal cancer susceptibility genes that may promote pituitary tumorigenesis.

METHODS: Using a next-generation sequencing panel, we analysed 26 cancer susceptibility genes in 136 patients with suspected familial or sporadic pituitary tumours. Rates of pathogenic germline variation were compared against the gnomAD database.

RESULTS: We identified nine pathogenic or likely pathogenic germline variants in eight patients, within ATM, BRCA2, CHEK2, MUTYH, MLH1 and APC. We also detected three pathogenic somatic variants in TP53 and MSH6 in two patients. Compared to the general population, more pathogenic germline variants in cancer predisposition genes were found in patients with pituitary tumours (relative rate 1.44, p = 0.46), particularly in mismatch repair genes, albeit not statistically significant. We additionally identified a trend of a larger burden of pathogenic cancer susceptibility gene variants in individuals with classical pituitary tumour predisposition pathogenic variants, compared to those without (29% vs. 4.7%, p = 0.057).

CONCLUSION: Our study provides a basis for ongoing research into the potential role of cancer susceptibility genes in driving pituitary tumorigenesis.

PMID:40563065 | DOI:10.1007/s11060-025-05140-8

J Racial Ethn Health Disparities. 2025 Jun 25. doi: 10.1007/s40615-025-02512-8. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to analyze the characteristics and utilization patterns of palliative care at the end of life among deceased gastric cancer patients, using a large-scale, representative population-based sample from US hospitals.

METHODS: A retrospective analysis was conducted on hospitalization data from the National Inpatient Sample (NIS) covering January 2016 to December 2019. The study population was identified and classified using ICD-10 codes. The objective was to examine the characteristics and disparities related to the provision of palliative care to deceased gastric cancer patients and to assess its impact on healthcare utilization, particularly total hospital charges and length of stay (LOS). Multivariate linear and logistic regression analyses were performed, with the data stratified by age, race, Charlson Comorbidity Index, insurance status, median household income, and hospital characteristics. A P-value of < 0.05 was considered statistically significant.

RESULTS: We identified 33,525 hospitalizations involving patients with gastric cancer. Among these, we identified 2475 gastric cancer patients who died in-patient, of whom 58.38% (n = 1445) received palliative care during their hospital stay at the end of their life. Multivariate linear regression analysis showed that the group receiving palliative care had significantly lower total charges ($108,144 vs. $151,425), with a mean decrease of $43,652 (95% CI – $61,441 to – $25,863, P < 0.001) compared to the group not receiving palliative care. However, there was no statistically significant difference in the adjusted length of stay between patients who received palliative care and those who did not (coefficient = – 1.00 days, 95% CI – 2.10 to 0.98, P = 0.074). Multivariate logistic regression analysis indicated that patients of Black race had lower odds of receiving palliative care compared to White patients. Patients with private insurance had higher odds of receiving palliative care compared to those with Medicare. There was no statistically significant difference in receiving palliative care based on hospital size, teaching status, or median household income.

CONCLUSION: This study reveals a significant impact and disparities in the provision of palliative care among deceased gastric cancer patients. Those who received palliative care had notably lower total hospital charges, though there was no significant difference in length of stay. Black patients and those with Medicare were less likely to receive palliative care. These findings emphasize the need for targeted interventions to ensure equitable access to palliative care. Future research should investigate the root causes of these disparities and develop strategies to enhance palliative care delivery across diverse patient populations.

PMID:40563062 | DOI:10.1007/s40615-025-02512-8

Eur Radiol. 2025 Jun 25. doi: 10.1007/s00330-025-11733-8. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess whether the diagnostic performance of a commercial artificial intelligence (AI) algorithm for mammography differs between breast-level and lesion-level interpretations and to compare performance to a large population of specialised human readers.

MATERIALS AND METHODS: We retrospectively analysed 1200 mammograms from the NHS breast cancer screening programme using a commercial AI algorithm and assessments from 1258 trained human readers from the Personal Performance in Mammographic Screening (PERFORMS) external quality assurance programme. For breasts containing pathologically confirmed malignancies, a breast and lesion-level analysis was performed. The latter considered the locations of marked regions of interest for AI and humans. The highest score per lesion was recorded. For non-malignant breasts, a breast-level analysis recorded the highest score per breast. Area under the curve (AUC), sensitivity and specificity were calculated at the developer’s recommended threshold for recall. The study was designed to detect a medium-sized effect (odds ratio 3.5 or 0.29) for sensitivity.

RESULTS: The test set contained 882 non-malignant (73%) and 318 malignant breasts (27%), with 328 cancer lesions. The AI AUC was 0.942 at breast level and 0.929 at lesion level (difference -0.013, p < 0.01). The mean human AUC was 0.878 at breast level and 0.851 at lesion level (difference -0.027, p < 0.01). AI outperformed human readers at the breast and lesion level (ps < 0.01, respectively) according to the AUC.

CONCLUSION: AI’s diagnostic performance significantly decreased at the lesion level, indicating reduced accuracy in localising malignancies. However, its overall performance exceeded that of human readers.

KEY POINTS: Question AI often recalls mammography cases not recalled by humans; to understand why, we as humans must consider the regions of interest it has marked as cancerous. Findings Evaluations of AI typically occur at the breast level, but performance decreases when AI is evaluated on a lesion level. This also occurs for humans. Clinical relevance To improve human-AI collaboration, AI should be assessed at the lesion level; poor accuracy here may lead to automation bias and unnecessary patient procedures.

PMID:40563050 | DOI:10.1007/s00330-025-11733-8

J Imaging Inform Med. 2025 Jun 25. doi: 10.1007/s10278-025-01582-8. Online ahead of print.

ABSTRACT

Contemporary surgical pathology workflows often prioritize slide examination based on case registry order rather than patient risk level. As a result, high-risk cases, especially those involving malignant lesions, may be unintentionally delayed, potentially affecting patient outcomes. In this study, we present an artificial intelligence (AI)-based framework designed to efficiently screen and prioritize malignant cases by analyzing hematoxylin and eosin (H&E)-stained, low-resolution thumbnail whole-slide images (TWSIs). The proposed approach includes three key components. First, image preprocessing is performed to reduce artifacts and identify the initial tissue region. Next, a multi-task deep learning network conducts both tissue segmentation and benign-versus-malignant classification. Finally, multi-dimensional feature reconstruction is utilized to improve classification accuracy. We evaluated the performance of our framework on 334 TWSI images (746 × 1632 pixels), comprising 100 benign and 234 malignant cases. The system achieved an average inference time of 2.33 ± 0.31 s per image, along with an accuracy of 91.91%, a sensitivity of 93.59%, a specificity of 88.00%, a positive predictive value of 94.84%, and a negative predictive value of 85.56%. These results correspond to a 6.41% false negative rate. The findings suggest that applying AI-driven analysis to TWSIs can effectively expedite case triage, thereby enhancing the sorting and prioritization of surgical pathology specimens and potentially improving clinical decision-making.

PMID:40563041 | DOI:10.1007/s10278-025-01582-8

J Imaging Inform Med. 2025 Jun 25. doi: 10.1007/s10278-025-01570-y. Online ahead of print.

ABSTRACT

Brain extraction is essential in neuroimaging studies for patient privacy and optimizing computational analyses. Manual creation of 3D brain masks is labor-intensive, prompting the development of automatic computational methods. Robust quality control (QC) is hence necessary for the effective use of these methods in large-scale studies. However, previous automated QC methods have been limited in flexibility regarding algorithmic architecture and data adaptability. We introduce a novel approach inspired by a statistical outlier detection paradigm to efficiently identify potentially erroneous data. Our QC method is unsupervised, resource-efficient, and requires minimal parameter tuning. We quantitatively evaluated its performance using morphological features of brain masks generated from three automated brain extraction tools across multi-institutional pre- and post-operative brain glioblastoma MRI scans. We achieved an accuracy of 0.9 for pre- and 0.87 for post-operative scans, thus demonstrating the effectiveness of our proposed QC tool for brain extraction. Additionally, the method shows potential for other tasks where a user-defined feature space can be defined. Our novel QC approach offers significant improvements in flexibility and efficiency over previous methods. It is a valuable tool, targeting reassurance of brain masks in neuroimaging and can be adapted for other applications requiring robust QC mechanisms.

PMID:40563038 | DOI:10.1007/s10278-025-01570-y

Ann Surg Oncol. 2025 Jun 25. doi: 10.1245/s10434-025-17691-1. Online ahead of print.

NO ABSTRACT

PMID:40563032 | DOI:10.1245/s10434-025-17691-1

World J Urol. 2025 Jun 25;43(1):392. doi: 10.1007/s00345-025-05764-5.

ABSTRACT

OBJECTIVE: To investigate why retractions in academic literature have risen substantially, leading to rising concerns about research reliability and integrity. While retraction trends have been explored across disciplines, urology-specific factors remain underexamined. This study investigates 292 retracted urological publications from 2014 to 2024, focusing on open-access journals to analyze how publishing models influence retraction trends.

METHODS: A retrospective analysis of retracted urological publications was conducted using the PubMed database. The study employed 84 MeSH search terms to identify articles and categorize them by research type, journal impact factor, citation count, geographical distribution, and retraction reasons. Statistical analyses were performed to assess associations between retraction characteristics.

RESULTS: The most common reason for retraction (90.4%) was discrepancies in data availability or research description, with systematic publication manipulation accounting for 5.1%. The majority of retractions (84.5%) originated from China. Journals with higher impact factors exhibited longer recall times for retractions but no significant difference in citation count at recall.

CONCLUSION: This study highlights the increasing frequency of retractions in urology and identifies key factors influencing these trends. Geographic disparities, open-access models, and journal impact factors play significant roles. Addressing research integrity requires improved editorial oversight, standardized reporting guidelines, and enhanced detection of publication misconduct.

PMID:40563020 | DOI:10.1007/s00345-025-05764-5

Lasers Med Sci. 2025 Jun 26;40(1):302. doi: 10.1007/s10103-025-04555-z.

ABSTRACT

PURPOSE: To evaluate the effects of neodymium-doped yttrium-aluminum-garnet (Nd: YAG) laser posterior capsulotomy on anterior segment parameters in pseudophakic eyes using ultrasound biomicroscopy (UBM).

METHODS: This prospective study included 35 pseudophakic eyes of 34 patients with visually significant posterior capsule opacification (PCO) following uncomplicated phacoemulsification with a one-piece hydrophobic acrylic intraocular lens. UBM was used to assess anterior segment parameters, including anterior chamber angle (ACA), anterior chamber depth (ACD), anterior chamber width (ACW), lens vault (LV), and iris thickness (IT). The angle opening distances (AOD) at 500 μm (AOD500), and at 750 μm (AOD750), the angle recess area (ARA) at 500 μm (ARA 500), the trabecular-iris space area at 500 μm (TISA 500), and at 750 μm (TISA 750) were measured both temporal and nasal area. The measurements were taken three times, the first time before the Nd: YAG capsulotomy, the second time 1 week after and the third time 1 month after the procedure.

RESULTS: No statistically significant changes were found in intraocular pressure (IOP), central corneal thickness, ACD, ACW, LV, or IT following capsulotomy. However, a significant and sustained increase was observed in angle-related parameters (ACA, AOD500/750, ARA500, and TISA500/750) at both 1 week and 1 month post-procedure(p < 0.05 for all). No significant changes were detected between the 1st week and 1st month measurements of angle-related parameters (p > 0.05 for all).

CONCLUSION: Nd: YAG laser capsulotomy leads to significant widening of anterior chamber angle structures without affecting IOP or ACD. These findings suggest that the procedure is safe and may positively influence aqueous humor dynamics.

PMID:40563013 | DOI:10.1007/s10103-025-04555-z

Int J Colorectal Dis. 2025 Jun 26;40(1):146. doi: 10.1007/s00384-025-04908-8.

ABSTRACT

BACKGROUND: Tumor deposits (TD) are well-established prognostic markers in advanced-stage colorectal cancer (CRC), but their independent significance in early-stage disease remains unclear. Current staging systems do not account for TD in node-negative CRC, despite emerging evidence suggesting a potential impact on survival. This study aimed to assess the prognostic impact of TD in early-stage (T1-T3, N0) colon cancer using a large population-based cohort and advanced statistical methods.

METHODS: A retrospective cohort study was conducted using the SEER database (2010-2021), including 111,106 patients with early-stage (T1-T3) colon cancer, of whom 4055 (3.6%) were TD-positive. To minimize baseline imbalances, propensity score matching (1:3 nearest-neighbor; caliper = 0.2) was applied. Overall survival (OS) and disease-specific survival (DSS) were assessed using the Kaplan-Meier analysis and compared with log-rank tests. Multivariate Cox regression was performed to evaluate the independent prognostic impact of TD status in both unmatched and matched cohorts.

RESULTS: TD-positive patients demonstrated significantly worse overall survival (OS) and disease-specific survival (DSS) compared to TD-negative patients (log-rank p < 0.001). In the unmatched cohort, TD positivity was independently associated with reduced OS (HR: 1.56, 95% CI: 1.48-1.65) and DSS (HR: 2.33, 95% CI: 2.14-2.54; both p < 0.001). These associations remained significant after propensity score matching (OS: HR: 1.44, 95% CI: 1.35-1.54; DSS: HR: 2.17, 95% CI: 1.97-2.40; both p < 0.001).

CONCLUSION: TD is an independent prognostic factor in early-stage colon cancer, warranting closer surveillance and reconsideration of treatment strategies. These findings suggest that TD should be integrated into risk stratification models, challenging current staging paradigms.

PMID:40563004 | DOI:10.1007/s00384-025-04908-8

Eur J Orthop Surg Traumatol. 2025 Jun 25;35(1):279. doi: 10.1007/s00590-025-04384-4.

ABSTRACT

PURPOSE: We hypnoses that the DHS with adequate reduction is comparable to PFN as regard functional outcome and offers low cost especially in developing and low-income countries. However PFN has a faster radiological union. Does the DHS and PFN provide comparable clinical and functional outcome for unstable trochanteric fractures? This is the research question.

METHODS: This was a retrospective study of unstable trochanteric fractures (AO-classification: 31-A2) that were managed surgically at a university hospital between 2020 and 2023. All patients were scheduled for a follow-up review for at least 18 months after the operation. The data collected included age, sex, medical history, injury mechanism, and plain radiographs. We excluded patients who had pathological fractures other than osteoporosis and excluded also unstable trochanteric fractures type AO31A3.

RESULTS: A total of 240 individuals with unstable trochanteric fractures, including 82 patients who underwent DHS and 158 who underwent PFN, were included. There were 76 (31%) males and 82 (69%) females, with mean ages of 71.56 ± 10.93 in the PFN group, while the DHS group had 40 (48%) males and 42 (52%) females, with mean ages of 71.73 ± 11.13. In most patients (210 patients, 87.5%), closed reductions were used, whereas only 30 patients (12.5%) had open reductions. The PFN group had significantly less external blood loss during surgery (150 ± 24 ml) than did the other group (350 ± 65 ml) (P < 0.05). The average length of hospital-stay did not differ significantly between the two groups. The DHS group had a significantly longer operative time (65.8 ± 16.2) than did the PFN group (49.8 ± 12.5), (P > 0.05), while the PFN group had a significantly longer fluoroscopy time (7 ± 1.4 min) than did the DHS group (4.1 ± 1 min) (P < 0.05). The incision length was significantly shorter in the PFN group (7.5 ± 1.5 cm) than in the DHS group (12.8 ± 2.5) (p < 0.001).

CONCLUSION: In the management of unstable trochanteric fractures (AO 31-A2), both DHS and PFN are effective fixation devices that can provide satisfactory functional outcomes when proper surgical technique and accurate reduction are achieved. While PFN offers advantages such as reduced blood loss, shorter operative time, and earlier radiological union, DHS remains a viable option in appropriately selected cases, particularly in settings where resource limitations necessitate lower-cost alternatives. However, the success of DHS is highly dependent on achieving and maintaining an accurate anatomical reduction. Therefore, surgical decision-making should prioritize fracture pattern, surgeon expertise, and intraoperative reduction quality, rather than the cost or the type of the implant alone.

PMID:40562981 | DOI:10.1007/s00590-025-04384-4