Tag: nevin manimala

Hepatol Int. 2026 Apr 7. doi: 10.1007/s12072-026-11083-7. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic hepatitis B virus (HBV) infection remains a major burden. The “Hot Wave Project,” a hospital-wide initiative launched in 2022, aims to enhance HBV care by integrating patient education with systematic screening, referral, diagnosis, treatment, and follow-up.

METHODS: We conducted a comparative analysis of hospital-wide HBV care metrics between 2021 (preintervention) and 2024 (postintervention). An interrupted time series (ITS) analysis was conducted on monthly data to evaluate the causal impact of the intervention. A decision-analytic Markov model was used to simulate the cost-effectiveness and epidemiological impact of the project on a hypothetical cohort of one million patients.

RESULTS: From 2021 to 2024, the HBsAg screening rate hospital-wide increased from 11.75% to 15.25%. Referrals of HBsAg-positive patients from nonhepatology departments surged from 9.26% to 17.87% (p < 0.0001), and the overall antiviral treatment rate rose from 71.00% to 80.25%. ITS analysis confirmed that the intervention caused significant immediate increases in screening and referral rates and a sustained acceleration in treatment uptake. Regular follow-up rates increased modestly from 59.96% to 61.5%. The model projected that the 2024 intervention levels would avert 17.4 HBV-related deaths per 100,000 person-years, yielding an incremental cost-effectiveness ratio (ICER) of $5688 per quality-adjusted life year (QALY) gained.

CONCLUSION: The “Hot Wave Project” is a cost-effective and scalable hospital-based model that significantly improves the HBV care continuum. By enhancing interdisciplinary coordination, this approach offers an adaptable framework to help China advance toward its viral hepatitis elimination targets.

PMID:41945219 | DOI:10.1007/s12072-026-11083-7

Insights Imaging. 2026 Apr 7;17(1):88. doi: 10.1186/s13244-026-02263-y.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the feasibility and accuracy of automated contrast-to-noise ratio (CNR) analysis in chest CT using the open-source body and organ analysis (BOA) framework and to validate segmentation modifications for reproducible image-quality assessment.

MATERIALS AND METHODS: This retrospective study analyzed 100 contrast-enhanced chest CTs (mean age 60.2 ± 15 years; 40% female; 50 CTA, 50 CTPA) and validated the approach in an external cancer imaging archive (TCIA) cohort (n = 100). Automated BOA segmentations of the aorta, pulmonary trunk, and paraspinal muscles were modified by fat subtraction and binary erosion and compared with manual measurements from three radiologists. Agreement was assessed using statistical testing, Bland-Altman analysis, and intraclass correlation coefficients (ICC).

RESULTS: Unmodified BOA segmentations yielded significantly lower CNRs than manual measurements (all p < 0.01, mean difference up to 6.3). Fat subtraction and binary erosion progressively reduced deviations, with the optimized variant (m_erode6 combined with a_erode6 or p_erode6) showing no significant differences from radiologists (p ≥ 0.35). In the external TCIA validation cohort (n = 100), agreement was excellent (ICC 0.89-0.93), and Bland-Altman analysis demonstrated minimal bias (Aorta: 0.16 [limits of agreement (LoA) -3.47 to 3.80]; PT: 0.42 [LoA -4.03 to 4.87]).

CONCLUSIONS: A minimally modified open-source segmentation framework enables fully automated, reproducible CNR assessment in chest CT, achieving expert-level agreement, including robust performance in external validation. This scalable alternative to manual region-of-interest (ROI) measurement streamlines image-quality assessment, facilitates protocol optimization, and provides standardized metrics ready for integration into AI workflows.

CRITICAL RELEVANCE STATEMENT: This study provides a validated, fully automated method for quantitative CT image quality assessment, reducing observer dependence and enabling consistent evaluation across scanners, protocols, and institutions, thereby supporting reproducible image quality metrics in clinical routine.

KEY POINTS: Automated CNR assessment enables objective and reproducible evaluation of image quality in CTA and CTPA. Adjustments of the segmentation strategy can substantially improve the accuracy of automated measurements. The fully automated approach provides a foundation for standardized and scalable CT image quality analysis in research and clinical practice.

PMID:41945209 | DOI:10.1186/s13244-026-02263-y

Support Care Cancer. 2026 Apr 7;34(5):409. doi: 10.1007/s00520-026-10605-1.

ABSTRACT

PURPOSE: Antineoplastic treatment commonly leads to nausea and vomiting (NV), which considerably affects the quality of life and adherence to therapy of patients. This study aimed to analyze the incidence of NV induced by antineoplastic agents using the Japanese Adverse Drug Event Report (JADER) database and to explore novel antiemetic therapies for oral antineoplastic agents.

METHODS: Data from April 2004 to March 2023 were extracted from the JADER database. The analysis considered guideline-recommended antiemetics and involved the temporal evaluation of cases with NV. The onset patterns of NV were analyzed for each oral antineoplastic agent. The reported odds ratio was used to identify adjunctive medications that showed inverse associations with these symptoms.

RESULTS: A large number of NV cases were reported for platinum compounds and irinotecan. Among the oral agents, a notable incidence of NV was induced by antimetabolites and tyrosine kinase inhibitors. A decreasing trend in the use of single-agent antiemetic therapy was observed from 2010. Distinct NV patterns were identified. Silodosin and meropenem emerged as potential adjunct therapies to suppress NV induced by oral agents.

CONCLUSION: Although there is a trend toward improvement in NV management with increased adherence to antiemetic therapies, a substantial gap remains between guidelines and actual practice. The need for tailored management strategies based on the onset patterns of NV for specific agents has been emphasized. Investigating the mechanisms underlying the antiemetic effects of adjunctive therapies, such as silodosin and meropenem, may pave the way for new antiemetic options for oral antineoplastic agents.

PMID:41945168 | DOI:10.1007/s00520-026-10605-1

World J Urol. 2026 Apr 7;44(1):285. doi: 10.1007/s00345-026-06343-y.

ABSTRACT

PURPOSE: Drug-coated balloon (DCB) urethral dilatation which offers an alternative to standard endoscopic treatments of male anterior urethral stricture disease (AUSD). Its ease of delivery has facilitated its use by urologists with various subspecialty interests. The objective of this study was to characterise real-world practice patterns of a DCB device.

METHODS: An exploratory cross-sectional online survey was distributed to Optilume^® users via national and international urological societies and device distributor mailing lists. Descriptive and inferential statistics were performed using SPSS software.

RESULTS: N = 102 urologists responded to the survey of whom n = 47 (46%) were reconstructive subspecialists. DCB dilatation was predominantly performed under general anaesthesia (n = 59, 58%). Significant variation was seen with catheter duration, perioperative antibiotic use and post-procedure contraception advice. Off-label use was common with respondents offering DCB for penile urethral strictures (65%), primary treatment (64%) and bladder neck stenoses (65%). Higher-volume users (≥ 10/year) were more likely to perform DCB under flexible cystoscopy (OR 5.14, 95% 1.57-16.79, p = 0.007), bladder neck stricture (OR 4.66, 95% CI 1.55-14.03, p = 0.006), and for recurrences (OR 6.92, 95% CI 2.22-21.6, p = 0.001). Limited practitioner experience, an evidence gap, and the importance of shared decision making were highlighted on thematic analysis.

CONCLUSIONS: This study provides an insight into the early experience a novel DCB among practicing urologists. Further research is required to optimize patient selection, procedural protocols and the understanding of long-term outcomes.

PMID:41945167 | DOI:10.1007/s00345-026-06343-y

Antonie Van Leeuwenhoek. 2026 Apr 7;119(5):90. doi: 10.1007/s10482-026-02297-8.

ABSTRACT

Airborne microbes from animal confinement facilities not only amplify the risk of disease spread among livestock but also pose substantial health threats to animals and farm workers. The objective of this study was to investigate the microbial counts in cattle sheds and their relationship with meteorological factors, including temperature, relative humidity, and air velocity, as well as microbial diversity. Sampling was carried out both indoors and outdoors of two cattle sheds throughout three seasons (summer, rainy, and winter), at fortnightly intervals. Results showed that bacterial and fungi counts ranged from 0.0 to 1.60 × 10³ CFU/m³ inside the sheds and from 0.0 to 1.08 × 10³ CFU/m³ outside, with significant variation between areas and seasons. The predominant microbial count was mesophilic bacteria followed by staphylococci, fungi and Enterobacteriaceae. The mesophilic bacteria, Enterobacteriaceae and fungi showed statistically significant positive correlation with air temperature while air velocity with Enterobacteriaceae bacteria. No significant correlation exists between relative humidity and microbial concentration. The bacterial families Staphylococcaceae and Bacillaceae from the mesophilic group of bacteria were identified as the most prevalent, whereas the dominant fungi taxa in the cattle sheds were Aspergillus spp. and Penicillium spp. The microbial environment within cattle sheds under loose housing systems was found to be well-regulated, with airborne bacteria and fungi levels remaining within recommended limits.

PMID:41945156 | DOI:10.1007/s10482-026-02297-8

Arch Gynecol Obstet. 2026 Apr 7;313(1):154. doi: 10.1007/s00404-025-08283-1.

ABSTRACT

PURPOSE: Recent studies have reported that embryos diagnosed as aneuploid by preimplantation genetic testing (PGT) can still result in successful live births after transfer. This suggests that, in addition to mosaic embryos, fully aneuploid embryos may also carry a risk of diagnostic error, potentially reducing the overall accuracy of PGT. Therefore, thoroughly investigating the risk and characteristics of aneuploidy misdiagnosis is crucial for optimizing PGT strategies and improving clinical outcomes in assisted reproductive technology (ART).

METHODS: Relevant studies published from January 2000 to December 2024 were identified through PubMed and Web of Science. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). A diagnostic meta-analysis was conducted using a random-effects model to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs), combining sensitivity and specificity. Results were visualized using forest plots.

RESULTS: A total of 22 studies were included to assess the discordance between trophectoderm (TE) biopsy and inner cell mass (ICM) or whole blastocyst (WB) results. The discordance rate for euploid embryo diagnosis was low (2.6%), whereas it was significantly higher for aneuploid embryos (9.2%). Segmental aneuploidies showed the highest discordance rate (17.4%). In the PGT-A population, misdiagnosis of segmental aneuploid embryos was particularly prominent (OR = 10.04, 95% CI: 7.60-13.27, I² = 0%, P < 0.001).

CONCLUSION: The results indicate that embryos with segmental aneuploidies have a significantly higher risk of misdiagnosis, especially in the PGT-A population. This highlights the need for caution when interpreting trophectoderm (TE) biopsy results involving segmental aneuploidies, to avoid misdiagnosis and the inadvertent discard of potentially viable embryos.

PMID:41945151 | DOI:10.1007/s00404-025-08283-1

Abdom Radiol (NY). 2026 Apr 7. doi: 10.1007/s00261-026-05492-3. Online ahead of print.

ABSTRACT

OBJECTIVES: This study conducted a natural language processing feasibility analysis aimed at comparing four large language models (LLMs) in terms of (a) reproducibility and (b) predictive accuracy for International Society of Urological Pathology Grade Groups (ISUP GGs) based on structured text reports from prostate multiparametric magnetic resonance imaging (mpMRI).

METHODS: The study first used LLMs to perform the initial round of ISUP GGs predictions based solely on the mpMRI text reports. This was followed by a second round of predictions that incorporated clinical information. Each prediction round was repeated three times to assess consistency. Three radiologists independently completed the first two rounds of ISUP GG predictions and then performed a third round of assessment after reviewing the LLMs’ predictions. The study recorded the response times.

RESULTS: The study included 150 patients (median age, 69 years). Statistically significant differences were observed among different ISUP GGs in terms of age, PSA levels, prostate volume, PSA density, and PI-RADS scores. The four LLMs demonstrated good to excellent reproducibility (Kappa 0.671-0.861). ChatGPT-4.1 had the shortest response time (0.95-17.19 s). Furthermore, the study found that the accuracy of the LLMs (32.7-50.0%) was significantly lower than that of senior radiologist (72.7-76.0%) and intermediate-level radiologist (66.0-68.7%), but was comparable to that of junior radiologist (59.3-65.3%).

CONCLUSION: General-purpose LLMs demonstrate excellent reproducibility. While ChatGPT-4.1 outperforms other LLMs in ISUP GGs prediction and response time, its predictive accuracy remains inferior to that of intermediate and senior radiologists. Therefore, specific fine-tuning of this technology is necessary before general-purpose LLMs can be applied in clinical practice.

PMID:41945149 | DOI:10.1007/s00261-026-05492-3

Skeletal Radiol. 2026 Apr 7. doi: 10.1007/s00256-026-05217-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore regional and depth-dependent associations between subchondral bone metabolic activity and adjacent cartilage composition in individuals with mild-to-moderate hip osteoarthritis using simultaneous [¹⁸F]-sodium fluoride (NaF) positron emission tomography (PET) and quantitative magnetic resonance (MR) imaging.

METHODS: In this exploratory cross-sectional study, 14 participants (28 hips) underwent [¹⁸F]-NaF PET/MR imaging. Subchondral bone metabolic activity was quantified using standardized uptake values (SUV); cartilage composition was assessed using T_1ρ and T₂ relaxation times. PET/MR images were registered to a reference space allowing regional cartilage and adjacent bone analysis across subregions and depths (4-16 mm from the articular surface). Linear mixed-effects models adjusted for age were used to explore regional differences and cartilage-bone relationships with false discovery rate (FDR) correction.

RESULTS: Higher T_1ρ and T₂ relaxation times were observed in the overall femoral cartilage compared with the acetabular cartilage, whereas higher SUV was observed in the acetabulum than in the femur. Within the femur, elevated SUV was observed in the femoral neck. No cartilage-bone relationships remained statistically significant after FDR correction. Exploratory analyses without the FDR correction suggested positive and negative regression coefficients between cartilage relaxation times and adjacent femoral bone SUV in the posterior and anterior femoral head regions. The magnitude and direction of these coefficients were consistent across increasing bone depths.

CONCLUSIONS: This preliminary study presents an exploratory framework for assessing region and depth-specific interactions between subchondral bone metabolic activity and cartilage composition in the hip. The observed patterns are hypothesis-generating and warrant confirmation in larger, longitudinal studies.

PMID:41945142 | DOI:10.1007/s00256-026-05217-z

Clin Res Cardiol. 2026 Apr 7. doi: 10.1007/s00392-026-02907-5. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate radiation exposure during pediatric cardiac catheterization over a 10-year period at a central European tertiary center and to establish contemporary, procedure-specific dose benchmarks and conversion factors for estimating effective dose (ED).

METHODS: All cardiac catheterization procedures in patients < 18 years performed between 2015 and 2024 were retrospectively reviewed. For procedures with multiple components, cumulative dose area product (DAP) was proportionally allocated using weight-adjusted (DAP/BW) median values from single-intervention cases. ED was estimated in silico in randomly selected examinations using Monte Carlo simulation. Dose conversion factors between DAP and ED were derived. Additionally, a structured review of the literature on recently published data on radiation doses was performed.

RESULTS: A total of 3683 procedures in 2494 patients (median age 3.8 years) were included. Body weight showed a stronger association with DAP than age. Median DAP/BW was 11.7 cGy·cm²/kg for diagnostic and 9.7 cGy·cm²/kg for interventional procedures. For most procedure types, DAP/BW was substantially lower than previously published benchmarks. Simulated conversion factors declined logarithmically with increasing body weight and differed only slightly between posterior-anterior and lateral projections. Only 0.9% of patients exceeded a cumulative ED of 30 mSv.

CONCLUSION: Radiation exposure in contemporary pediatric cardiac catheterization is markedly lower than in earlier reports, with procedure complexity being the primary determinant of effective dose.

PMID:41945132 | DOI:10.1007/s00392-026-02907-5

Surg Today. 2026 Apr 7. doi: 10.1007/s00595-026-03291-3. Online ahead of print.

NO ABSTRACT

PMID:41945103 | DOI:10.1007/s00595-026-03291-3