Tag: nevin manimala

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

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12798-9. Online ahead of print.

NO ABSTRACT

PMID:42593502 | DOI:10.1007/s00330-026-12798-9

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12786-z. Online ahead of print.

ABSTRACT

OBJECTIVES: The sensitivity of mammographic screening is lower for women with mammographically dense vs fatty breasts. We aimed to explore automated mammographic breast density and malignancy risk scores generated by an artificial intelligence (AI) model for breast cancer detection, stratified by mammography vendor.

MATERIALS AND METHODS: This retrospective study included information from 200,000 examinations within BreastScreen Norway. An automated volumetric breast density (VBD) assessment and risk scores were obtained from a commercial AI model. The continuous VBD output from the AI model was categorized into four groups, VBD 1-4, with 15%, 40%, 40%, and 5% of the examinations in each group for exam level and for right and left breast. Area under the receiver operating characteristic curve (AUC) for breast cancer detection was calculated using a continuous AI risk score. Analyses were performed for exam-level and breast-level measures.

RESULTS: At exam level, the difference in AUC estimates between the VBD groups was statistically significant, with the highest AUC observed for VBD 1 (0.955, 95% CI: 0.937-0.992) and lowest for VBD 4 (0.857, 95% CI: 0.803-0.910). Stratified by vendor, 3.3% and 6.7% were classified as VBD 4 for A vs B. At breast level, 18.5% of the examinations were classified with different VBD groups for the right and left breast.

CONCLUSION: Despite high AUC estimates across all VBD groups and the potential advantages of an automated density assessment, several factors, such as vendor and breast vs exam level, must be carefully considered before implementing automated density measures in screening programs.

KEY POINTS: Question What are the benefits and drawbacks of mammographic density assessment using an AI model for breast cancer detection? Findings The AI model’s performance for cancer detection was promising but decreased with increasing density category. Density distribution varied by equipment vendor and examination level. Clinical relevance AI risk assessment at the current examination was promising despite the variation by mammographic density. However, discrepancies in density by equipment vendors and examination level highlight the need for careful consideration before use in risk-stratified screening.

PMID:42593501 | DOI:10.1007/s00330-026-12786-z

Eur Radiol. 2026 Aug 13. doi: 10.1007/s00330-026-12792-1. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the prognostic significance of whole-body diffusion-weighted imaging (WBDWI)-derived metrics, including total diffusion volume (TDV) and global apparent diffusion coefficient (gADC), in patients with metastatic castration-resistant prostate cancer (mCRPC).

MATERIALS AND METHODS: This retrospective single-centre study included patients with mCRPC and bone-predominant disease who underwent whole-body MRI (WBMRI) prior to the start of a new treatment. Bone lesions were segmented on b900 DWI using an AI-assisted tool with radiologist refinement, and TDV and gADC were extracted. Automated bone scan index (aBSI) was calculated when bone scintigraphy was available. Clinical and laboratory parameters were recorded. Overall survival (OS) was the primary endpoint. Kaplan-Meier analysis and Cox regression models were used to assess prognostic associations.

RESULTS: Among 360 patients, higher TDV was associated with significantly shorter OS (median OS: 13.2 vs 33.4 months; p < 0.001), whereas gADC showed no significant association. In multivariable analysis including patients with WBMRI and bone scintigraphy (n = 182), log-TDV (HR 1.20; p = 0.027), LDH > 500 U/L (HR 7.79; p < 0.001) and ALP between 200 and 400 U/L (HR 1.78; p = 0.019) were independently associated with OS, while aBSI was not. In patients without aBSI data (n = 85), log-TDV remained prognostic (HR 1.60; p < 0.001), whereas LDH and ALP were not.

CONCLUSION: TDV derived from WBDWI independently predicts OS in mCRPC and demonstrates stronger prognostic performance than aBSI and conventional laboratory markers in multivariable models, whereas gADC was not prognostic.

KEY POINTS: QuestionThere is no widely adopted quantitative imaging biomarker for prognostic stratification in mCRPC. Can whole-body diffusion-weighted MRI-derived metrics improve prognostic risk stratification in patients with bone metastases? FindingsHigher TDV of bone disease on baseline whole-body diffusion-weighted MRI was independently associated with shorter OS in patients with mCRPC. Clinical relevance Whole-body diffusion-weighted MRI-derived tumour volume may provide a practical quantitative imaging biomarker for prognostic stratification in mCRPC, potentially supporting individualised treatment planning.

PMID:42593500 | DOI:10.1007/s00330-026-12792-1