Tag: nevin manimala

Lancet Reg Health Southeast Asia. 2025 Jul 28;40:100643. doi: 10.1016/j.lansea.2025.100643. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Breast cancer in young adult women is a rapidly growing group of cancer patients in India which needs to be addressed with urgency. Despite increasing global focus on breast cancer in young women, data from India remain scarce. Considering this gap, we undertook this study to analyse the clinicopathological characteristics and prognostic outcomes of young adult women (aged 18-30 years) with breast cancer in Ahmedabad, India.

METHODS: This was a retrospective observational study of a prospectively maintained database of 201 patients with breast cancer (aged 18-30 years) treated in a high-volume tertiary centre in Ahmedabad, India, from January 2015 to December 2020. Patients were followed up until June 2023. The demographic parameters, clinicopathological characteristics and survival of all patients were studied. Statistical analyses were done using SPSS and DATAtab.

FINDINGS: In this study 49.2% of cases were early breast cancers, 26.8% locally advanced, and 23.8% were metastatic. The proportion of aggressive cancers was higher with 38.8% hormone negative, 39.3% HER2-positive, 26.8% triple-negative and 50.8% grade 3. The median overall survival for all patients was 56 months (95% CI 28-84 months) and the 5-year overall survival was 48% (95% CI 40-56%). The multivariate analysis suggested that clinical stage, grade and luminal A status, significantly affected overall survival. The 5-year overall survival and disease-free survival of patients undergoing surgery were 65% (95% CI 57-74%) and 56% (95% CI 47-65%) respectively.

INTERPRETATION: The 5-year overall survival rate of 48% among young adult women with breast cancer included in this study is poor compared to the 77% observed in high-income countries in the western parts of the world. Adoption of appropriate and aggressive treatment strategies may enhance the outcomes in this age group of women with breast cancer.

FUNDING: None.

PMID:40778288 | PMC:PMC12329285 | DOI:10.1016/j.lansea.2025.100643

One Health. 2025 Jul 25;21:101151. doi: 10.1016/j.onehlt.2025.101151. eCollection 2025 Dec.

ABSTRACT

Knowing Echinococcus multilocularis prevalence in wild canids helps us assess the risk of zoonotic spillover. In this study, we updated the infection statistics among red foxes in northern and northeastern Poland since the last monitoring effort at the district (Polish: powiat) level (2001-2004). We collected faecal samples from 192 red foxes from the districts of Słupsk, Puck, Wejherowo, Kościerzyna, and Kartuzy (Pomorskie Voivodship); 200 individuals from the districts of Bartoszyce, Kętrzyn, Gołdap, Iława, and Węgorzewo (Warmińsko-Mazurskie Voivodship); and 47 individuals from the district of Augustów (Podlaskie Voivodship). Based on nested PCR testing confirmed by Sanger sequencing, we calculated the prevalence with a 95 % confidence interval and compared the results to previous reports. We recorded the highest proportion of infected red foxes in Gołdap District (21/40, 52.5 %, 95 % CI: 37.5 %-67.1 %). The shared prevalence in Puck, Wejherowo, Kościerzyna, and Kartuzy Districts was 10.4 % (19/182, 95 % CI: 6.7 %-15.8 %). One red fox tested positive in Iława District (1/48, 2.1 %, 95 % CI: -0.6 %-11.9 %). We found no statistically significant changes in prevalence in the sampled areas. Our results indicate that E. multilocularis prevalence has remained stable in red fox populations throughout the region over the past 20 years.

PMID:40778283 | PMC:PMC12329506 | DOI:10.1016/j.onehlt.2025.101151

Front Endocrinol (Lausanne). 2025 Jul 24;16:1634875. doi: 10.3389/fendo.2025.1634875. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the value of constructing a multimodal deep-learning video model based on 2D ultrasound and contrast-enhanced ultrasound (CEUS) dynamic video for the preoperative prediction of OLNM in papillary thyroid carcinoma (PTC) patients.

METHODS: A retrospective analysis was conducted on 396 cases of clinically lymph node-negative PTC cases with ultrasound images collected between January and September 2023. Five representative deep learning architectures were pre-trained to construct deep learning static image models (DL_image), CEUS dynamic video models (DL_CEUSvideo), and combined models (DL_combined). The area under the receiver operating characteristic curve (AUC) was used to evaluate model performance, with comparisons made using the Delong test. A P-value of less than 0.05 was considered statistically significant.

RESULTS: The DL_CEUSvideo, DL_image, and DL_combined models were successfully developed and demonstrated. The AUC values were 0.826 (95% CI: 0.771-0.881), 0.759 (95% CI: 0.690-0.828), and 0.926 (95% CI: 0.891-0.962) in the training set, and 0.701 (95% CI: 0.589-0.813), 0.624 (95% CI: 0.502-0.745), and 0.734 (95% CI: 0.627-0.842) in the test set. Finally, sensitivity, specificity, and accuracy for the DL_CEUSvideo, DL_image, and DL_combined models were 0.836, 0.671, 0.704; 0.673, 0.716, 0.707; and 0.818, 0.902, 0.886 in the training set, and 0.556, 0.775, 0.724; 0.556, 0.674, 0.647; and 0.704, 0.663, 0.672 in the test set, respectively.

CONCLUSION: These results demonstrated that the multimodal deep learning dynamic video model could preoperatively predict OLNM in PTC patients. The DL_CEUSvideo model outperformed the DL_image model, while the DL_combined model significantly enhanced sensitivity without compromising specificity.

PMID:40778281 | PMC:PMC12329689 | DOI:10.3389/fendo.2025.1634875

Front Endocrinol (Lausanne). 2025 Jul 24;16:1564752. doi: 10.3389/fendo.2025.1564752. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aimed to compare the prognosis of unilateral papillary thyroid carcinoma(PTC) patients with ipsilateral cervical lymph node metastasis(IC-LNM) under the treatment of unilateral lobectomy(uLT) vs total thyroidectomy(TT) in order to find out the optimal surgery for these patients without other clinical risk characteristics.

METHODS: PTC patients at Zhejiang Cancer Hospital between 2012 and 2022 were retrospectively reviewed. Additionally, a propensity score matching(PSM) was performed on patients treated with uLT or TT. Recurrence-free survival(RFS), overall survival(OS), hospitalization costs, postoperative complications, and other clinical characteristics were analyzed between the two groups.

RESULTS: Ultimately, 682 unilateral PTC patients with IC-LNM were available in the study. After PSM with possible prognostic factors(such as gender, age, primary tumor size, multifocality, extrathyroidal invasion, and T-stage), 225 pairs of patients were available. With a median of 81(5-154) months follow-up, 22 patients(9.8%) in the uLT and 12(5.3%) in the TT recurred. There were no significant differences in 5-year RFS and 5-year OS between uLT and TT groups. However, TT group was significantly correlated with higher risk of transient and permanent hypoparathyroidism, higher levothyroxine doses, longer hospital stays, and higher hospitalization costs than uLT group(p<0.05).

CONCLUSIONS: Our study indicated that there were no differences in recurrence and survival between unilateral PTC patients with IC-LNM treated with uLT or TT for the primary tumor. However, uLT group had a lower risk of postoperative complications and a lower hospitalization cost than TT group. Thus, for selected unilateral PTC patients with IC-LNM without other risk features, uLT could be recommended.

PMID:40778278 | PMC:PMC12328177 | DOI:10.3389/fendo.2025.1564752

Front Endocrinol (Lausanne). 2025 Jul 24;16:1602844. doi: 10.3389/fendo.2025.1602844. eCollection 2025.

ABSTRACT

BACKGROUND: Thyroid cancer (TC) has shown a rising prevalence worldwide. While numerous studies have explored the relationship between vitamin D levels and TC risk, their conclusions remain inconsistent.

OBJECTIVE: This meta-analysis aims to evaluate the association between serum vitamin D levels, vitamin D deficiency, and TC based on existing evidence.

METHODS: We systematically searched the Embase, Web of Science, and PubMed databases for human studies investigating the relationship between vitamin D and TC including a control group. A random-effects model with forest plots was employed to calculate the mean difference (MD) in serum vitamin D levels, the odds ratio (OR) for vitamin D deficiency, and the risk difference (RD) between TC cases and controls. Meta-regressions and subgroup analyses were conducted based on the season of serum 25(OH)D sampling, source of controls, timing of measurement, study type, and testing methods of 25(OH)D. A p-value <0.05 was considered statistically significant.

RESULTS: A total of 23 studies were included. The meta-analysis revealed that TC patients had significantly lower serum vitamin D compared to the controls [SMD = -0.38 (95% CI: -0.62 to -0.14)].Additionally, vitamin D deficiency was significantly more prevalent among TC patients (OR = 1.33, 95% CI: 1.02 to 1.73, P < 0.05). The subgroup analyses demonstrated significant differences across most subgroups, except for post-operative measurements. Seasonal variation in 25(OH)D sampling was identified as a key source of heterogeneity.

CONCLUSIONS: The meta-analysis suggests that lower serum vitamin D levels and vitamin D deficiency are significantly associated with an increased risk of TC. However, further studies with standardized protocols for seasonal sampling of vitamin D, source of control, measurement timing, study type, and testing methods of 25(OH)D are needed to clarify this relationship and its underlying mechanisms.

PMID:40778274 | PMC:PMC12328179 | DOI:10.3389/fendo.2025.1602844

Front Endocrinol (Lausanne). 2025 Jul 24;16:1595097. doi: 10.3389/fendo.2025.1595097. eCollection 2025.

ABSTRACT

BACKGROUND: The prevalence of hypertension in children is rising globally, with early-onset high blood pressure linked to future cardiovascular risk. Identifying early risk markers beyond obesity and high salt intake is necessary. Although cost-effective indicators of insulin resistance (IR), such as TyG and METS-IR, have been associated with new-onset hypertension in adults, their links with pediatric hypertension, particularly specific phenotypes of hypertension remain unclear.

METHODS: 12,087 individuals aged 7-17 years from the 2017 China National Nutrition and Health Surveillance of Children and Lactating Women were included. Hypertension was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥95th percentile for sex, age, and height. Isolated systolic hypertension (ISH), defined as SBP ≥95th and DBP <95th percentile. Isolated diastolic hypertension (IDH), defined as DBP ≥95th and SBP <95th percentile. Systolic-diastolic hypertension (SDH), defined as both SBP and DBP ≥95th percentile. The associations of TyG and METS-IR with hypertension phenotypes were investigated using multivariable logistic regression and restricted cubic spline regression.

RESULTS: TyG and METS-IR were positively associated with hypertension and all its phenotypes after multivariable adjustment. Treated as continuous variables, each 1-unit rise in TyG corresponds to 44%, 47%, and 61% higher chance of ISH, IDH, and SDH, respectively (odds ratio [OR]: 1.44, 95% confidence interval [CI]: 1.31-1.59; OR: 1.47, 95%CI: 1.21-1.79; OR: 1.61, 95%CI: 1.35-1.91); each 1-unit rise in METS-IR corresponds to 10%, 6%, and 12% higher chance of ISH, IDH, and SDH, respectively (OR: 1.10, 95%CI: 1.09-1.12; OR: 1.06, 95%CI: 1.03-1.08; OR: 1.12, 95%CI: 1.10-1.14). Consistent positive associations were observed across different subgroups for ISH and SDH, whereas this association for IDH was not statistically significant in several subgroups (e.g., age ≥12 years, sufficient sleep, daily exercise). TyG and METS-IR exhibited linear dose-response relationships with all hypertension phenotypes (p-nonlinear >0.10).

CONCLUSION: TyG and METS-IR show strong relationships with three kinds of hypertension phenotypes. They are promising markers that may contribute to the primary prevention of hypertension in pediatric populations.

PMID:40778272 | PMC:PMC12328147 | DOI:10.3389/fendo.2025.1595097

Eplasty. 2025 Jun 27;25:e22. eCollection 2025.

ABSTRACT

BACKGROUND: Many amputees are left with chronic localized pain, centralized pain, and phantom limb pain or sensation, often resulting from neuromas in the residual limb. Historically, there is no reliably effective intervention for pain associated with neuroma-related residual or phantom limb pain. Targeted muscle reinnervation (TMR) is a surgical procedure first described in 2002 that involves the transfer of residual nerves from amputated limbs to new muscle targets. TMR has been shown to significantly reduce neuroma pain and facilitate the use of prostheses.

METHODS: A prospective study was conducted of 61 patients who underwent TMR for neuroma treatment or prevention between 2017 and 2022. Primary outcomes included overall, phantom, and residual limb pain recorded using the Visual Analog Scale (VAS), as well as Patient-Reported Outcomes Measurement Information System (PROMIS) forms for Pain Intensity, Quality, Interference, and Behavior. Retrospective data was collected for a propensity-matched cohort of non-TMR amputees to compare pain outcomes.

RESULTS: TMR was performed for 25 upper extremity and 35 lower extremity amputations, and 5 patients underwent TMR on multiple limbs. Significant reductions were observed in overall limb pain (-3.2 points), phantom limb pain (-2.6 points), and residual limb pain (-3.0 points) for the TMR cohort. Mean PROMIS scores for TMR patients were 49.7 for Pain Intensity, 54.0 for Pain Quality, 55.3 for Pain Interference, and 56.1 for Pain Behavior. At the 8.4-month follow-up, 43.8% of TMR patients (vs 84% of controls) remained on neuromodulators, opioids, or both, for pain control.

CONCLUSIONS: TMR improved phantom and residual limb pain in amputees, as evidenced by clinically and statistically significant reductions in pain with reduced need for long-term opioids and/or neuromodulators. These findings support the current understanding of TMR but underscore the need for continued investigation to comprehensively assess the potential of this promising technique in improving the functional outcomes and quality of life in the amputee population.

PMID:40778246 | PMC:PMC12331023

Jpn J Appl Phys (2008). 2022 Jul;61(SG):SG1049. doi: 10.35848/1347-4065/ac48d3. Epub 2022 May 30.

ABSTRACT

In a previous study, an annular-array transducer was employed to characterize homogeneous scattering phantoms and excised rat livers using backscatter envelope statistics and frequency domain analysis. A sound field correction method was also applied to take into account the average attenuation of the entire scattering medium. Here, we further generalized the evaluation of backscatter coefficient (BSC) using the annular array in order to study skin tissues with a complicated structure. In layered phantoms composed of two types of media with different scattering characteristics, the BSC was evaluated by the usual attenuation correction method, which revealed an expected large difference from the predicted BSC. In order to improve the BSC estimate, a correction method that applied the attenuation of each layer as a reference combined with a method that corrects based on the attenuation of the analysis position were applied. It was found that the method using the average attenuation of each layer is the most effective. This correction method is well adapted to the extended depth of field provided by an annular array.

PMID:40778239 | PMC:PMC12330873 | DOI:10.35848/1347-4065/ac48d3

Npj Ment Health Res. 2025 Aug 7;4(1):35. doi: 10.1038/s44184-025-00153-7.

ABSTRACT

Investigating long-term posttraumatic stress disorder (PTSD) course and its predictors may guide prevention and early intervention strategies following trauma exposure, potentially reducing the long-lasting impact of trauma. N = 155 emergency-admitted adults with (suspected) serious injury were repeatedly assessed until one-year post-trauma and completed a 12-15 year follow-up including a clinical PTSD interview. Adverse one-year PTSD trajectories; more exposure to additional potentially traumatic events and recent life stressors; and early post-trauma predictors (younger age, greater perceived impact of prior potentially traumatic events, higher heart rate) were significantly associated with higher PTSD symptom severity 12-15 years post-trauma. This study showed high consistency between one-year PTSD and its early post-trauma predictors with long-term PTSD outcomes. Early post-trauma predictors had predictive value up to 12-15 years. This suggests that early risk identification of one-year PTSD and subsequent effective early interventions also hold long-term beneficial effects for PTSD outcome.

PMID:40775520 | DOI:10.1038/s44184-025-00153-7

Sci Rep. 2025 Aug 7;15(1):28935. doi: 10.1038/s41598-025-14817-z.

ABSTRACT

Carbapenem-resistant Enterobacterales (CRE), particularly carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Escherichia coli (CREC), are significant pathogens causing healthcare-associated infections. This retrospective study assesses the effectiveness of ceftazidime-avibactam (CAZ/AVI) in achieving perianal swab (PAS) negativity compared to other treatments, including colistin, polymyxin B, meropenem, and combinations with fosfomycin. We retrospectively analyzed 147 CRE-colonized patients (76 females) screened with PAS samples from January 14, 2021, to April 27, 2024. Patients were divided into two groups: those treated with CAZ/AVI (n = 40) and those receiving alternative treatments (n = 44) for bloodstream infections or ventilator associated pneumonia caused by CRE. PAS negativity was defined as conversion from positive to negative, while relapse was a positive PAS result after initial negativity. A p-value below 0.05 was considered to be statistically significant. The CAZ/AVI group achieved a higher rate of PAS negativity (32 patients) with a median time to PAS negativity of 1 week. Relapse rates were similar between CAZ/AVI (23/24) and non-CAZ/AVI groups (8/10). Significant differences in PAS negativity were observed at two weeks (p < 0.001) but not at four weeks (p = 0.492). The median time to PAS negativity was shorter in the CAZ/AVI group (1 week) compared to the non-CAZ/AVI group (2 weeks; p = 0.027). CAZ/AVI is more effective than alternative treatments for short-term PAS negativity, but relapse rates are comparable, highlighting challenges in long-term CRE management. Continuous surveillance and personalized decolonization strategies are essential. Further research is needed to investigate relapse mechanisms and evaluate combination therapies or novel strategies for sustained decolonization.

PMID:40775514 | DOI:10.1038/s41598-025-14817-z