Tag: pubmed

ISA Trans. 2025 Sep 25:S0019-0578(25)00530-0. doi: 10.1016/j.isatra.2025.09.025. Online ahead of print.

ABSTRACT

In this paper, we propose a novel event-triggered (ET) distributed neurodynamic (DND) approach that integrates a distributed controller to tackle distributed time-varying optimization problems (DTOP). The approach achieves optimization of a global cost function in real time while simultaneously steering agent states toward consensus. Two key features distinguish the proposed method from prior works. First, communication among agents is governed by ET schemes, allowing updates only at specific triggering moments, which helps conserve communication energy. Second, the ET distributed controller eliminates the computation of the inverse of the Hessian matrix of the local objective function, which effectively reduces the computational cost. Finally, a case study of the battery charging problem demonstrates the effectiveness of the proposed approach.

PMID:41046194 | DOI:10.1016/j.isatra.2025.09.025

Clin Breast Cancer. 2025 Sep 4:S1526-8209(25)00251-4. doi: 10.1016/j.clbc.2025.09.001. Online ahead of print.

ABSTRACT

INTRODUCTION/BACKGROUND: Breast cancer affects over 61,000 women annually in France. While only 5-10% of breast cancers are hereditary, BRCA1/2 mutations significantly increase the lifetime risk of breast and ovarian cancer, with cumulative invasive breast cancer risks of 72% (BRCA1) and 69% (BRCA2) by age 80. Surgical management in this population is crucial, as it directly impacts quality of life (QoL). However, prospective comparative data on surgical strategies are lacking.

MATERIALS AND METHODS: This prospective study analyzed data from the CANTO cohort to assess the impact of different surgical approaches on QoL in BRCA1/2 mutation carriers diagnosed with invasive breast cancer. Four surgical options were compared: breastconserving surgery (BCS), mastectomy, immediate breast reconstruction (IBR), and delayed breast reconstruction (DBR). Patient-reported outcomes were evaluated over time, focusing on body image, future perspective, sexual functioning, and physical symptoms.

RESULTS: BCS and IBR were associated with better preservation of body image throughout follow-up. DBR significantly improved body image, future perspective, and sexual functioning beginning at the time of surgery. Breast and arm symptoms were overall moderate, but mastectomy resulted in increased arm symptoms, likely due to the higher rate of axillary lymphadenectomy.

CONCLUSION: When feasible, BCS should be preferred for BRCA1/2 mutation carriers, as it best preserves QoL. For patients requiring mastectomy, IBR is a valuable option, while DBR offers long-term benefits in body image and psychosocial well-being. Psychological support and structured postsurgical rehabilitation are strongly recommended to alleviate symptoms and optimize patient quality of life.

PMID:41046190 | DOI:10.1016/j.clbc.2025.09.001

Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Aug 27:S2212-4403(25)01195-2. doi: 10.1016/j.oooo.2025.08.016. Online ahead of print.

ABSTRACT

OBJECTIVE: Oral submucous fibrosis (OSF) is a progressive disease with an increased risk of developing oral cancer. There exists a notable scarcity of evidence on treatments that can promote tissue regeneration in OSF. Autologous platelet-rich plasma (PRP) is an emerging therapy with limited applications in OSF.

STUDY DESIGN: A prospective case-series was conducted in 10 patients with a histopathologically confirmed diagnosis of OSF. Baseline data included sociodemographic and risk habits, self-reported burning sensation to food was recorded using a visual analogue scale, and inter incisor distance at maximum mouth opening was measured in cm. Autologous PRP was infiltrated into bilateral buccal mucosa, once a month, and measurements were repeated at 6 months. Thresholds for clinically significant improvement were defined at ≥ 50% change in burning sensation, and ≥ 25% change in mouth opening. Data analysis was done using a paired sample T test and effect size (Cohen’s D).

RESULTS: Patients were aged 31 to 69 years, female to male ratio was 1:4 with mild to moderate disease severity. Clinically significant change in mouth opening was reported in 60% of patients, whereas 100% reported significant reduction in burning sensation, no side effects were reported. There were statistically significant differences (P < .05) on mouth opening and burning sensation following PRP therapy.

CONCLUSIONS: Based on this exploratory evidence, we propose intralesional PRP therapy as a safe and clinically effective treatment for mild to moderate OSF. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

PMID:41046183 | DOI:10.1016/j.oooo.2025.08.016

Eur Urol. 2025 Oct 3:S0302-2838(25)04687-1. doi: 10.1016/j.eururo.2025.09.4144. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Our aim was to evaluate the effect of addition of radical prostatectomy (RP) to best systemic therapy (BST) on cancer-specific mortality (CSM) in patients with oligometastatic prostate cancer (omPC).

METHODS: This randomised controlled trial included patients with omPC with a low metastatic burden (1-5 bone metastases with/without nodal involvement) on conventional or PET imaging. Patients were randomised to receive either RP with pelvic lymph-node dissection plus BST (RP + BST) or BST alone. The primary endpoint was CSM. Secondary endpoints included clinical progression and overall survival (OS). Study accrual was stopped early because of a change in medical practice. Statistical analyses included cumulative incidence plots, Gray’s test, competing-risks regression, Kaplan-Meier estimates, and log-rank tests.

KEY FINDINGS AND LIMITATIONS: Between May 2015 and December 2018, 132 patients were randomised. The median age was 67 yr (interquartile range 63-71) and median prostate-specific antigen was 20 ng/ml (interquartile range 10-39). The 5-yr CSM cumulative incidence was 13% for RP + BST and 23% for BST alone (p = 0.037), with a hazard ratio of 0.39 (95% confidence interval 0.16-0.98; p = 0.045). The 5-yr cumulative incidence of clinical progression including CSM was 59% for RP + BST and 60% for BST alone. The 5-yr OS rate was 81% for RP + BST and 74% for BST alone. Clavien-Dindo grade ≥III surgery-related complications occurred in nine of 66 (14%) patients in the RP + BST arm. Limitations include early discontinuation of study accrual and the lack of statistical significance for the OS benefit.

CONCLUSIONS AND CLINICAL IMPLICATIONS: While this trial has substantial limitations, the results support addition of RP as local therapy to BST in omPC. This trial is registered on ClinicalTrials.gov as NCT02454543.

PMID:41046179 | DOI:10.1016/j.eururo.2025.09.4144

Eur J Clin Microbiol Infect Dis. 2025 Oct 4. doi: 10.1007/s10096-025-05276-5. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to investigate the impact of our institutional sepsis protocol on the empirical treatment of carbapenem-resistant Gram-negative bacteria in a setting where infectious disease consultation (ID) is available 7 days / 24 h and broad-spectrum antibiotic use requires ID approval.

METHODS: A total of 612 patients (168 patients pre-guideline, 444 patients post-guideline) who received empirical antibiotics for suspicion of sepsis before documentation of antibacterial susceptibility were included. Demographic, clinical and microbiological data were collected from the hospital’s electronic medical record system, retrospectively. Compliance with institutional guidelines and the rate of appropriate antibiotic use prior to the availability of antibiograms were assessed.

RESULTS: There was a statistically significant increase in the utilization rate of empirical antibacterial treatment based on pre-defined risk factors of multidrug resistance [OR (95% CI) 1.73 (1.21-2.48), p = 0.003]. Furthermore, appropriateness of the initial antibacterial treatment according to the antibiogram results increased significantly in the post-guideline period [OR (95% CI) = 3.25 (2.09-5.06), p < 0.001]. The rate of compliance with guideline recommendations (p = 0.004) and the rate of appropriate empirical antibiotic treatment (p < 0.001) by each year were significant when compared with the pre-guideline period. Also, practices that improve drug pharmacokinetics such as loading dose, prolonged infusion of meropenem and adjusting antibiotic doses according to renal function increased statistically after the release of guideline.

CONCLUSION: An institutional sepsis protocol based on risk factors for multidrug resistance and local epidemiology increased the rate of appropriate empirical antibiotic treatment even in a setting where ID consultation is readily available.

PMID:41045444 | DOI:10.1007/s10096-025-05276-5

Cancer Causes Control. 2025 Oct 4. doi: 10.1007/s10552-025-02073-5. Online ahead of print.

ABSTRACT

PURPOSE: Epidemiological studies have reported the influence of legume consumption on multiple cancers risk, but the association in esophageal cancer (EC) remains unclear. This study aimed to investigated the prospective associations between legume consumption and EC risk, especially among Chinese populations.

METHODS: We conducted a prospective cohort study with 15,184 participants aged 40 to 69 years from two high-risk areas of EC in China between 2005 and 2009, with follow-up until 2022. A validated questionnaire was used to collect the consumption frequency of major food groups at baseline and subsequent resurveys, including legume. The Cox proportional hazard regression was used to evaluate the multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of legume consumption and EC risk. To quantify the linear association of legume consumption and EC risk and to account for regression dilution bias, the mean usual consumption amount for each baseline group was estimated by combining the consumption level at both baseline and the second resurvey.

RESULTS: The final study sample included 15,184 participants in the cohort (mean [SD] baseline age, 51.8 [7.5] years). During a follow-up of 219,365 person-years, a total of 176 new EC cases were identified. Legume consumption was inversely associated with EC risk, with a 63% reduction in risk for participants who consumed legume regularly compared with nonconsumption (HR: 0.37; 95% CI 0.16, 0.84; p for trend = 0.022). After correction for regression dilution bias, each 10 g/day increased legume consumption was associated with a HR of 0.35 (0.13, 0.96) for esophageal squamous cell carcinoma (ESCC) risk. The associations were consistent across most subgroups and sensitivity analyses.

CONCLUSION: Higher frequency of legume consumption was associated with lower risk of EC among Chinese adults, particularly ESCC. Our findings suggest legume consumption may play an important role in preventing the development of EC.

PMID:41045426 | DOI:10.1007/s10552-025-02073-5

Hepatol Int. 2025 Oct 4. doi: 10.1007/s12072-025-10920-5. Online ahead of print.

NO ABSTRACT

PMID:41045421 | DOI:10.1007/s12072-025-10920-5

Gastric Cancer. 2025 Oct 4. doi: 10.1007/s10120-025-01660-4. Online ahead of print.

ABSTRACT

BACKGROUND: Several programmed cell death protein-1 inhibitors are approved for the first-line treatment of advanced gastric/gastroesophageal junction cancer, including pembrolizumab, nivolumab and, more recently, tislelizumab. Since direct comparisons between these agents are lacking, advanced statistical modeling can be utilized to evaluate the relative efficacy and safety of tislelizumab compared with other first-line immunotherapy regimens in this indication.

METHODS: A systematic literature review was performed to identify and summarize published randomized controlled trials investigating first-line treatments in adult patients with unresectable, locally advanced, or metastatic human epidermal growth factor receptor 2-negative gastric/gastroesophageal junction cancer. Relevant trials were synthesized using a Bayesian network meta-analysis; fixed-effect models were conducted for all analyses. The network meta-analysis base case used the intent-to-treat populations for tislelizumab + chemotherapy and placebo + chemotherapy from RATIONALE-305.

RESULTS: Key comparators included nivolumab + chemotherapy (ATTRACTION-4, CheckMate 649), and pembrolizumab + chemotherapy (KEYNOTE-062, KEYNOTE-859). Tislelizumab + chemotherapy demonstrated similar efficacy compared with nivolumab + chemotherapy and pembrolizumab + chemotherapy for both overall survival and progression-free survival. Tislelizumab + chemotherapy was associated with significantly lower odds of grade ≥ 3 treatment-related adverse events compared with nivolumab + chemotherapy, and there were no statistically significant differences between tislelizumab + chemotherapy compared with pembrolizumab + chemotherapy.

CONCLUSION: Overall, these analyses suggest that tislelizumab + chemotherapy is similarly efficacious to pembrolizumab + chemotherapy and nivolumab + chemotherapy, and is associated with a similar or lower incidence of grade ≥ 3 treatment-related adverse events in the first-line treatment of gastric/gastroesophageal junction cancer.

PMID:41045401 | DOI:10.1007/s10120-025-01660-4

Genes Genomics. 2025 Oct 4. doi: 10.1007/s13258-025-01688-x. Online ahead of print.

ABSTRACT

BACKGROUND: Predictive models using microbiome data often suffer from covariate imbalance and class imbalance, biasing results. Propensity Score Matching (PSM) balances covariates but reduces sample size, while borderline synthetic minority oversampling technique (borderline-SMOTE) oversamples minority classes but can generate uninformative examples.

OBJECTIVE: To develop and evaluate PSM-SMOTE, a novel hybrid sampling method that integrates PSM and borderline-SMOTE to handle both covariate and class imbalance in microbiome data.

METHODS: We developed PSM-SMOTE, a three-step hybrid sampling algorithm for microbiome data: (1) PSM at four caliper levels to balance covariates, (2) selection of at least ten robust differential markers via seven statistical tests with false discovery rate correction, and (3) application of borderline-SMOTE on the marker-based distance matrix to oversample minority classes. We evaluated PSM-SMOTE on three publicly available microbiome case-control datasets: pancreatic ductal adenocarcinoma (PDAC), colorectal cancer (CRC), and obesity, using logistic regression (LR), random forest (RF), and support vector machine (SVM) classifiers. Performance was assessed via area under the ROC curve (AUC).

RESULTS: PSM-SMOTE improved test AUCs in multiple model-dataset combinations compared with using PSM alone. Notably, for the RF model, PSM-SMOTE consistently enhanced AUC across nearly all oversampling settings in the PDAC and obesity cohorts. For the SVM model, PSM-SMOTE also achieved a significant AUC increase in the CRC cohort. For the LR model, PSM-SMOTE showed modest improvement under strict matching.

CONCLUSION: PSM-SMOTE effectively addresses dual imbalance in microbiome data and consistently enhances performance, providing a practical solution for imbalanced data analyses.

PMID:41045399 | DOI:10.1007/s13258-025-01688-x

World J Urol. 2025 Oct 4;43(1):596. doi: 10.1007/s00345-025-05979-6.

ABSTRACT

PURPOSE: To validate the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Best Practice Policy Statement (BPPS) risk factors (RFs) for predicting urinary-tract infection (UTI) after urodynamic study (UDS) and to identify possible RFs that could better guide antibiotic prophylaxis.

METHODS: A retrospective cohort study included all adults undergoing UDS at a single institution. Patients with asymptomatic bacteriuria received a 3-day antibiotic course, while those without bacteriuria received no prophylaxis. The primary endpoint was a culture-confirmed UTI within 7 days. Regression analysis was performed to check SUFU BPPS RFs as predictors for post-UDS UTI.

RESULTS: Among 1666 patients (median age 68 years; 42% female), UTI occurred in 31 (1.9%). Abnormal GU anatomy was found as a predictor for post-UDS UTI (OR = 3.26, p = 0.033). Other examined RFs were not found to predict post-UDS UTI. More concise variables were identified as statistically significant predictors: hydronephrosis (OR = 4.98, p = 0.004), elevated post-void residual (PVR) (OR = 2.80, p = 0.011), and NLUTD due to neurologic disease (OR = 2.27, p = 0.042). In multivariate analysis, elevated PVR and NLUTD caused by neurologic disease remained independent predictors.

CONCLUSION: The current SUFU BPPS criteria exhibit limited accuracy for predicting post-UDS UTI. Our study emphasizes hydronephrosis, NLUTD caused by neurologic disease, and elevated PVR as predictors of post-UDS UTI. Updating prophylactic guidelines to incorporate these findings could enhance patient safety and antimicrobial stewardship without compromising infection control.

PMID:41045391 | DOI:10.1007/s00345-025-05979-6