Tag: pubmed

Ecancermedicalscience. 2026 Mar 12;20:2090. doi: 10.3332/ecancer.2026.2090. eCollection 2026.

ABSTRACT

BACKGROUND: Multidisciplinary tumour board (MTB) plays an important role in cancer care by collaborating specialist from various disciplines to discuss diagnosis, treatment plan and patient management. Despite its importance, a systematic evaluations of tumour board in hospital registered under hospital-based cancer registries (HBCRs) is limited. This study aims to assess the characteristics, composition and functioning of tumour board in these hospital to identify gaps and challenges to improve the tumour board operations.

METHODS: The study was conducted from October 1st to 31st 2024 using cross sectional design among hospital under HBCR. A set of structured questionnaires was administered using Google Form, which consists of both qualitative and quantitative questionnaires. Descriptive statistics and chi-square test were used to analyze the quantitative data, while manual thematic analysis was carried out to analyze the qualitative responses.

RESULT: Of 229 hospitals, only 172 (75%) responded. Among them, 137 (79.7%) reported having a functional tumour board. Most of the tumour boards were established in tertiary care centres (45.3%) and medical colleges (43.6%). In-person meeting (73.7%) was the most common with 24.8% following a hybrid model. Only 5.1% of hospitals engaged in cross-hospital case discussions; 16.8% maintained electronic medical record notes; and 48.2% lacked any follow-up mechanisms to track tumour board recommendations and outcomes. Involvement of palliative care specialists and other supportive paramedical health professionals was low. In addition to that, thematic analysis also identified that there was inadequate documentation, inconsistent follow-up and limited tumour board participation.

CONCLUSION: Although MTBs are established widely in most of the HBCR-affiliated hospitals, variation exist in structure, composition and functionality. Strengthening MTBs through standardised protocol, participation of diverse specialities, increased cross-hospital collaboration, virtual tumour boards and proper documentation practices through electronic data recording systems could enhance the decision making and cancer care outcomes.

PMID:42131886 | PMC:PMC13161587 | DOI:10.3332/ecancer.2026.2090

Ecancermedicalscience. 2026 Mar 12;20:2089. doi: 10.3332/ecancer.2026.2089. eCollection 2026.

ABSTRACT

BACKGROUND: Understanding symptom prevalence and palliative care needs is essential to advancing palliative care research in South America. This study aimed to assess these outcomes using the Palliative Outcome Scale (POS) and explore their relationship with the self-rated importance of spirituality.

METHODS: A cross-sectional study was conducted among adult persons with cancer receiving palliative care at an outpatient clinic in a Brazilian public hospital. Data were collected through structured interviews using the POS, which assesses physical and psychosocial symptoms, communication, practical concerns and information received. Spirituality was measured using a self-rated single-item question. Associations between symptom burden and spirituality were analysed using t-tests and logistic regression was used to examine the relationship between spirituality importance and inadequate pain control, adjusting for potential confounders. Statistical significance was set at p < 0.05.

RESULTS: Sixty-seven patients (mean age 60 ± 13.8 years; 68.6% female) participated. Pain (77.6%), nausea (27%), weakness/fatigue (20.9%) and psychological distress (19.4%) were the most prevalent symptoms. Most had metastatic cancer (62.7%), and 32.8% were undergoing chemotherapy. Patients rating spirituality as highly important had significantly lower pain scores (mean 1.4 ± 1.4 versus 2.6 ± 0.9, p = 0.006) and were over ten times less likely to report inadequate pain control (odds ratios = 10.74, 95% confidence intervals: 1.87-203.82, p = 0.028).

CONCLUSION: Our findings underscore the high prevalence of physical, psychological and social challenges among persons with cancer receiving palliative care. Symptom patterns aligned with global data, suggesting a universal burden. The strong association between spirituality and pain highlights the protective role of spiritual well-being in mitigating suffering, reinforcing the need to integrate spiritual care into palliative frameworks. These results offer valuable insights for guiding clinical practice, shaping international policy and informing future research to optimise care delivery and patient outcomes.

PMID:42131884 | PMC:PMC13161588 | DOI:10.3332/ecancer.2026.2089

Ecancermedicalscience. 2026 Mar 18;20:2095. doi: 10.3332/ecancer.2026.2095. eCollection 2026.

ABSTRACT

OBJECTIVE: To compare patient-reported outcomes of breast-conserving surgery (BCS) and breast reconstruction post-mastectomy (BRPM) at Mater Dei Hospital using the BREAST-Q™ questionnaire, with a focus on multiple quality-of-life domains including satisfaction with breasts, psychosocial well-being, physical well-being, sexual well-being, fatigue, cancer worry and impact on work.

METHODS: This retrospective audit analysed 46 patients treated between 2017 and 2020 at Mater Dei Hospital, Malta: 23 underwent BCS via wide local excision, and 23 underwent two-stage implant-based reconstruction following mastectomy. To reduce variability, only cases performed by a single breast surgeon were included, and age distributions were matched between groups. Patient-reported outcomes were assessed using the validated BREAST-Q™ version 1.0 questionnaire. Statistical comparisons between the BCS and BRPM groups were conducted using the Mann-Whitney U test.

RESULTS: BCS patients reported higher scores in physical well-being (70.0% versus 64.6%, p = 0.01) and slightly better sexual well-being (73.3% vs versus 66.7%, p = 0.83), while BRPM patients showed higher psychosocial well-being (74.0% vs versus 69.4%, p = 0.17). Satisfaction with breast outcomes appeared higher in the BCS group when expressed as a percentage of the maximum possible score (83.5% vs versus 63.3%, p = 0.43), though raw scores favoured BRPM. Cancer worry, fatigue and impact on work scores were similar between groups, with no statistically significant differences.

CONCLUSION: Both BCS and BRPM yielded broadly comparable patient-reported outcomes across most domains. BRPM was associated with higher psychosocial well-being, while BCS patients experienced better physical and sexual well-being. The only statistically significant difference was found in physical well-being, favouring BCS. These findings underscore the importance of personalised counselling and shared decision-making to align surgical choices with patient values and expectations.

PMID:42131881 | PMC:PMC13161581 | DOI:10.3332/ecancer.2026.2095

Ecancermedicalscience. 2026 Mar 12;20:2093. doi: 10.3332/ecancer.2026.2093. eCollection 2026.

ABSTRACT

BACKGROUND: São Tomé and Príncipe, a small island developing state, relies heavily on medical evacuations for specialised cancer care. This country does not yet have a population-based cancer registry. Therefore, limited data exist on cancer epidemiology in this population.

OBJECTIVE: To characterise the profile of cancer among patients evacuated from São Tomé and Príncipe for medical treatment abroad.

METHODS: Descriptive study of medical evacuation records from the Ministry of Health’s Patient Evacuation Board (2019-2025). Descriptive statistics were reported for patient demographics, year of evacuation, primary diagnosis, referring speciality, number of evacuations per patient and if travelled with an escort.

RESULTS: Of 1,066 total evacuations, 413 (38.7%) were cancer-related. Cancer patients had a mean age of 48.3 ± 18.7 years with female predominance (58.6%). Breast cancer was most frequent (24.7%), followed by prostate (17.9%) and cervical cancer (9.4%). Most patients (76.9%) required single evacuation, with cancer patients more likely to have multiple evacuations.

CONCLUSION: Cancer represents a substantial burden among medical evacuees, with patterns suggesting opportunities for enhanced prevention and early detection programs. The high evacuation rate highlights critical gaps in local oncological capacity. Establishing a population-based cancer registry would enhance epidemiological data and inform public health strategies.

PMID:42131878 | PMC:PMC13161590 | DOI:10.3332/ecancer.2026.2093

J Saudi Heart Assoc. 2026 May 2;38(2):3. doi: 10.37616/2212-5043.1499. eCollection 2026.

ABSTRACT

OBJECTIVES: Accurate patient centring at the computed tomography (CT) scanner isocentre is essential for optimising radiation dose. This study aimed to quantify positioning errors, assess their relationship with radiation dose, and estimate the potential dose reduction achievable with optimal centring.

METHODS: This retrospective observational study included adult patients (≥18 years) who underwent electrocardiography (ECG)-gated cardiac CT angiography between January 2023 and July 2025 at a tertiary hospital. Scans were performed using Siemens SOMATOM Force dual-source CT systems. Vertical and lateral deviations from the scanner isocentre were calculated from scout images using integrated analytics within the institutional dose monitoring platform (Qaelum NV, Leuven, Belgium). Radiation dose indices, including the volume-weighted CT dose index (CTDI_vol) and dose length product (DLP), were extracted from DICOM dose reports. Statistical analyses comprised descriptive statistics, correlation analysis, multivariable regression, and simulation of potential dose reductions with ideal centring.

RESULTS: Data from 399 patients were evaluated. Significant off-centring (>10 mm) occurred in 83% of scans in the anteroposterior (AP) direction and 50% laterally. Severe AP off-centring (>30 mm) was present in 39% of cases. Off-centring showed no independent association with CTDI_vol or DLP after adjustment for body mass index (BMI), age, and sex. Male patients demonstrated significantly greater off-centring in both the AP (p = 0.048) and lateral (p = 0.037) directions, and BMI category was significantly associated with off-centring magnitude in the AP (p = 0.031) and lateral (p = 0.022) directions. Literature-based scenario modelling suggested that ideal centring could hypothetically reduce mean CTDI_vol by approximately 12%, with a similar reduction in DLP.

CONCLUSION: Patient off-centring was highly prevalent in cardiac CT examinations. No independent association between off-centring and radiation dose was observed when adjusting for BMI, age, and sex. Literature-based scenario modelling suggests that meaningful radiation dose reductions may be achievable with optimum centring, although this requires prospective confirmation.

PMID:42131871 | PMC:PMC13166806 | DOI:10.37616/2212-5043.1499

Alzheimers Dement. 2026 May;22(5):e71458. doi: 10.1002/alz.71458.

ABSTRACT

INTRODUCTION: Subtle symptoms, like subjective cognitive decline (SCD) and minor neuropsychological deficits (MNPD), can improve the risk stratification in preclinical Alzheimer´s disease (AD) but their importance is insufficiently elaborated.

METHODS: We pooled data from cognitively normal individuals participating in three longitudinal cohort studies (N = 13,192, 8,359[63.3%] female, mean [SD] age 71.0[8.4]).

RESULTS: Compared to participants without SCD and MNPD (SCD-/MNPD-), SCD-/MNPD+, SCD+/MNPD-, and SCD+/MNPD+ participants had an increased risk for mild cognitive impairment (MCI) and dementia, including in amyloid-positive individuals. Focusing on SCD+/MNPD+ participants triples the positive predictive value of amyloid biomarker testing for the 5-year prediction of MCI and reduces the required samples size for trials in preclinical AD to one fourth, compared to considering all cognitively normal participants regardless of subtle symptoms.

DISCUSSION: SCD and MNPD offer a powerful approach for risk stratification in preclinical AD, which can improve clinical trial designs, risk counseling, and future case identifications for early treatment.

PMID:42129577 | DOI:10.1002/alz.71458

Nat Cancer. 2026 May 13. doi: 10.1038/s43018-026-01161-y. Online ahead of print.

ABSTRACT

Over 50% of persons with unresectable stage III non-small cell lung cancer (NSCLC) treated with standard-of-care concurrent chemoradiotherapy (CCRT) and durvalumab consolidation progress or die within 18 months. Here adults with untreated, unresectable stage III NSCLC were randomized to nivolumab plus CCRT followed by consolidation with nivolumab plus ipilimumab (arm A) or nivolumab alone (arm B) or CCRT followed by consolidation with durvalumab (arm C). The primary endpoint was progression-free survival (PFS) in arm A versus arm C and secondary endpoints included overall survival (OS), PFS in arm B versus arm C, response rates and safety. At a median follow-up of 30.5 months, there was no statistically significant difference in the primary endpoint of PFS in the nivolumab plus ipilimumab arm versus durvalumab arm (hazard ratio (HR): 0.95, 96% confidence interval (CI): 0.77-1.19; P = 0.65). Descriptive OS analysis showed no improvement (HR: 1.12, 95% CI: 0.87-1.43). Nivolumab alone did not improve PFS or OS versus durvalumab (PFS, HR: 0.84, 95% CI: 0.69-1.04; OS, HR: 0.97, 95% CI: 0.76-1.24). Nivolumab plus ipilimumab and nivolumab alone plus CCRT resulted in increased pneumonitis. These results emphasize the need for novel efficacious treatments for these individuals. (ClinicalTrials.gov: NCT04026412 ).

PMID:42129521 | DOI:10.1038/s43018-026-01161-y

Commun Med (Lond). 2026 May 13. doi: 10.1038/s43856-026-01646-y. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to investigate associations between newborn metabolite concentrations and the development of early-life wheezing and asthma. Our goal was to advance understanding of pathways involved in childhood asthma pathogenesis and identify potential targets for disease prevention.

METHODS: Our study populations included children enrolled in two Environmental influences on Child Health Outcomes (ECHO) cohorts (INSPIRE, discovery; Healthy Start, replication) with linked newborn screening metabolic and outcome data (4-year recurrent wheeze and 5-year current asthma). We used elastic net penalized regression, followed by multivariable logistic regression, to determine metabolite-wheeze and metabolite-asthma associations. We secondarily assessed whether metabolite-asthma associations differed by asthma phenotype in the discovery cohort.

RESULTS: Among 1554 INSPIRE children, the prevalence of recurrent wheeze and current asthma is 11% and 18%, respectively. Newborn concentrations of butyrylcarnitine + isobutyrylcarnitine (C4) and decenoylcarnitine (C10:1) are associated with recurrent wheeze (C4: aOR 0.75 [95% CI 0.59, 0.95]; C10:1: aOR 1.42 [95% CI 1.13, 1.78]), while linoleoylcarnitine (C18:2) and citrulline (CIT) are associated with current asthma (C18:2: aOR 1.20 [95% CI 1.02, 1.41]; CIT: aOR 0.74 [95% CI 0.58, 0.93]). The effect size and directionality of the association between C18:2 and childhood asthma is similar in Healthy Start (n = 518), although the relationship is not statistically significant. C18:2 is additionally associated with increased odds of non-allergic asthma compared to no asthma in INSPIRE.

CONCLUSIONS: These findings suggest biologic pathways that may be involved in childhood asthma pathogenesis and support investigation of the mechanisms underlying these relationships given the potential for targeted prevention strategies.

PMID:42129510 | DOI:10.1038/s43856-026-01646-y

Sci Rep. 2026 May 13;16(1):15058. doi: 10.1038/s41598-026-52851-7.

ABSTRACT

A novel stereological framework to generate synthetic three-dimensional cellular material structures using Voronoi tessellations is presented. While conventional investigations of microstructural features rely on costly and often destructive three-dimensional imaging techniques, our method enables the reconstruction of 3D cellular structures from two-dimensional planar-sectional image data. By representing 3D cell architectures through Voronoi tessellations, we obtain an analytical representation requiring only three parameters per cell, ensuring efficient storage and computational processing. Our framework employs a differentiable approximation of Voronoi tessellations combined with a discriminator neural network in an adversarial learning context, enabling gradient-based optimization of tessellation parameters to generate random 3D cellular structures with statistically similar 2D planar sections as observed in measured 2D image data. We demonstrate the framework on image data of various cellular materials including metallic alloys, biological cells, and foam structures. The presented framework shows state-of-the-art capability of stereologically reconstructing 3D cellular microstructures, while introducing a low-parameter representation, preserving physical interpretability, and ensuring computational efficiency.

PMID:42129505 | DOI:10.1038/s41598-026-52851-7

Sci Rep. 2026 May 13. doi: 10.1038/s41598-026-52827-7. Online ahead of print.

ABSTRACT

Mycoplasmas are known for being fastidious, with scientists still struggling to propagate them in vitro. Improving their culture is vital for future research, despite limited metabolomics studies available. This study explored the chemical composition changes in four liquid media (A, B, C, D) inoculated with Mycoplasma gallisepticum (MG), aiming to uncover overlooked metabolic features. We used Direct Analysis in Real Time High-Resolution Mass Spectrometry (DART-HRMS) across five time points over 71 h. Integration of DART-HRMS data with statistical analysis showed that media A and D initially contained higher glucose levels, which declined over time. Lactic acid levels rose in all media, with signals reaching saturation at the latest time points. Subsequent pathway enrichment analysis revealed an unexpected overexpression of arginine metabolism. Spermidine accumulation in certain media suggests a potential link to inhibited biofilm formation, opening questions about polyamine function in MG. Histidinal accumulation indicated an unpredicted amino acid synthesis capability in a mycoplasma and MG’s inability to convert arginine into glutamic acid. Additionally, MG was observed to utilize creatine when present. These findings highlight the importance of metabolomics in understanding enigmatic microorganisms like mycoplasmas, reaffirming that environmental factors drive alternative metabolic routes in MG and opening new research avenues.

PMID:42129501 | DOI:10.1038/s41598-026-52827-7