Nevin Manimala

Am Surg. 2026 Jan 24:31348261419763. doi: 10.1177/00031348261419763. Online ahead of print.

ABSTRACT

BackgroundSurgical costs per procedure may vary by surgeon due to operating time and equipment selection.MethodsCost and materials data were analyzed using an institutional database from a large academic, quaternary care center. The analysis included 475 thyroidectomy-coded operations performed by 13 surgeons from department A (n = 6) and department B (n = 7) between 2021 and 2023.ResultsMean time cost of procedures was significantly lower for department A surgeons by $112 compared to department B (p = .03). There was no statistically significant difference between the material cost of procedures between departments (p = .40). The highest average material cost for a single surgeon was $1590 with the lowest being $523, demonstrating the high degree of variability between surgeons.DiscussionExamining cost of materials alone, the highest and lowest-cost-ranked surgeons had a difference of $1067. Standardization of surgical trays and avoidance of outlier materials may be future avenues for research in decreasing costs.

PMID:41579333 | DOI:10.1177/00031348261419763

Int Urol Nephrol. 2026 Jan 24. doi: 10.1007/s11255-026-05029-z. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate whether systematic contralateral biopsy can be safely omitted in men with MRI-detected prostate lesions (PI-RADS ≥ 3) and to assess the impact of contralateral findings on treatment decisions.

MATERIALS AND METHODS: A retrospective cohort of 617 patients with pre-biopsy multiparametric MRI showing at least one PI-RADS ≥ 3 lesion underwent cognitive MRI-targeted biopsy of the index lesion, perilesional sampling (≥ 6 cores), and contralateral systematic biopsy (≥ 6 cores). Primary endpoint was upgrading in the contralateral lobe versus index/perilesional regions. Secondary endpoint was the impact of contralateral biopsy omission on treatment decision. Statistical analyses included Friedman’s test, Wilcoxon signed-rank, one-way ANOVA with Games-Howell, and McNemar’s test.

RESULTS: Median age was 69 years, median PSA 7.83 ng/mL, and median prostate volume 46 cc. Positive cores were observed in 76.3%, 83.3%, and 51.9% of index, perilesional, and contralateral biopsies, respectively. Contralateral lobe ISUP grade was significantly lower than the maximum index/perilesional grade (median 1 vs 2, p < 0.001). Clinically significant prostate cancer (ISUP ≥ 2) was present in 81% of index/perilesional regions versus 39% of contralateral. Only 2.1% of patients had clinically significant cancer isolated to the contralateral lobe (number needed to test = 48). Contralateral findings altered management in 6.3% of cases, predominantly in patients with low-risk features.

CONCLUSIONS: Tumor burden is predominantly localized to the index and perilesional regions. Contralateral biopsy minimally contributes to detecting high-grade disease or modifying treatment decisions. A selective MRI-directed approach combining targeted and perilesional sampling with judicious contralateral biopsy may optimize diagnostic yield while reducing procedural burden.

PMID:41579321 | DOI:10.1007/s11255-026-05029-z

Eur J Epidemiol. 2026 Jan 24. doi: 10.1007/s10654-025-01347-1. Online ahead of print.

ABSTRACT

Since its establishment in the late 1980s, the UK Clinical Practice Research Datalink (CPRD) has become one of the most widely utilised data resources in both national and international research. Its value lies in the richness, scale and quality of its routinely collected primary care data, as well as the availability of numerous linkable datasets. This study provides comprehensive scientometric analyses of CPRD-related research output, impact, and data usage from 1988 to 2024. A total of 3779 peer-reviewed publications were identified, and for 98.78% of them, enriched bibliometric metadata were retrieved through Scopus and Web of Science. The UK emerged as the leading contributing country, with the United States and Canada ranking second and third. ‘McGill University’ was the most frequently affiliated institution, followed by the ‘University of Manchester’ and the ‘University of Oxford’, with seven UK universities among the top ten. The three journals most frequently publishing CPRD-based research overall, and since 2020, were ‘BMJ Open’, ‘Pharmacoepidemiology and Drug Safety’ and ‘British Journal of General Practice’. Analyses of primary care data sources utilisation revealed that overall, 86.35% of manuscripts used CPRD GOLD exclusively, 8.39% used both CPRD GOLD and CPRD Aurum, and 4.76% used CPRD Aurum alone, although recent years showed an increased use of CPRD Aurum. Between 2016 and 2024, most articles (80.26%) were associated with CPRD research applications that referenced linked or CPRD algorithm-derived datasets. The three most frequently used were ‘Hospital Episode Statistics’ (69.77%), ‘Small Area Linkages’ (62.27%) and ‘Office for National Statistics’ mortality data (53.28%).

PMID:41579286 | DOI:10.1007/s10654-025-01347-1

Eur J Epidemiol. 2026 Jan 24. doi: 10.1007/s10654-025-01348-0. Online ahead of print.

ABSTRACT

Individuals with mental disorders face a substantially higher risk of mortality and are more likely to be lonely, socially isolated, and with low social support compared to those without mental disorders. We aimed to quantify the extent to which the observed mortality gap associated with mental disorders could be explained by these social factors. This cohort study included 162,483 participants from the Danish National Health Survey in 2013 and 2017 who were followed for six years after survey participation. Survey data on social disconnection (loneliness, social isolation, social support in the form of perceived emotional support, and a composite measure) was linked with register data on hospital-diagnosed mental disorders and mortality. We applied G-computation-based causal decomposition to compare the sex-specific relative risk of mortality associated with mental disorders under a natural course to a counterfactual scenario in which all individuals had a distribution of social disconnection similar to individuals without mental disorders. We found that social disconnection and the distribution of loneliness, social isolation, and social support accounted for 10-34% of the mortality gap associated with mental disorders among men and 2-20% among women, assuming a causal effect of social disconnection on mortality. The largest contributions were found for social isolation and loneliness, whereas the smallest were found for social support. Our results highlight the possibility that different aspects of social disconnection, especially social isolation and loneliness, could explain part of the mortality gap associated with mental disorders, with larger contributions among men than women.

PMID:41579285 | DOI:10.1007/s10654-025-01348-0

Discov Oncol. 2026 Jan 24. doi: 10.1007/s12672-026-04420-7. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to compare the efficacy and safety of perioperative somatostatin versus octreotide in peritoneal carcinomatosis (PC) patients after cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC).

METHODS: Peritoneal cancer patients treated with CRS + HIPEC were divided into two groups (somatostatin group and octreotide group). The postoperative gastric drainage volume, levels of inflammatory factors, perioperative safety and adverse effects were compared between two groups.

RESULTS: There were 48 (54.5%) patients in the somatostatin group and 40 (45.4%) in the octreotide group. There was no statistically significant difference in the postoperative gastric drainage volume between two groups. The median time to exhaust and defecation (7 d) was comparable between two groups (3-14 d in the somatostatin group and 4-13 d in the octreotide group). There were significant differences in the serum amylase level on postoperative day 3 (P = 0.044), and white blood cell level and neutrophil percentage at every monitoring time. The serious adverse events (SAEs) were similar and there were no long-term follow-up results between two groups.

CONCLUSIONS: Somatostatin and octreotide analogues appear to decrease the duration of enterocutaneous fistulas, but their application in PC patients after CRS + HIPEC might reduce SAEs.

PMID:41579284 | DOI:10.1007/s12672-026-04420-7

Discov Ment Health. 2026 Jan 24. doi: 10.1007/s44192-026-00378-8. Online ahead of print.

ABSTRACT

BACKGROUND: Anxiety and depressive symptoms are common in elite sports but remain understudied in female professional beach volleyball. Unique stressors including financial insecurity, dyadic team structures, and public visibility may increase vulnerability to mental health issues.

OBJECTIVE: The aim of this study was to assess the prevalence and severity of anxiety and depressive symptoms among female professional beach volleyball players and to investigate potential influencing factors such as training volume, financial security, and perceived social support.

METHODS: This cross-sectional study included 52 professional female beach volleyball players ranked within the top 200 of the world ranking (mean age 26.14 ± 4.70 years) from German-speaking countries, the United States, and Canada. Data were collected using standardized self-report instruments, including the State Trait Anxiety Inventory Trait version (STAI-T) and the Beck Depression Inventory II (BDI-II). Additionally, psychosocial and structural stressors such as financial uncertainty, interpersonal team dynamics, and support from coaches and teammates were assessed. Descriptive statistics, correlation analyses, and multiple regression analyses were conducted to identify significant associations.

RESULTS: In total, 67.3% (n = 35) of athletes exceeded the clinical cut-off score for trait anxiety (STAI-T ≥ 44), and 71.2% (n = 37) reported depressive symptoms above the clinical threshold (BDI-II ≥ 14). Trait anxiety and depressive symptoms were strongly correlated (r = 0.777, p < 0.001). Higher training volume correlated with more severe depressive symptoms (r = 0.450, p <0 .001), and several sport-related factors showed significant correlations with trait anxiety (all p < 0.05). Multiple regression identified poor team communication (p < 0.001) and financial insecurity (p = 0.026) as significant predictors of psychological burden, whereas international ranking showed no association with either anxiety or depression.

CONCLUSIONS: Elite female beach volleyball players exhibit high rates of clinically relevant anxiety and depressive symptoms. Psychosocial stressors, structural insecurities and subjective success perceptions, rather than objective competitive success, appear to be key contributors. These findings underscore the need for targeted sport-psychological support, financial stabilization, and long-term preventive strategies tailored to the unique demands of elite beach volleyball.

PMID:41579268 | DOI:10.1007/s44192-026-00378-8

J Med Ultrason (2001). 2026 Jan 24. doi: 10.1007/s10396-026-01617-9. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the dynamics of the talus-lateral malleolus distance during landing and compare the results between individuals with chronic ankle instability (CAI) and healthy adults.

METHODS: Participants were divided into the healthy (12 adults, 12 feet) and CAI (12 adults, 12 feet) groups. Participants performed forward single-leg drop landing from a 30-cm-high box. Through the synchronization of ultrasound with a motion capture system, measurements of the talus-lateral malleolus distance and ankle joint angles were obtained during forward single-leg drop landing. The analysis interval was from 200 ms before to 200 ms after initial contact; the time was normalized to 100%. Statistical parametric mapping was employed to investigate differences in the temporal changes of the talus-lateral malleolus distances and ankle joint angles during landing between groups.

RESULTS: A significantly longer talus-lateral malleolus distance was observed before initial contact in the CAI group (1-49%) as compared with the healthy group (p = 0.000). In addition, the ankle adduction angle before initial contact (12-61%) was larger in the CAI group than in the healthy group (p = 0.005).

CONCLUSION: Our findings suggest that the talus-lateral malleolus distance increases along with the ankle adduction movement in individuals with CAI, especially before initial contact, potentially indicating high mechanical ankle instability. This study established an innovative measurement system for quantitative evaluation of the dynamics of the talus and lateral malleolus during landing. The findings of this study may contribute to a more detailed understanding of pathology and features of movement in patients with CAI.

PMID:41579262 | DOI:10.1007/s10396-026-01617-9

EJNMMI Radiopharm Chem. 2026 Jan 24. doi: 10.1186/s41181-026-00425-3. Online ahead of print.

ABSTRACT

BACKGROUND: Glutamate carboxypeptidase II (GCPII), also known as prostate-specific membrane antigen (PSMA) is overexpressed in 90-100% of prostate cancer cells. The radiopharmaceutical [¹⁸F]PSMA-1007, recognised as a PET tracer for prostate cancer imaging, is based on PSMA inhibitor [Glu-CO-Lys(2Nal-Amb-Glu-Glu-PyTMA)] bound to the radioisotope Fluorine-18. [¹⁸F]Fluoride was obtained via the ¹⁸O(p,n)¹⁸F reaction using a cyclotron for medical use, while synthesis of [¹⁸F]PSMA-1007 was performed with two different platforms: FASTlab2 and NEPTIS^® Perform. Both modules enabled synthesis through nucleophilic substitution reaction and subsequent purification in solid phase extraction (SPE). Quality control process was validated according to the current specific monograph (3116) of the European Pharmacopoeia (Ph. Eur.) before clinical use.

RESULTS: Twenty syntheses of [¹⁸F]PSMA-1007 for each module were performed in order to evaluate and compare radiochemical purity (96.58% ± 1.25 with FASTlab2 vs 95.86% ± 0.79 with NEPTIS^® Perform) and decay-corrected radiochemical yield (43.7% ± 3 with FASTlab2 vs 28.5% ± 3.1 with NEPTIS^® Perform).

CONCLUSION: Both platforms produced [¹⁸F]PSMA-1007 that consistently met all pharmacopoeial quality control standards. However, the FASTlab2 system demonstrated a statistically significant higher decay-corrected radiochemical yield (43.7% ± 3% vs. 28.5% ± 3.1%, p-value < 0.001 after statistical testing). While this yield difference does not impact radiochemical purity or product safety, it may represent a relevant advantage in terms of production efficiency and available activity for clinical use, which may influence the choice of synthesizer.

PMID:41579247 | DOI:10.1186/s41181-026-00425-3

Spine Deform. 2026 Jan 24. doi: 10.1007/s43390-026-01289-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Posterior spinal fusion (PSF) for adolescent idiopathic scoliosis entails notable bleeding and transfusion risk, yet optimal tranexamic acid dosing remains undefined. We conducted a network meta-analysis (NMA) comparing high dose, low dose, and no-TXA regimens in this setting.

METHODS: We conducted a PROSPERO-registered NMA (CRD420251033929) of RCTs in AIS patients undergoing PSF. PubMed, CINAHL, EMBASE, reference lists, and grey literature were searched for trials comparing high dose (20-50 mg/kg load; 10-20 mg/kg/h infusion), low dose (10 mg/kg load; 1 mg/kg/h infusion), or no TXA. Outcomes were pooled using a random-effects model to produce mean differences for continuous data and relative risks for binary data.

RESULTS: Five RCTs (n = 475) were included. Patients had a frequency-weighted average (FWA) (SD) age of 15.1 (1.5) years, preoperative Cobb angle of 58.0 (7.9)°, 10.4 (1.3) levels fused, and operative time of 186.9 (62.0) minutes. They were allocated to high-dose TXA (n = 184), low-dose TXA (n = 144), or no-TXA (n = 147) arms. The FWA total EBL was 787.3 (261.5) mL in the high-dose group, 705.3 (219.0) mL in the low-dose group, and 1016.3 (492.2) mL in controls. There was no significant difference in EBL between high- vs low-dose TXA (MD -98.3 mL [-646.9, 426.2]). In the NMA, high-dose TXA reduced total EBL by 319 mL (95% CI -818 to 133) and low-dose by 219 mL (95% CI -764 to 294) versus no TXA-an 81% probability that no TXA was worst strategy-though neither comparison reached statistical significance. When compared per fused level, High- and low-dose TXA reduced EBL per level by 38.2 mL (MD -38.2 [-86.3, 6.1]) and 29.5 mL (MD -29.5 [-85.2, 27.3]) versus no TXA, respectively, without statistical significance; however, the no-TXA arm had an 87% probability of being worst for EBL by level. The FWA EBL per level was 78.9 ± 6.3 mL, 78.2 ± 7.2 mL, and 116.3 ± 17.8 mL for high-dose, low-dose, and no-TXA groups (very low certainty). When compared by operative time, high and lowdose TXA reduced EBL per hour by 81.0 mL/h (MD -81.0 [-250.0, 80.5]) and 60.2 mL/h (MD -60.2 [-285.0, 160.0]) versus no TXA, respectively, with no statistical significance. FWA EBL per hour was 273.8 ± 112.6 mL/h, 315.4 ± 133.6 mL/h, and 249.8 ± 150.2 mL/h for high dose, low dose, and no TXA (very low certainty). Both TXA arms had no complications vs. one uncontrolled bleed in the no-TXA group (0.7%).

CONCLUSION: High and low dose TXA in AIS PSF yielded modest, non-significant reductions in total blood loss and per-level EBL. No thromboembolic, neurologic, or renal complications occurred among, underscoring its safety. These results support a case-by-case approach to TXA use and highlight the need for larger, standardized RCTs to confirm its clinical value.

PMID:41579239 | DOI:10.1007/s43390-026-01289-y

Sports Med. 2026 Jan 24. doi: 10.1007/s40279-025-02386-0. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity is associated with impaired physical fitness, including physical functional performance and cardiorespiratory fitness, which affect health-related quality of life and mortality.

OBJECTIVE: We aimed to investigate the efficacy of a moderate-to-vigorous intensity exercise program and glucagon-like peptide-1 receptor agonist treatment alone or in combination during weight maintenance for physical fitness.

METHODS: This is secondary analysis of a randomized controlled trial involving 193 adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity. The exercise program was a combination of group sessions (interval-based indoor cycling followed by circuit training) and individual sessions of moderate-to-vigorous intensity, designed to meet the World Health Organization recommendations on physical activity for health. Exercise adherence was measured with sports watches and heart rate monitors. Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).

RESULTS: Participants randomized to exercise performed a median 2.65 session/week (116 min/week at 79% of maximum heart rate) with no significant difference between those who received placebo or liraglutide. Compared with liraglutide alone, the combined treatment decreased time to complete a stair climb test by 1.2 s [95% confidence interval 0.6-1.9] (corresponding to 8.6%) and improved peak oxygen consumption by 3.0 mL/min/kg fat-free mass [95% confidence interval 0.5-5.5]. Exercise alone led to similar benefits, whereas liraglutide alone did not improve physical fitness. Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.

CONCLUSIONS: Structured exercise combined with glucagon-like peptide-1-based obesity pharmacotherapy led to clinically meaningful improvements in physical functional performance and cardiorespiratory fitness, in contrast to pharmacotherapy alone.

CLINICAL TRIAL REGISTRATION: EudraCT number, 2015-005585-32; ClinicalTrials.gov number, NCT04122716.

PMID:41579235 | DOI:10.1007/s40279-025-02386-0