Category: Nevin Manimala

Orv Hetil. 2026 Jun 28;167(26):1034-1040. doi: 10.1556/650.2026.33595. Print 2026 Jun 28.

ABSTRACT

INTRODUCTION: One of the most serious potential complications of thyroid surgery is temporary or permanent dysfunction of the recurrent laryngeal nerve. According to the literature, the development of nerve injury is influenced by several predictive factors, including demographic, surgical and pathological factors.

OBJECTIVE: The aim of our research was to determine the prevalence of temporary and permanent vocal cord paralysis following thyroid surgery in our patient population, and to identify preoperative factors that may be associated with the development of paralysis.

METHOD: We retrospectively analyzed the data of patients who underwent thyroid surgery between January 1, 2022 and March 31, 2024. In addition to demographic data, we examined the surgical indication, interventional procedure and postoperative histological results. Fisher’s exact test and multivariate regression analysis were used to analyze whether age 65 years or older, malignant indication, and total thyroidectomy had prognostic significance for recurrent laryngeal nerve injury.

RESULTS: During the study period, a total of 155 operations were performed on 153 patients (125 women, 30 men; mean age: 53.7 years) (nerve at risk: 227). Of these, 143 were primary operations, 11 were completion thyroidectomies and 1 was reoperation; 83 cases were lobectomy, 72 cases were total thyroidectomy. The surgical indication was benign in 123 cases (category II-IV according to The Bethesda System for Reporting Thyroid Cytopathology [2023], drug-resistant hyperthyroidism, compression symptoms), and malignant in 32 cases (category V-VI, contralateral malignancy, cold nodule). Histological examination confirmed 128 benign and 27 malignant lesions. Immediate postoperative laryngeal dysmotility occurred in 18 cases (nerve at risk: 19; 8.4%). 4 patients were lost to follow-up, so 11 cases (5.0% of 220 nerve at risk) proved to be temporary and 3 cases (1.4% of 220 nerve at risk) proved to be permanent paralysis. Statistical analysis did not confirm any of the examined factors as independent predictors.

CONCLUSION: The incidence of postoperative laryngeal paralysis was in line with international data, and none of the examined potential risk factors were able to prove their prognostic significance, so the personalized risk assessment still relies primarily on literature data in our practice. Orv Hetil. 2026; 167(26): 1034-1040.

PMID:42365591 | DOI:10.1556/650.2026.33595

Sports Med Open. 2026 Jun 28;12(1):81. doi: 10.1186/s40798-026-01042-9.

ABSTRACT

OBJECTIVE: Police force recruits have a high musculoskeletal injury burden, which results in a substantial economic burden and can lead to attrition. The objective of this study was to identify and prioritise the strategies perceived as important and feasible to reduce the prevalence, incidence, and burden of injury in police force recruits.

DESIGN: Mixed-methods concept mapping study.

METHODS: Forty-eight participants were recruited from four broad groups: police force recruits/officers; police force staff; health professionals; and research experts. Participants brainstormed statements in response to a prompt (“To prevent injury and/or reduce the impact of injury on law enforcement recruit training, I think it’s important to….”) before sorting and rating the statements/strategies for importance and feasibility. Descriptive statistics, multi-dimensional scaling, hierarchical cluster analysis, pattern matching and Welch’s t-tests were applied.

RESULTS: Ninety-six unique prevention strategies were identified (42 were above the grand mean for both importance and feasibility). Eight clusters appropriately represented all statements. From highest to lowest mean cluster importance these were: i) clearly communicate physical training program expectations and requirements; ii) prepare for, monitor and manage physical training load; iii) provide best practice injury identification, prevention and management; iv) educate recruits, staff and other stakeholders involved in academy training delivery; v) provide a supportive training environment that promotes health, wellbeing and injury reporting; vi) have experienced staff deliver training and use appropriate equipment; vii) deliver a comprehensive and holistic physical training program; and viii) have appropriate physical entry standards and requirements.

CONCLUSION: We identified 42 strategies above the grand means for both importance and feasibility to reduce the burden of injury in police force recruits. These strategies can be implemented by recruits, staff delivering the training program, and/ or staff managing or governing the training program. Future research should refine how these strategies can be implemented in practice and policy.

PMID:42365570 | DOI:10.1186/s40798-026-01042-9

CJEM. 2026 Jun 28. doi: 10.1007/s43678-026-01186-3. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe public awareness of the Centre antipoison du Québec (CAPQ), expectations regarding acute poisoning management and service delivery, and satisfaction among prior users.

METHODS: We conducted a cross-sectional, bilingual online survey of Quebec residents aged ≥ 14 years between April 13, 2024, and June 27, 2025. The questionnaire collected demographic data, assessed awareness and prior use of the CAPQ, explored past poisoning events and expectations for acute poisoning management, and measured satisfaction among previous users using a 5-point Likert scale, with open-ended questions for qualitative input. Participants were recruited through convenience and snowball sampling via public settings, social media, and CIUSSS newsletters. Descriptive statistics summarized responses and explored trends.

RESULTS: A total of 611 respondents were included; 541 (88.5%) were aware of the CAPQ, including 152 prior users, while 70 (11.5%) were unaware. Unawareness was more common among females (60.0%), non-healthcare workers (91.4%), respondents with a non-North American ethnic background (34.2% vs. 10.1%), and those not primarily French-speaking (12.9% vs. 3.0%). Regional variation was observed, with Capitale-Nationale contributing the largest number of unaware respondents (35/70) and Laurentides showing the highest proportion (26.7%). Among respondents without prior CAPQ use who reported a poisoning event, most contacted emergency services or presented to the emergency department. Expectations were similar among aware and unaware respondents, particularly for acute poisoning management, with nurses expected to respond within five minutes. Among prior users, overall satisfaction was high across all domains, though communication and outreach were identified as areas for improvement. Key service expectations included rapid 24/7 access (76.9%), responder expertise (69.9%), and clear, adapted recommendations (56.1%). Most respondents preferred French (84.9%), telephone communication (94.1%), and follow-up calls (81.7%).

CONCLUSIONS: User satisfaction with the CAPQ was high, but gaps in public awareness and service expectations remain. These findings highlight opportunities to improve accessibility, communication and outreach strategies.

PMID:42365556 | DOI:10.1007/s43678-026-01186-3

J Evid Based Soc Work (2019). 2026 Jun 28:1-20. doi: 10.1080/26408066.2026.2692572. Online ahead of print.

ABSTRACT

PURPOSE: Involving community members with lived experience of social issues or services is crucial to improve social work education, however no published studies have examined this specifically within simulated learning environments. This study examined student perspectives on community member involvement in simulations.

MATERIAL AND METHODS: This quantitative and qualitative study surveyed current and alumni Bachelor of Social Work students about their perspectives of engaging in simulations with community members through an online questionnaire. Sampling was purposive from a target of 200 students reached through online advertisement. Fifty-eight responses were received. Descriptive statistics were used to summarize the data, inferential statistics (t-test and ANOVA) to compare groups, and Cohen’s d to assess effect size, while thematic analysis was applied to qualitative data.

RESULT: High mean scores indicate that simulations were perceived as effective in preparing students for real practice (M = 8.34), more impactful than role plays (M = 8.54), and increased awareness of diversity and difference (M = 7.64), cultural sensitivity (M = 7.53), and comfort working with the community (M = 7.16). Themes reflect the benefits and challenges of having real-life situations in the classroom.

DISCUSSION: Students valued the authenticity of lived experience knowledge as central to their learning. Read through a decolonial lens, results represent a challenge to the epistemic hierarchies that have historically determined whose knowledge counts in education.

CONCLUSION: Social work programs must move toward building sustained, equitable, accountable and reciprocal partnerships with communities. Future research could target a larger sample to increase generalizability of findings.

PMID:42365550 | DOI:10.1080/26408066.2026.2692572

Vet Med Sci. 2026 Jul;12(4):e71067. doi: 10.1002/vms3.71067.

ABSTRACT

BACKGROUND: Ethnoveterinary medicine (EVM) remains central to livestock health management in Afar region of Ethiopia. However, this Indigenous knowledge is increasingly threatened by environmental degradation and socio-cultural transformation. This study aimed to document medicinal plants used by pastoralists in the Megale district, Afar region, Ethiopia.

METHODS: Ethnobotanical data were collected through semi-structured interviews and field observations involving 13 key informants. Medicinal plant specimens were collected and identified, and their nomenclature was verified using Plants of the World Online following the Angiosperm Phylogeny Group classification system. Data were analysed using descriptive statistics and quantitative ethnobotanical indices, including informant consensus factor (ICF), fidelity level (FL) and relative importance (RI).

RESULTS: Twenty-seven medicinal plant species belonging to 14 families were documented. Euphorbiaceae (35.71%) and Fabaceae (28.57%) were the most represented families. Leaves were the most frequently utilized plant part (54.55%), and crushing was the predominant preparation method (61.77%). Dermal and oral routes accounted for over 70% of administrations. Wound management involved the highest number of plant species (20%), whereas musculoskeletal disorders showed the highest informant consensus (ICF = 0.67). Balanites rotundifolia (RI = 0.88) and Calotropis procera (RI = 0.78) were the most culturally important species.

CONCLUSION: Ethnoveterinary medicinal plants remain integral to livestock healthcare in Megale district. High cultural consensus highlights key species priorities for conservation and future pharmacological investigation. The concentration of knowledge among elderly informants underscores the urgency of documentation, conservation and integration into community-based veterinary services.

PMID:42365533 | DOI:10.1002/vms3.71067

Echocardiography. 2026 Jul;43(7):e70527. doi: 10.1111/echo.70527.

ABSTRACT

BACKGROUND: Automated right ventricular (RV) analysis in 2D echocardiography is limited by the morphological complexity of RV segmentation and the domain fragility of single-center deep learning models across ultrasound vendors. No prior framework has jointly addressed both challenges for RV-specific segmentation.

OBJECTIVES: To develop and prospectively validate TACA-Net (Bi-Phase Adversarial Cross-Attention Network), a unified multi-center framework for simultaneous RV endocardial segmentation and three-class functional severity classification (normal, mildly reduced, significantly reduced) in 2D apical four-chamber echocardiography.

METHODS: Data were prospectively collected from three clinical sites within a single tertiary hospital network, each equipped with a different ultrasound vendor. Centers A and B (n = 1,240 patients) were used for training and 5-fold cross-validation; Center C (n = 320 patients) served as the fully held-out external test set. TACA-Net integrates a gradient reversal layer-based domain discriminator for vendor-agnostic feature learning, a bidirectional bi-phase cross-attention module encoding the complementary information between end-diastolic and end-systolic representations, and a dual-head decoder jointly optimizing segmentation and classification with an auxiliary bi-phase consistency loss. Performance was benchmarked against six segmentation baselines (U-Net, Attention U-Net, TransUNet, Swin-UNETR, nnU-Net, MACS) and five classification baselines (ResNet-50, EfficientNet-B4, ViT-B/16, segmentation-then-classify pipeline, MACS + head). Primary segmentation endpoints were Dice Similarity Coefficient (DSC) and Hausdorff Distance 95th percentile (HD95); primary classification endpoint was macro-averaged area under the receiver operating characteristic curve (AUC).

RESULTS: On the external test set, TACA-Net achieved a DSC of 0.903 ± 0.013 and an HD95 of 7.1 ± 1.0 mm for RV segmentation, and a macro-averaged AUC of 0.911 (95% CI: 0.885-0.937) for functional classification, statistically significantly superior to all six segmentation and five classification baselines (all p < 0.01). Ablation analyses demonstrated independent contributions of domain alignment (ΔDSC = -0.038 when removed), bi-phase cross-attention (ΔAUC = -0.032), and multi-task joint training (ΔDSC = -0.014). No significant differential performance was detected across diagnosis subgroups, sex, or image quality strata. GradientSHAP attribution maps revealed highest feature importance in the RV lateral free wall, consistent with established RV pathophysiology. Expected calibration error for TACA-Net was 0.041 on the external test set, the lowest among all classification models evaluated.

CONCLUSIONS: TACA-Net achieves vendor-agnostic RV segmentation and functional classification from routinely acquired 2D echocardiography, with robust multi-vendor generalization demonstrated under rigorous prospective external validation. The framework provides a clinically interpretable and methodologically transparent foundation for AI-assisted right heart assessment at scale.

PMID:42365531 | DOI:10.1111/echo.70527

Arthroscopy. 2026 Jun 28. doi: 10.1002/arj.70359. Online ahead of print.

ABSTRACT

PURPOSE: To compare clinical outcomes following hip arthroscopy for femoroacetabular impingement syndrome using either limited interportal (IP) or T-capsulotomy (TC) technique, with routine capsular closure.

METHODS: This retrospective cohort study included patients ≤50 years old who underwent primary hip arthroscopy for femoroacetabular impingement syndrome between May 2021 and January 2024 with a minimum of 12-month follow-up. Patients were treated with either IP or TC, and all underwent standardized capsular repair. Patient-reported outcomes (PROs) were collected preoperatively and at final follow-up. Cohort-specific minimum clinically important difference thresholds were calculated for each PROs and compared between groups. Improvements in scores were compared with established thresholds for the patient acceptable symptomatic state (PASS). Statistical significance was set at P < .05.

RESULTS: A total of 116 patients met the inclusion criteria (54 IP, 62 TC; mean age 34.5 ± 8.8 years; 55% female). Mean follow-up was 15.5 ± 5.4 months. Both groups showed significant improvements in all PROs. Although mean improvements were not statistically different, the interportal group showed consistently higher average postoperative scores. Cohort-specific minimum clinically important difference thresholds were achieved at similar rates in both groups, whereas exploratory analyses using previously published PASS thresholds showed higher PASS achievement in the interportal group for International Hip Outcomes Tool (76% vs 54%) and Patient Reported Outcome Measurement Information System Physical Function (58% vs 46%). No revisions or Clavien-Dindo grade ≥2 complications occurred in either group.

CONCLUSIONS: Both IP and TC techniques led to significant improvements in PROs following hip arthroscopy with capsular repair, with similar rates of cohort-specific minimum clinically important difference achievement and no differences in revision surgery or major complications. Exploratory analyses showed higher PASS rates for International Hip Outcomes Tool and Patient Reported Outcome Measurement Information System Physical Function in the IP group, suggesting that a more limited capsulotomy may confer functional advantages.

LEVEL OF EVIDENCE: Level III, retrospective comparative case series.

PMID:42365525 | DOI:10.1002/arj.70359

Int J Dermatol. 2026 Jun 28. doi: 10.1111/ijd.70548. Online ahead of print.

ABSTRACT

BACKGROUND: Keloids are an abnormal fibroproliferative disorder that often causes pruritus, pain, and hyperpigmentation, thereby significantly impacting quality of life. Vascular endothelial growth factor (VEGF) is upregulated in scars and, therefore, can be a potential target for their treatment.

OBJECTIVES: Our aim was to evaluate the efficacy and safety of intralesional triamcinolone acetonide (TAC) versus intralesional bevacizumab injection in the treatment of post-traumatic keloids.

METHODS: This randomized clinical trial was conducted on 28 adult patients with post-traumatic keloids. Patients were randomized into two groups; one group received intralesional triamcinolone acetonide, and the other received intralesional bevacizumab. Injections were done monthly. Patients received a total of three sessions. Therapeutic efficacy was defined in terms of the modified Vancouver Scar Scale (mVSS), erythema index by spectrophotometry, histopathological evaluation, and biochemical assessment of VEGF, collagen type I, and collagen type III levels.

RESULTS: A statistically significant difference in mVSS was observed between the triamcinolone acetonide and bevacizumab groups, favoring the TAC group. The TAC group showed a significant decrease in VEGF level and an increase in collagen type III after treatment. The bevacizumab group showed significant improvement in the spacing between collagen fibers after treatment. The patient satisfaction score and the physician global assessment revealed superior outcomes regarding intralesional triamcinolone acetonide.

CONCLUSION: Despite the superior results observed with triamcinolone, bevacizumab warrants further investigation to determine whether it can be used for early and vascular keloids or as an adjuvant to optimize results.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT07014280.

PMID:42365524 | DOI:10.1111/ijd.70548

Aust J Prim Health. 2026 Aug 17;32(4):PY25238. doi: 10.1071/PY25238.

ABSTRACT

BACKGROUND: Well-implemented vaccination programs can reduce infectious disease burden in an equitable and cost-effective manner. This rapid review used a strengths-based approach to identify enablers and barriers to vaccination for Aboriginal and Torres Strait Islander children aged 0-5 years, and identify the characteristics of effective programs to improve vaccination coverage and timeliness.

METHODS: Databases and grey literature sources were searched for articles published between 2013 and 2025. Following screening, an inductive coding process informed by Braun and Clarke’s reflexive thematic analysis was utilised to consolidate qualitative data.

RESULTS: Twelve studies discussing enablers, barriers and characteristics of successful programs to increase vaccination rates were included. These studies were heterogenous in design and population.

CONCLUSIONS: Despite variability between settings and communities, service access barriers, such as lack of adequate transport and opening hours, were commonly cited throughout the included studies, as well as lack of cultural safety. This review emphasises the value of community ownership and local responsiveness of programs aimed at increasing vaccination timeliness and coverage, and the importance of strengthening the Aboriginal and Torres Strait Islander health workforce.

PMID:42365523 | DOI:10.1071/PY25238

Am J Hematol. 2026 Jun 28. doi: 10.1002/ajh.70430. Online ahead of print.

NO ABSTRACT

PMID:42365517 | DOI:10.1002/ajh.70430