Category: Nevin Manimala

Front Pediatr. 2025 Jun 16;13:1553317. doi: 10.3389/fped.2025.1553317. eCollection 2025.

ABSTRACT

BACKGROUND: The appropriate length of resection for the dilated segment in Hirschsprung’s disease (HSCR) remains a subject of debate, and the correlation between postoperative clinical outcomes has yet to be elucidated. This study aimed to explore the relationship between the dilated segment resection length (DSRL) and the short-term clinical outcome of HSCR, as well as to determine the optimal DSRL value.

METHODS: The clinical data of all children with HSCR who underwent a pull-through surgery at Shanxi Children’s Hospital from May 2016 to September 2023 were analyzed retrospectively, the baseline characteristics such as sex, gestational age, family history, and complications such as soiling, perianal erosion, constipation were collected. The groups were stratified in recto-sigmoid aganglionosis (short-segment) and extended colonic (long-segment), and DSRL was divided into three groups: DSRL < 10 cm, 10 ≤ DSRL < 20 cm, and DSRL ≥ 20 cm. The Wingspread score system was used to evaluate anal function and analyze the short-term clinical outcome.

RESULTS: A total of 223 children were included in the study, among which 104 cases had short-segment HSCR and 119 cases had long-segment HSCR. The median age at which pull-through surgery was performed was 4 months. In cases of short-segment HSCR, aside from preoperative anemia, baseline characteristics showed no statistically significant differences among the three groups. No statistically significant association was observed between DSRL, the total length of intestinal resection, the length of aganglionosis,and postoperative clinical outcomes.For short-segment HSCR, the best postoperative bowel function was observed when DSRL < 10 cm, with the optimal value being 7.25 cm. In cases of long-segment HSCR, no statistically significant differences in baseline characteristics were observed among the three groups. DSRL, the total length of intestinal resection and the length of aganglionosis all showed statistically significant differences in relation to soiling and perianal erosion. For long-segment HSCR, the best postoperative bowel function was observed when 10 ≤ DSRL < 20 cm, with the optimal value being 13.00 cm.

CONCLUSIONS: Not only the dilated segment resection length matters for the outcome but also the length of aganglionosis. For short-segment HSCR, DSRL, the total length of intestinal resection and the length of aganglionosis showed no significant impact on short-term clinical outcomes. In contrast, these parameters in long-segment HSCR were significantly associated with soiling and perianal erosion, although overall patient quality of life remained satisfactory. Data from a single clinical center suggest that optimal clinical outcomes for children are achieved when the DSRL measurements are 7.25 cm for short-segment HSCR and 13.00 cm for long-segment HSCR.

PMID:40590015 | PMC:PMC12206712 | DOI:10.3389/fped.2025.1553317

J Mech Behav Biomed Mater. 2025 Jun 27;170:107115. doi: 10.1016/j.jmbbm.2025.107115. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the mechanical and adhesive properties of additively manufactured (AM) materials with variable sustainability and recyclability as alternatives to traditional light-cured acrylic resin for dental custom trays.

MATERIALS AND METHOD: Four different AM materials; a photopolymer resin tray material printed with DLP and three FDM printed polylactic acid (PLA), recycled PLA and Polyethylene Terephthalate Glycol (PETG) and a conventional light-cure acrylic resin (LC PMMA) as a control were used to construct dumbbell (tensile testing), rectangular (flexural testing) to verify suitability for custom trays (n=10/group). To evaluate bond strength, specimens were manufactured at 0, 45 and 90° printing orientation (n=10/group). Surface roughness was evaluated with confocal scanning microscopy. The three mechanical tests were completed in a universal testing machine (Instron) according to ISO 527-2 and ISO 20795-1. Results were statistically analysed with PRISM (Version 10) Software using one-way ANOVA and Kruskal-Wallis tests, with statistical significance set at p < 0.05. Confocal analysis and SEM analysis were conducted for quantitative and qualitative surface analysis.

RESULTS: For tensile and flexural strength, PLA (Recycled) and PETG showed no statistically significant difference (p > 0.05) from LC PMMA. AM materials yielded a higher bond strength than the LC PMMA material. Print orientation was found to affect the bond strength of some materials with varying surface roughness as contributing factors.

CONCLUSION: LC PMMA, PLA (Recycled), and PETG have the greatest flexural and tensile strengths. PLA (Recycled) and PETG were the highest performing AM options with regard to flexural and tensile strength for custom trays. All AM materials showed a significantly higher bond strength compared to LC PMMA. To maximise the bond strength, PLA (Recycled) should be printed at an angle of 0°, and PETG at 0 or 90°. Dental practitioners should consider the varying degrees of recyclability of materials, in addition to their mechanical properties.

PMID:40587918 | DOI:10.1016/j.jmbbm.2025.107115

Eur J Surg Oncol. 2025 Jun 24;51(8):110281. doi: 10.1016/j.ejso.2025.110281. Online ahead of print.

ABSTRACT

INTRODUCTION: Retroperitoneal lymph node dissection (RPLND) is an integral part of the multidisciplinary treatment of Testis cancer (TC). Up to now, only few studies compared traditional open RPLND (O-RPLND) with minimally invasive approach. We investigated surgical outcomes and complication rates of patient with TC treated with O-RPLND or robot assisted (RA-RPLND).

MATERIALS AND METHODS: We performed a retrospective analysis of all consecutive patients who underwent RPLND for TC, between 2001 and 2023. We recorded Patient demographics, perioperative and post-operative data. Descriptive statistics depicted differences between O-RPLND and RA-RPLND. Multivariable Poisson regression models (MPRMs) tested for predictors of surgical drain permanence, NSAIDs use (days), LOS, EBL and OT. Multivariable logistic regression models (MLRM) tested for of post operative complications.

RESULTS: Of 144 patients who underwent RPLND, 53 (36.4 %) were treated with RA-RPLND and 91 (63.6 %) with O-RPLND. RA-RPLND group had significantly lower median EBL (50 ml vs 150 ml in O- RPLND; p < 0.01), median LOS (4 days vs 5.5 days in O-RPLND; p < 0.01), median drain indwelling days (4 vs 5 in O-RPLND; p = 0.03), Hb drop (1.5 g/dl vs 1.9 g/dl; p = 0.02) and median NSAIDs use (1 day vs 3 days in O-RPLND; p < 0.01). No difference in intra- and postoperative complication rates was recorded. In MPRM, RA-RPLND was associated with shorter LOS (RR:0.28; p < 0.01), drain permanence time (RR: 0.83; p = 0.01), NSAIDs use (RR:0.63; p < 0.01), and OT (RR 0.85; p < 0.01).

CONCLUSION: RA-RPLND appears to lead to shorter LOS and permanence of surgical drain, lower need for painkillers, lower blood loss and lower OT to O-RPLND, but does not seem associated with lower complication rates compared to O-RPLND. Our findings require prospective validation in future randomized trials.

PMID:40587911 | DOI:10.1016/j.ejso.2025.110281

Biochem Biophys Res Commun. 2025 Jun 27;777:152258. doi: 10.1016/j.bbrc.2025.152258. Online ahead of print.

ABSTRACT

OBJECTIVE: To minimize local recurrence of tongue cancer, it is necessary to tackle the issues of radiotherapy resistance and sensitivity in tongue squamous cell carcinoma (TSCCa). This study focuses on understanding how HOX transcript antisense intergenic RNA (HOTAIR) influences resistance to radiotherapy in TSCCa by modulating the Notch signaling pathway.

METHODS: The TSCCa cells SCC9 and SCC25 were divided into six experimental groups: (1) 8 Gy irradiation group, (2) 8 Gy with negative control, (3) 8 Gy with silent HOTAIR, (4) 8 Gy with null control, (5) 8 Gy with overexpressing HOTAIR, and (6) 8 Gy with silent HOTAIR and Jagged1. After assessing changes in apoptosis, proliferation, and invasion abilities of cells in each group using CCK-8, flow cytometry, and Transwell assays, we also utilized qRT-PCR and WesternBlot to evaluate changes in genes and proteins associated with the Notch pathway. These alterations induced by HOTAIR were validated in vivo using nude mouse tumor-bearing model.

RESULTS: In the silenced HOTAIR group, both ex vivo and in vivo studies revealed decreased cell survival and invasiveness, increased apoptosis, and significantly reduced expression of Notch1, Jagged1, and HES-1 at gene and protein levels (all P < 0.05). In contrast, adding an agonist of the Notch signaling pathway produced opposite results (all P < 0.05).

CONCLUSION: The regulation of the Notch signaling pathway by HOTAIR is associated with resistance to radiotherapy in squamous cell carcinoma of the tongue.

PMID:40587909 | DOI:10.1016/j.bbrc.2025.152258

J Med Internet Res. 2025 Jun 30;27:e75585. doi: 10.2196/75585.

ABSTRACT

BACKGROUND: Pregnant women hospitalized due to preterm labor often experience anxiety, stress, and physical discomfort, which may influence uterine contractions and cervical changes, underscoring the need for effective prenatal management. Virtual reality (VR)-based prenatal education programs can enhance interaction and engagement for these women. The Cox Interaction Model of Client Health Behavior (IMCHB) provides an appropriate framework for nursing interventions addressing their complex needs. This study developed a VR prenatal education program based on the IMCHB and evaluated its effectiveness.

OBJECTIVE: This study aims to develop, implement, and evaluate the effects of a prenatal educational program using VR technology for pregnant women hospitalized with preterm labor.

METHODS: This program was developed based on the Cox IMCHB. To guide program development, we applied the Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model, following its 5 stages: analysis, design, development, implementation, and evaluation. The study used a pre- and posttest design with a nonequivalent control group. A total of 15 participants in the experimental group and 16 participants in the control group, all pregnant women hospitalized with preterm labor, were analyzed. Data were analyzed using descriptive statistics; homogeneity tests; the chi-square test; the Fisher exact test; and independent, unpaired, 2-tailed t tests.

RESULTS: The experimental group that participated in the VR-based prenatal education program showed significantly lower levels of state anxiety (P=.009), stress related to preterm labor (P=.002), frequency of uterine contractions (P=.004), and intensity of uterine contractions (P<.001) compared with the control group. Additionally, the experimental group demonstrated a significantly greater increase in cervical length (P=.009). Practice behavior (P=.047) and self-efficacy in pregnancy health care (P<.001) were also significantly higher in the experimental group than in the control group.

CONCLUSIONS: Prenatal education using VR was shown to be effective across physical, emotional, and educational domains by delivering a professional, integrated intervention tailored to the complex nursing needs of hospitalized patients with preterm labor.

PMID:40587895 | DOI:10.2196/75585

Retin Cases Brief Rep. 2025 Jun 20. doi: 10.1097/ICB.0000000000001779. Online ahead of print.

ABSTRACT

PURPOSE: To report three cases of acute choroidal ischemia in patients diagnosed with catastrophic antiphospholipid syndrome (CAPS).

METHODS: The medical and imaging records of patients with CAPS were retrospectively reviewed. Patients underwent retinal imaging, including fundus photography, spectral-domain optical coherence tomography (SD-OCT), fluorescein and indocyanine green angiography.

RESULTS: This report summarizes three cases of pregnant women (six eyes) with CAPS and posterior ocular involvement. SD-OCT revealed multiple subretinal detachments. Fluorescein and indocyanine green angiography showed triangular non-perfused areas consistent with Amalric triangular choroidal infarction and multiple spots of subretinal leakage. Patients were hospitalized in intensive care unit for treatment with corticosteroids, anticoagulants and plasma exchanges/intravenous immunoglobulins. Full recovery was observed in all cases.

CONCLUSION: The presence of acute choroidal ischemia in patients with antiphospholipid syndrome should alert ophthalmologists to the possibility of CAPS, which is a life-threatening disease. Patients should immediately be referred to a specialist.

PMID:40587879 | DOI:10.1097/ICB.0000000000001779

Ann Intern Med. 2025 Jul 1. doi: 10.7326/ANNALS-25-00253. Online ahead of print.

ABSTRACT

BACKGROUND: Ablation of atrial fibrillation can restore normal heart rhythm, but its effect on clinical outcomes is uncertain.

PURPOSE: To determine the effect of ablation on ischemic stroke at more than 30 days (primary outcome).

DATA SOURCES: Search of 9 databases without language restrictions from 1 January 1987 to 13 September 2024, and bridge search of 2 databases to 1 May 2025.

STUDY SELECTION: Randomized controlled trials of catheter or surgical ablation versus no ablation that had at least 1 month of follow-up and reported stroke and/or mortality.

DATA EXTRACTION: Dual independent data extraction and risk-of-bias assessment.

DATA SYNTHESIS: Compared with medical therapy, catheter ablation reduced risks for ischemic stroke after 30 days (relative risk [RR], 0.63 [95% CI, 0.43 to 0.92]), mortality (RR, 0.73 [CI, 0.60 to 0.88]), and heart failure (HF) hospitalization (RR, 0.68 [CI, 0.55 to 0.85]). However, catheter ablation increased the RR for ischemic stroke at or before 30 days (6.81 [CI, 1.56 to 29.8]) such that the RRs were 0.77 (CI, 0.55 to 1.09) for any ischemic stroke and 0.77 (CI, 0.57 to 1.05) for all strokes. Surgical ablation reduced the RRs for ischemic stroke (0.54 [CI, 0.34 to 0.86]) and stroke from any cause (0.54 [CI, 0.35 to 0.82]) but had uncertain benefit for other outcomes; RRs were 0.63 (CI, 0.37 to 1.06) for ischemic stroke after 30 days, 0.90 (CI, 0.70 to 1.15) for mortality, and 0.90 (CI, 0.60 to 1.35) for HF hospitalization.

LIMITATIONS: Clinical heterogeneity of trials, lack of participant-level data, and inclusion of unblinded trials.

CONCLUSION: Catheter ablation reduced the risks for ischemic stroke at more than 30 days, mortality, and HF hospitalization. Surgical ablation had uncertain benefit, except for stroke.

PRIMARY FUNDING SOURCE: National Center for Advancing Translational Sciences of the National Institutes of Health (Awards TL1TR002344 and UL1TR002345). (PROSPERO: CRD42023409751).

PMID:40587868 | DOI:10.7326/ANNALS-25-00253

J Med Internet Res. 2025 Jun 30;27:e75938. doi: 10.2196/75938.

ABSTRACT

BACKGROUND: Depression, a prevalent mental illness among older people, is associated with some adverse health problems and lower quality of life. Against the backdrop of a growing aging population, coping with late-life depression has become an important public health priority. Emerging evidence suggests that short video addiction tendency may be a new risk factor for depression. However, there has been limited discussion on the potential association between short video addiction tendency and depression among older adults.

OBJECTIVE: We aimed to investigate the relationship between short video addiction tendency and depression in a sample of rural older adults. In addition, we aimed to examine the mediating roles of asthenopia and sleep efficiency in the relationship between short video addiction tendency and depression.

METHODS: A face-to-face interview design was used to collect valid data from 872 rural older adults aged ≥60 years from October 2024 to January 2025 in 2 provinces of China. Participants were requested to complete self-report measures on short video addiction tendency (Short Video Addiction Scale), asthenopia (11-item Asthenopia Survey Questionnaire), sleep efficiency (actual sleep time and time in bed at night), and depression (Center for Epidemiologic Studies Depression Scale). Linear regression analyses were performed using model 6 of the PROCESS 4.1 macro in SPSS 26.0 to assess the relationship between short video addiction tendency and depression and to examine the mediating roles of asthenopia and sleep efficiency in this relationship, adjusting for sex, age, education, and marital status.

RESULTS: We observed that the prevalence of depression was 27.8% (242/872) in this study. There was a significant positive relationship between short video addiction tendency and depression (β=.263; P<.001). Short video addiction tendency affected depression through 3 different pathways: the mediating role of asthenopia (β=.084, 95% CI .059-.114); the mediating role of sleep efficiency (β=.021, 95% CI .001-.043); and the chain mediating role of asthenopia and sleep efficiency (β=.017, 95% CI .010-.026). The effect values of the 3 pathways accounted for 31.94%, 7.99%, and 6.46% of the total effect, respectively.

CONCLUSIONS: We highlighted a direct and statistically substantial relationship between short video addiction tendency and depression, with asthenopia and sleep efficiency serving as potential mediating factors. Our findings predicted that guiding and assisting rural older adults to use short video apps appropriately, addressing asthenopia, and enhancing sleep efficiency may be a valuable approach to improve their mental health, preventing and delaying the occurrence and development of depression.

PMID:40587851 | DOI:10.2196/75938

JMIR Res Protoc. 2025 Jun 30;14:e66112. doi: 10.2196/66112.

ABSTRACT

BACKGROUND: Performance anxiety represents a significant challenge for students, manifesting as a fear of failure and difficulties managing examination-related concerns and academic pressures. According to recent statistics, anxiety affects >4% of the global population, underscoring the need for effective management methods. Studies indicate that yoga and virtual reality (VR) training can alleviate symptoms of performance anxiety.

OBJECTIVE: This trial aims to compare VR-assisted cognitive behavioral therapy (CBT) with yoga interventions to find effective treatments.

METHODS: A single-blinded randomized controlled trial will be conducted with 60 participants (n=30, 50% per intervention group) recruited from university and preuniversity counseling centers. The trial will measure whether the interventions reduce performance anxiety in students. Stratified randomization will be used to ensure equal distribution of baseline anxiety levels and gender across both groups. The primary outcome is a reduction in anxiety, measured using the State-Trait Anxiety Inventory-Y1 and State-Trait Anxiety Inventory-Y2 subscales. Secondary outcomes include emotional regulation and quality of life. Data will be collected at baseline, after the intervention, and during follow-up assessments. Statistical analyses will include parametric tests (eg, repeated-measures ANOVA and t tests) to compare anxiety reduction, emotional regulation, and quality of life across groups. The intention-to-treat approach will be applied to minimize bias due to participant dropouts. Sensitivity analyses will assess the robustness of the findings.

RESULTS: This study is planned to start in September 2025 and end in June 2026. VR-assisted CBT is expected to reduce anxiety very quickly, whereas yoga is predicted to have long-term benefits.

CONCLUSIONS: More generally, this research highlights the need for new, accessible forms of mental health support. VR-assisted CBT is an emerging digital mental health intervention, and it enables individuals to access and explore anxiety in virtual, safe environments. In contrast, yoga is a more conventional, all-encompassing discipline that enhances mental health through physiological and psychological processes that may have long-term effects.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06639841; https://clinicaltrials.gov/study/NCT06639841.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/66112.

PMID:40587850 | DOI:10.2196/66112

JMIR Form Res. 2025 Jun 30;9:e68297. doi: 10.2196/68297.

ABSTRACT

BACKGROUND: Worldwide, the COVID-19 pandemic contributed to further gaps in mental health care, particularly in low- and middle-income countries such as Vietnam, where care is inaccessible for 90% of those who need it. There has subsequently been a considerable increase in the use of digital mental health interventions such as smartphone apps. Presently, the evidence for such interventions is limited, especially in cases in which the interventions have been adapted from evidence-based in-person formats. Implementation science aims to promote the incorporation of scientific findings into practice. A key determinant of implementation success is an intervention’s usability. Hurdles to usability include an intervention being too confusing or time-intensive to use. Facilitators include incorporating a greater number of engagement features and integrating human support.

OBJECTIVE: The aim of this implementation science feasibility study was to describe the challenges and mitigation strategies used in the development, usability testing, and implementation of a digital depression intervention (VMood smartphone app) developed in Vietnam. VMood was adapted from an evidence-based in-person intervention originally developed in Canada that is grounded in principles of cognitive behavioral therapy with supportive coaching by a lay health or social services worker. The research team is currently testing the effectiveness and cost-effectiveness of VMood in a randomized controlled trial across 8 provinces in Vietnam informed by the results of this feasibility assessment.

METHODS: This mixed methods feasibility study was organized using an implementation outcome framework focused on acceptability, adoption, appropriateness, and feasibility. This study involved three data collection components: (1) usability testing (interviews and focus groups with app user and provider participants who tested VMood in 1 Vietnamese province), (2) app metrics (from the early phase of the randomized controlled trial in the same province but from different municipalities), and (3) discourse data (notes from various team meetings, communications, and reports on VMood’s development and implementation). Qualitative data were analyzed using thematic content analysis. App use data were analyzed using basic descriptive statistics.

RESULTS: The findings of the 3 data components showed that there were seven main challenges: (1) challenges with recruitment and uptake of the app, (2) challenges with use and engagement, (3) screening challenges, (4) digital divide, (5) limitations to digital applications for mental health, (6) technological challenges, and (7) funding and policy constraints. Various solutions to help mitigate the challenges were used by the team.

CONCLUSIONS: The findings contribute important evidence on the challenges to the development and feasibility assessment of a digital depression app adapted from an in-person intervention in Vietnam. The findings have applicability for others looking to develop and implement digital interventions in similar contexts, serving as a unique opportunity to share the lessons learned regarding the development and testing process.

PMID:40587849 | DOI:10.2196/68297