Category: Nevin Manimala

Scand J Surg. 2026 Jul 20:14574969261467712. doi: 10.1177/14574969261467712. Online ahead of print.

ABSTRACT

BACKGROUND: Anastomotic leakage after anterior resection for rectal cancer is associated with long-term morbidity, such as bowel dysfunction, but its impact on health-related quality of life remains insufficiently studied. The aim of this study was to evaluate the association between anastomotic leakage and health-related quality of life 3 years after surgery.

METHODS: In this population-based prospective cohort study, patients who underwent anterior resection for rectal cancer in Sweden between 2015 and 2017 were identified through the Swedish Colorectal Cancer Registry. Health-related quality of life was assessed 3 years after surgery using the EORTC QLQ-C30 and QLQ-CR29 questionnaires. The primary outcome was the QLQ-C30 summary score. Targeted maximum likelihood estimation was applied to estimate the adjusted effect of anastomotic leakage on health-related quality of life.

RESULTS: Of 1778 eligible patients, 1178 (66.3%) responded, including 104 (8.8%) with anastomotic leakage. Patients with anastomotic leakage reported a lower mean QLQ-C30 summary score compared to those without anastomotic leakage (80 vs 86, p < 0.001). After adjustment for confounders, anastomotic leakage was associated with a 4-point difference in summary score (p < 0.01). Patients with anastomotic leakage also reported worse body image. Compared with patients without anastomotic leakage, those with anastomotic leakage and no stoma reported more perianal skin irritation, while those with a stoma more frequently reported stool leakage from the stoma bag.

CONCLUSIONS: Anastomotic leakage after anterior resection is associated with a small negative effect on overall health-related quality of life 3 years after surgery. Nevertheless, specific functional impairments-particularly related to body image, and stoma- or perianal symptoms-persist and warrant attention. These findings highlight the importance of patient counseling and long-term follow-up after anastomotic leakage.

PMID:42473772 | DOI:10.1177/14574969261467712

Anim Health Res Rev. 2026 Jul 20;27:e5. doi: 10.1017/S1466252326100127.

ABSTRACT

Antimicrobial resistance (AMR) is a global threat, and responsible antimicrobial use (AMU) in animals is crucial. However, AMR development is influenced by numerous factors. This scoping review aims to describe the association between AMR, AMU, and other risk factors in European livestock farms. Understanding the impact of different risk factors is essential for mitigating AMR. The results confirm that the AMR prevalence varies between livestock farms and that AMU affects this prevalence. At herd level, factors related to infection pressure and AMU have been predominantly studied and are often associated with AMR. Only a few other factors such as temperature and metals or disinfectants in the farm environment have been investigated. Overall, the associations between AMR and the studied farm level. Risk factors, including AMU, were variable and complex. The studies varied in their methodological approaches. Different AMR indicators were used, with phenotypic resistance in indicator Escherichia coli being most common, and resistome characterisation gaining interest in recent years. Some studies did not include AMU data or had insufficiently detailed data, while some calculated treatment incidences in different ways. Standardised measures for risk factors and outcome variables would facilitate comparisons between studies and meta-analyses. For deeper insights into resistance dynamics, resistome characterisation is preferable, whereas phenotypic characterisation of pathogenic bacteria is more appropriate for developing clinical guidelines, and resistance profiles in indicator bacteria are useful for monitoring. In conclusion, farm-level risk factors are complex and risk factor studies including AMU, using validated methods, sufficient sample sizes, and sound statistical analyses are still needed.

PMID:42473768 | DOI:10.1017/S1466252326100127

Biol Open. 2026 Jul 20:bio.062488. doi: 10.1242/bio.062488. Online ahead of print.

ABSTRACT

Repeated measures designs are a common experimental setup in biology, from ecology to biomedical sciences. Traditional statistical techniques for analyzing such data, such as repeated measures ANOVA (RMANOVA), have limitations that prevent them from being used to answer many questions relevant to measurements taken over time. Response feature analysis (RFA) techniques can provide an ideal means for answering those questions by analyzing data based on a creatively chosen summary function of the individual subject’s data. The process and rationale for the RFA is laid out in a step-by-step manner and is demonstrated on an example of behavioral data from a rodent spinal cord injury study. In the original analysis, a difference in average functional score was only found at one timepoint early in the study. Using RFA, we show that the female rats reached 90% of their peak recovery 15.3 days (95% CI 1.73, 28.86 days) earlier than the male rats. RFA enables answering the important question “do the two sexes differ in the speed at which they recovery functional ability?”, and, by way of demonstration, illustrates its flexibility in answering questions that traditional repeated measures analyses cannot.

PMID:42473766 | DOI:10.1242/bio.062488

Foot Ankle Int. 2026 Jul 20:10711007261446621. doi: 10.1177/10711007261446621. Online ahead of print.

ABSTRACT

BACKGROUND: Hallux valgus is a common and potentially debilitating foot deformity, and the modified Lapidus is a prominent corrective procedure in the United States. The clinical distinctions between the minimally invasive surgery (MIS) and the established open techniques for modified Lapidus have not yet been well-described, particularly in the context of patient-reported outcomes. This study aims to systematically compare patient-reported outcomes between the 2 surgical approaches.

METHODS: One hundred forty moderate to severe hallux valgus patients who received modified Lapidus (66 MIS, 74 open) were identified via retrospective review. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were used to assess clinical outcomes preoperatively and at 1 year postoperatively. Hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA) were measured on radiographs. Meary angle, first-ray length, first-ray elevation, first-ray pronation, and sesamoid position were analyzed on weightbearing computed tomography (WBCT). Surgical complications were identified through chart review and radiographic assessments.

RESULTS: MIS and open Lapidus patients reported clinically meaningful improvements in PROMIS physical function, pain interference, pain intensity, and global physical health scores at 1 year postoperatively, along with modest changes in global mental health and depression scores. There were no statistically significant differences in PROMIS scores between groups (adjusted P > .05, 95% CIs excluding zero). Although both techniques reliably achieved excellent correction, there was greater correction of HVA (3.82°) and IMA (2.02°) in open Lapidus patients and greater correction of Meary angle (3.16°) in MIS patients (adjusted P < .05, 95% CIs excluding zero). Rates of nonunion, recurrence, infection, and hardware removal were not statistically significant between surgical cohorts.

CONCLUSION: With the numbers available, no statistically significant difference was detected between the MIS and open Lapidus groups across all collected PROMIS measures, implying that the foot and ankle surgeon can expect to see similar patient-reported outcomes at 1 year postoperatively using either approach.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

PMID:42473753 | DOI:10.1177/10711007261446621

Pulm Med. 2026;2026(1):e4702786. doi: 10.1155/pm/4702786.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the value of therapeutic bronchoscopy in malignant central airway obstruction (MCAO) patients secondary to non-small cell lung cancer (NSCLC), especially in those experiencing respiratory failure (RF).

METHODS: This retrospective cohort study was conducted on 101 cases of NSCLC-related MCAO patients who received therapeutic bronchoscopy from January 2018 to January 2025. Patients were classified into the RF group (n = 39) and the non-RF group (n = 62) based on the presence of RF (PaO₂/FiO₂ ≤ 300) resulting from MCAO.

RESULTS: Therapeutic bronchoscopy achieved technical success in 93.1% of 101 patients, with no significant differences in technical success (p = 0.521), complication rates (p = 0.147), and short-term or intermediate-term efficacy between RF and non-RF groups. Kaplan-Meier curves indicated a median survival of 16.98 months posttherapeutic bronchoscopy, with univariate analysis revealing statistically significant differences between the RF and non-RF groups (10.46 months vs. 18.62 months, log – rank χ² = 4.494, p = 0.034). Multivariate Cox survival regression indicated that ECOG PS of 3-4 points (HR = 3.437, 95% CI: 1.751-6.746, p < 0.001), serum lactate dehydrogenase (LDH) ≥ 250 U/L (HR = 2.538, 95% CI: 1.328-4.852, p = 0.005), and lack of systemic antitumor treatment (HR = 3.274, 95% CI: 1.481-7.235, p = 0.003) are risk factors affecting the 2-year survival of NSCLC-related MCAO patients. Notably, the presence of secondary RF, the location, and the degree of airway stenosis in patients before surgery were not associated with the prognosis (p > 0.05).

CONCLUSION: Therapeutic bronchoscopy is safe and effective in NSCLC patients with MCAO. This intervention should be performed promptly when airway narrowing causes RF. The ECOG PS, serum LDH level, and systemic antitumor treatment might be independent factors affecting the prognosis of MCAO patients.

PMID:42473740 | DOI:10.1155/pm/4702786

Laryngoscope. 2026 Jul 20. doi: 10.1002/lary.70748. Online ahead of print.

ABSTRACT

OBJECTIVE: Maxillomandibular advancement (MMA) is the most effective surgical treatment for obstructive sleep apnea (OSA) after tracheotomy. However, the influence of patient characteristics such as age and gender on MMA outcomes remains understudied. This meta-analysis evaluates MMA outcomes stratified by age and gender.

DATA SOURCES: A comprehensive literature search of CINAHL, Cochrane Library, PubMed, and Scopus was performed from inception through 2026. Studies reporting age- or gender-specific outcomes of MMA for adults with OSA were included.

REVIEW METHODS: Extracted data included cephalometric measurements, apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), SpO2 nadir (LSAT), surgical success, and cure rates. Meta-analysis was performed.

RESULTS: Thirty-six studies comprising 608 patients were included. MMA significantly improved AHI, ESS, and LSAT (p < 0.05), with no significant differences in improvement between males and females or across age groups. Mean maxillary/mandibular advancement was 9.7/11.7 mm in males and 9.2/10.6 mm in females. Surgical success and cure rates were comparable between genders (OR_success = 1.06 [95% CI 0.54-2.10]; OR_cure = 1.17 [95% CI 0.51-2.69]). Increasing age was associated with decreased surgical success and cure, although only the decline in odds of cure reached statistical significance (OR = 0.97 annually, p = 0.029).

CONCLUSION: Maxillomandibular advancement yields significant improvements in OSA outcomes regardless of age or gender. While outcomes are generally consistent across groups, clinicians should counsel older adults on the reduced likelihood of surgical cure.

LEVEL OF EVIDENCE: N/A.

PMID:42473733 | DOI:10.1002/lary.70748

J Eur Acad Dermatol Venereol. 2026 Jul 20. doi: 10.1111/jdv.70619. Online ahead of print.

NO ABSTRACT

PMID:42473713 | DOI:10.1111/jdv.70619

High Alt Med Biol. 2026 Sep;27(3):152-158. doi: 10.1177/15578682251411931. Epub 2026 Jan 9.

ABSTRACT

Pan, Cuiping, Qunyuan Wang, Minglei Zhang, Ruizhe Li, Yining Liu, and Zongbin Li. Role of mitochondrial tRNA^Leu 12320 A>G mutation on heart rate variability and blood pressure at low altitude and in a high-altitude hypoxic environment. High Alt Med Biol. 27:152-158, 2026.

INTRODUCTION: Mutations-gene mutations-can exert dual, environment-dependent effects on cardiovascular disease.

MATERIALS AND METHODS: We analyzed clinical data and mitochondrial DNA from 84 young Han Chinese men ascending from low-altitude to high-altitude regions (>4,000 m).

RESULTS: Nine subjects harbored the mitochondrial tRNA A12320G mutation. Notably, none of these 9 mutation carriers developed acute mountain sickness (AMS), whereas 34 (40.5%) of the 84 volunteers in the cohort were diagnosed with AMS, indicating a significant protective association (p = 0.009). In the low-altitude environment, time domain parameters of heart rate variability (HRV) in the mutant volunteers were significantly lower than those in the unmutated volunteers (SDNN: 141.76 ± 30.75 ms vs.169.08 ± 32.83 ms, p = 0.020; RMSSD: 29.70 ms vs. 41.35 ms, p = 0.022; HRV triangular index: 41.8% vs. 52.4%, p = 0.024; SDSD: 37.4 ms vs. 50.5 ms, p = 0.016; PNN50: 3.1% vs 7.6%, p = 0.008); 24-hour mean systolic blood pressure (118.63 ± 9.54 vs. 113.39 ± 6.30 mmHg, p = 0.029), nocturnal mean diastolic blood pressure (67.37 ± 7.91 vs. 61.11 ± 7.08 mmHg, p = 0.015) were also higher; HRV and blood pressure were not statistically different between the mutant and nonmutant groups in the high-altitude environment. Hematological analysis revealed mutants at high altitude had significantly lower plateletcrit (0.23% vs. 0.26%, p = 0.019) and total protein (72.78 ± 3.84 g/L vs.75 .65 ± 3.0 g/L, p = 0.008).

CONCLUSION: The A12320G mutation acts as a cardiovascular risk factor (reduced HRV, increased blood pressure) at low altitude, whereas at high altitude it was associated with a reduced incidence of AMS, possibly through metabolic adaptive mechanisms, reflecting the environmentally dependent dual roles of this gene effect.

PMID:42473712 | DOI:10.1177/15578682251411931

Pain Pract. 2026 Sep;26(7):e70191. doi: 10.1111/papr.70191.

ABSTRACT

INTRODUCTION: Transforaminal epidural steroid injection (TFESI) is commonly applied for lumbar radicular pain. High-level evidence supports the use in disc-related radiculopathy, while evidence for TFESI in neuroforaminal stenosis remains consensus-based.

METHODS: A retrospective repeated cross-sectional study was conducted covering January 2013-December 2022. The dataset comprised 11,208 unique patients reimbursed for TFESI. Trends in clinical indications were analyzed using automated keyword-based text recognition. Representative cohorts from 2014 (n = 266) and 2022 (n = 299) were randomly selected for clinical and radiologic reviews. Imaging was reassessed according to established grading systems. Pain intensity and global perceived effect were evaluated approximately 6 weeks post-injection. Parametric and non-parametric statistics, linear regression, and ordinal logistic regression were applied. A two-sided p < 0.05 was considered statistically significant.

RESULTS: Mean patient age and the proportion of stenosis-related indications both increased steadily between 2013 and 2022 (p < 0.001). In the studied cohorts, short-term pain decreased significantly after TFESI across all phenotypical subcategories, except for moderate-to-severe central canal compression in 2014. Neuroforaminal stenosis predicted greater pain improvement regardless of its nature in 2014 (p = 0.006), whereas disco-osteophyte abnormalities and chronic or recurrent symptoms were associated with less pain reduction in 2022 (p < 0.05). Female patients showed less short-term improvement than males. At one-year follow-up, central canal stenosis predicted a lower likelihood of being pain-free (OR = 0.63, p = 0.022).

CONCLUSIONS: This retrospective study found an upward trend in patient age and a growing proportion of non-discogenic neuroforaminal stenosis as indications for TFESI. While modest short-term pain reduction was observed, outcomes were slightly negatively influenced by central compression, disco-osteophyte abnormalities, chronic symptoms, and female sex.

PMID:42473702 | DOI:10.1111/papr.70191

Front Genet. 2026 Jul 6;17:1818099. doi: 10.3389/fgene.2026.1818099. eCollection 2026.

ABSTRACT

Understanding tissue-specific transcriptomic structures in livestock is essential for elucidating the molecular basis of economically important traits. Conventional differential gene expression analysis efficiently identifies genes with large average expression differences but does not fully capture multivariate expression structures and gene-gene interaction patterns that define tissue identity. In this study, we developed an explainable machine learning framework to classify seven Hanwoo cattle tissues using RNA sequencing data and to systematically compare the relative contributions of statistical and model-derived signals. A Random Forest-based one-versus-rest classification model was trained on 130 Hanwoo transcriptomes and externally validated using 231 independent Bos taurus samples derived from heterogeneous public datasets following reference-based batch correction. Repeated balanced validation demonstrated stable generalization performance, achieving a mean accuracy of 0.907 and a macro-average area under the receiver operating characteristic curve of 0.963. A comparative analysis of gene sets selected by differential expression analysis, genes prioritized by model-based feature attribution, their union, and randomly selected genes within the same classification framework revealed that strongly differentially expressed genes form the primary discriminatory structure for tissue classification. In contrast, integration of model-prioritized genes enhanced classification performance, particularly for biologically related tissues, whereas randomly selected genes produced reduced and unstable predictive performance. Model interpretation further revealed that highly contributory genes were consistent with known tissue-specific biological functions and exhibited non-linear, expression-dependent contribution patterns shaped by coordinated multigene contexts. These findings indicate that tissue identity is supported by a hierarchical transcriptional structure in which dominant differential signals establish primary class boundaries and multivariate interaction patterns refine decision surfaces. The proposed framework provides an interpretable strategy for distinguishing statistical significance from predictive relevance in high-dimensional transcriptomic data and offers practical implications for molecular marker development in livestock genomics and breeding programs.

PMID:42473676 | PMC:PMC13381022 | DOI:10.3389/fgene.2026.1818099