Nevin Manimala

Sci Rep. 2025 Dec 8. doi: 10.1038/s41598-025-31739-y. Online ahead of print.

ABSTRACT

Propofol infusion syndrome (PRIS) is a rare, severe complication from prolonged high-dose propofol use. Predictive biomarkers, especially in spinal surgery, remain unclear. This study aimed to biochemically and pharmacologically characterize risk markers of PRIS following high-dose propofol infusion in patients undergoing elective spinal surgery. A quasi-experimental interventional study was conducted in 2024 at Allameh Bohlool Gonabadi Hospital. Fifty-four patients aged 20-70 years scheduled for elective spinal surgery and classified as ASA physical status I or II were enrolled via convenience sampling. Baseline blood samples were collected one day prior to surgery. Propofol maintenance anesthesia were performed using standardized dosages, including continuous intravenous infusion at 10 mg/kg/h. A second blood sample was taken four hours after propofol infusion initiation. Biochemical parameters assessed included triglycerides, HDL, LDL, total cholesterol, arterial blood pH, bicarbonate ion (HCO3-), and base excess (BE). Data analysis employed paired t-tests and Pearson correlation coefficients with significance set at p < 0.05. Serum triglyceride levels increased significantly postoperatively from a mean of 153.07 mg/dL to 214.30 mg/dL (p < 0.001, CI = (- 1.19,- 0.57)). Other biochemical markers showed no statistically significant changes. Additionally, surgical duration correlated with changes in bicarbonate levels and lipid profiles. High-dose propofol infusion during elective spinal surgery was associated with a significant increase in serum triglycerides, emphasizing the potential risk of PRIS. These results underscore the importance of perioperative monitoring of lipid profiles in patients receiving high doses of propofol to enable early detection and timely intervention. A notable limitation of our study was the lack of a control group.

PMID:41361566 | DOI:10.1038/s41598-025-31739-y

Sci Rep. 2025 Dec 8;15(1):43290. doi: 10.1038/s41598-025-30984-5.

NO ABSTRACT

PMID:41361563 | DOI:10.1038/s41598-025-30984-5

Sci Rep. 2025 Dec 8. doi: 10.1038/s41598-025-31470-8. Online ahead of print.

ABSTRACT

Traffic congestion, anomalies and incident significantly impact urban transportation efficiency and road safety. Accurate detection and classification of such events are crucial for effective traffic managements, emergency response and infrastructure planning. Traditional approaches based statistical and conventional machine learning models often struggle to generalize across the dynamic and complex traffic patterns which evolves around the time. To address these limitations, we proposed a multi-head + LSTM model in a multistage classification framework. This proposed framework systematically detects anomalies using isolation forest, classifies the congestion into low, medium, high using K-means clustering and determine whether an incident caused an anomaly using a spatial threshold-based approach (1.5 km). the model is trained on 15 days of PeMS traffic data integrated with weather information to enhanced predictive accuracy. Through hierarchical classification the proposed model captures temporal dependencies, integrates contextual weather information and ensures robust anomaly detection, congestion classification and incident identification. Experimental results demonstrates that the multi-Head model significantly outperforms existing methods achieving higher precision, recall, f1-score and ROC-AUC across all classification stages. The results highlight the potential of deep learning-based traffic analysis for intelligent transportation system (ITS) enabling data-driven decision making for urban traffic management.

PMID:41361558 | DOI:10.1038/s41598-025-31470-8

Surg Radiol Anat. 2025 Dec 8;48(1):19. doi: 10.1007/s00276-025-03795-6.

ABSTRACT

PURPOSE: To investigate the association between the anatomical course of the optic nerve within the sphenoid and posterior ethmoid sinuses (Delano classification) and anterior skull base morphology, particularly lateral lamella length and olfactory fossa depth.

METHODS: Paranasal sinus CT scans from 192 patients (384 hemi-sinuses) were retrospectively reviewed. The course of the optic nerve was categorized using the Delano classification (types 1-4). Lateral lamella length and Keros classification were assessed for each case. Statistical comparisons were performed using ANOVA, post-hoc Tukey tests, and Chi-square analysis.

RESULTS: Lateral lamella length significantly differed among the Delano types (p = 0.001). Delano type 3 and type 4 sinuses demonstrated significantly longer lateral lamella compared to type 1 (p = 0.026 and p = 0.016, respectively). Additionally, a significant variation in Keros classification was observed across Delano groups (p = 0.025), with higher Delano types showing increased prevalence of Keros type 3. These findings suggest that optic nerve protrusion is associated with elongation of the lateral lamella and deepening of the olfactory fossa.

CONCLUSION: This is the first study to demonstrate a significant anatomical correlation between Delano classification and anterior skull base morphology. As optic nerve protrusion into the sphenoid sinus increases, adjacent skull base structures-particularly the lateral lamella-become elongated, potentially heightening the risk of iatrogenic injury during endoscopic sinus surgery. Combined use of Keros and Delano classifications in preoperative imaging may enhance surgical risk stratification and improve patient safety.

PMID:41361551 | DOI:10.1007/s00276-025-03795-6

Surg Endosc. 2025 Dec 8. doi: 10.1007/s00464-025-12473-y. Online ahead of print.

ABSTRACT

BACKGROUND: Minimally invasive adrenalectomy (MIA) is mostly performed as lateral transabdominal adrenalectomy (LTA) or posterior retroperitoneoscopic adrenalectomy (PRA). This study aims to compare LTA and PRA in terms of perioperative outcomes.

METHODS: A retrospective cohort study was conducted on 225 patients who underwent MIA from 2013 to 2023. Patients were divided into two groups: LTA (n = 182) and PRA (n = 43). Propensity score matching (PSM) was used for group balancing.

RESULTS: PRA was associated with shorter operative times (p = 0.004), shorter hospital stay (p < 0.001), fewer drainage placements (p < 0.001), shorter time to catheter removal (p = 0.028), shorter time to return to oral diet (p = 0.012), and higher need for postoperative ICU stay (p = 0.001). After PSM, PRA remained associated with shorter hospital stay (p = 0.019) and lower rate of drainage placement (p < 0.001). In multivariate analysis, no factors resulted in association with postoperative complications, while BMI resulted in association with a longer hospital stay (p = 0.016).

CONCLUSION: Both LTA and PRA demonstrated comparable safety profiles. PRA, however, was associated with a shorter hospital stay and reduced drain placement frequency.

PMID:41361517 | DOI:10.1007/s00464-025-12473-y

Surg Endosc. 2025 Dec 8. doi: 10.1007/s00464-025-12445-2. Online ahead of print.

ABSTRACT

BACKGROUND: Colonoscopic resection of adenomatous polyps reduces mortality from colorectal cancer, which remains the third leading cause of cancer-related deaths in the U.S. Most polyps can be removed endoscopically by cold snare resection, endoscopic mucosal resection, or endoscopic submucosal dissection. However, technically challenging polyps often require partial colectomy, which confers increased rates of morbidity and mortality. Emerging hybrid approaches such as combined endoscopic-laparoscopic techniques have been developed to manage benign, complex colonic polyps and reduce the need for surgical resection.

OBJECTIVE: Patients with SLD completed a 14-item questionnaire that assigned barriers to healthy eating to three categories: lack of knowledge, lack of self-control, and lack of time, with a higher summary score indicating more perceived barriers. We administered assessments of health literacy and physical activity. We analyzed the data using descriptive statistics and ordinal regression analysis.

METHODS: A hybrid approach integrating endoscopic visualization via colonoscope with robotic-assisted transcolonic access was performed to achieve complete polypectomy in a patient with a technically challenging, benign colonic lesion and a past surgical history of extended right colectomy. The technique was evaluated in terms of feasibility, adequacy of resection, and operative considerations.

RESULTS: The combined endoscopic and robotic-assisted approach successfully enabled complete resection of a benign, complex colonic polyp that had previously failed endoscopic submucosal dissection. The procedure was performed without significant complications and allowed for reduced operative time and anticipated shorter recovery as compared to partial colectomy.

CONCLUSIONS: This case demonstrates that combined endoscopic and robotic-assisted transcolonic polypectomy is a safe, feasible, minimally invasive alternative for select complex, benign colonic polyps. This novel technique may reduce the need for partial colectomy and associated morbidity, offering a promising option for managing challenging lesions, especially in patients with multiple comorbidities and high operative risk.

PMID:41361512 | DOI:10.1007/s00464-025-12445-2

Evid Based Dent. 2025 Dec 8. doi: 10.1038/s41432-025-01197-6. Online ahead of print.

ABSTRACT

A COMMENTARY ON: Massouda J, Ghaltakhchyan N, Judd J, Bocklage C, Selden R, TumSuden O, Nanney E, Lee J, Ginnis J, Strauman T, Sawicki C, Hodges EA, Graves C, Divaris K, Jacox L. Evaluating effects of animal-assisted therapy on paediatric dental care patients: A pilot clinical trial. J Am Dent Assoc. 2025;156:447-457. https://doi.org/10.1016/j.adaj.2025.03.006 DATA SOURCES: This commentary is based on the published pilot clinical trial by Massouda et al. (2025) evaluating animal-assisted therapy (AAT) in paediatric dental care.

STUDY SELECTION: The study included children aged 7-14 undergoing invasive dental procedures, allocated to either an AAT or control group.

DATA EXTRACTION AND SYNTHESIS: Outcome measures included validated self-reported anxiety and pain scales, physiological stress markers, and behavioural observations. Data was synthesised narratively given pilot design and small sample size.

DESIGN: A prospective, non-randomised pilot trial carried out in a university paediatric dental setting assessed the practicality and initial effects of integrating animal-assisted therapy (AAT) into dental treatment.

CASE SELECTION: Thirty-nine children aged 7-14 years scheduled for invasive dental procedures were enroled. Participants were allocated to an AAT group (n = 18) or a control group (n = 21). Inclusion criteria included the ability to assent and a willingness to interact with a certified therapy animal. Exclusion criteria included previous traumatic experiences with AAT, or significant developmental or behavioural disorders affecting cooperation.

DATA ANALYSIS: Physiological and psychological measures were recorded at baseline, during treatment, and post-operatively. Primary outcomes included self-reported pain and anxiety scores using validated scales. Secondary outcomes included heart rate monitoring, salivary cortisol, α-amylase, and video-coded behavioural relaxation. Given the small sample size, statistical analyses employed nonparametric 35 tests with significance set at P < 0.05.

RESULTS: Children exposed to the therapy dog reported significantly lower postoperative pain scores (P = 0.001) and demonstrated smaller heart rate fluctuations during stressful procedural moments, suggesting lower physiological stress responses. Behavioural observations indicated longer periods of relaxed posture in the AAT group, though this did not reach statistical significance (P = 0.204). No significant differences were detected in salivary cortisol or α-amylase. AAT was reported as safe, well-tolerated, and feasible to implement.

CONCLUSIONS: AAT shows potential for reducing distress in paediatric dental settings, but larger, randomised studies are required. Within the limits of a pilot design, animal-assisted therapy may reduce pain and physiological stress in paediatric dental patients. While encouraging, larger randomised trials are needed to confirm these effects, explore mechanisms, and assess practicality and cost in routine dental practice.

PMID:41361505 | DOI:10.1038/s41432-025-01197-6

J Health Popul Nutr. 2025 Dec 8. doi: 10.1186/s41043-025-01184-8. Online ahead of print.

NO ABSTRACT

PMID:41361501 | DOI:10.1186/s41043-025-01184-8

BMC Psychol. 2025 Dec 9. doi: 10.1186/s40359-025-03810-w. Online ahead of print.

ABSTRACT

BACKGROUND: Depression is a big health concern and a leading cause of disability worldwide that is inadequately addressed. Severe somatic illnesses are often associated with psychological distress that can reach the level of a depressive disorder requiring treatment. Depression as a comorbidity is linked with a poor quality of life and noncompliance to treatment in these patients, which may lead to increased use of health services. Information on the frequency and the disease course of depression in patients with severe somatic diseases and the need for inpatient treatment and subsequent treatment is still lacking.

METHODS: A cohort study including patients with a diagnosis of cardiovascular diseases (heart attack, stroke, peripheral artery disease) or systemic inflammatory disease (rheumatoid arthritis, inflammatory bowel disease) who are admitted to the University Hospital of Augsburg will be established. At recruitment during hospital stay/outpatient visit, data on mental health (e.g. depressive symptoms, stress, quality of life), clinical data, and lifestyle data will be gathered through self-administered questionnaires and chart review. Furthermore, blood samples will be collected and stored. After hospital discharge, study participants will be repeatedly contacted over time (at the beginning in shorter intervals, then about every 3 months) to provide further information about their mental well-being, life circumstances (e.g. incapacity to work), quality of life, and utilization of medical services. Altogether at least 500 patients should be included and followed up in this study. Descriptive statistics including prevalence and group differences will be calculated. Multivariable generalized linear mixed-effects models with random intercepts will be performed to examine determinants of depression and predict the occurrence and course of the disease.

DISCUSSION: The strengths of the DESIE study are the mainly digital assessments and its longitudinal character with frequent follow-up questionnaires. The study will substantially contribute to the current research about comorbid depression in somatic diseases.

TRIAL REGISTRATION: The study was prospectively registered in the German Clinical Trials Registry and WHO International Clinical Trials Registry Platform (registration number: DRKS00033245, date of registration: 14 December 2023) prior to the start of recruitment.

PMID:41361494 | DOI:10.1186/s40359-025-03810-w

J Health Popul Nutr. 2025 Dec 8. doi: 10.1186/s41043-025-01168-8. Online ahead of print.

ABSTRACT

BACKGROUND: Climate change threatens food security and child nutrition in Africa. This study assessed the impact of community-based, solar-powered drip irrigation gardens (SMGs) on the nutritional status of children in households reliant on local food production.

METHODS: Women’s groups (WGs) from 16 matched villages in Northern Benin were randomly assigned to receive SMGs (WG_SMG) or continue traditional irrigation (WG_C). Additional households without women’s groups (NWG_SMG and NWG_C) were recruited from intervention and comparison villages. Children aged 1-5 years participated in baseline and one-year follow-up surveys. Outcomes included dietary diversity, anthropometry, anemia, and micronutrient status. Dietary diversity was assessed using the WHO minimum dietary diversity indicator, based on consumption from at least five of eight food groups in the previous 24 h. Anemia was defined as hemoglobin < 10.5 g/dL or < 11 g/dL, age dependent. Difference-in-differences analysis estimated treatment effects (TEs).

RESULTS: WG_SMG participation increased the percentage of children meeting minimum dietary diversity compared with all groups (TE: 0.64; p < 0.001). Hemoglobin concentrations increased in WG_SMG children versus all groups (TE: 0.53; p < 0.05), with reductions in anemia compared with WG_C (TE: – 0.15; p < 0.05). WG_SMG membership also improved weight-for-age z-scores (TE: 0.35; p < 0.05) and reduced wasting (TE: – 0.04; p < 0.01). Effects remained statistically significant when clustering at child or village levels.

CONCLUSIONS: Children from women-owned SMGs had improved dietary diversity, hemoglobin status, and growth outcomes while reducing anemia and wasting compared to controls. Expanding this technology may enhance food security and child nutrition in climate-vulnerable regions.

PMID:41361488 | DOI:10.1186/s41043-025-01168-8