Nevin Manimala

Bone Jt Open. 2025 Oct 28;6(10):1330-1342. doi: 10.1302/2633-1462.610.BJO-2025-0098.R1.

ABSTRACT

AIMS: This systematic review and meta-analysis aimed to compare the patient-reported outcomes of operative and nonoperative management in adults with a fracture of the distal radius, with a focus on the outcomes in older patients (aged ≥ 65 years).

METHODS: Randomized controlled trials comparing operative and nonoperative management of patients aged ≥ 18 years with dorsally displaced distal radius fractures were included. Operative management included open reduction and internal fixation (ORIF), manipulation and Kirschner-wiring, or external fixation. Nonoperative management included cast/splint immobilization with or without closed reduction. Primary outcome was the 12-month Patient-Rated Wrist Evaluation (PRWE). Additional outcomes included the Disabilities of Arm, Shoulder and Hand (DASH), pain, complications, and radiological parameters. A sub-group analysis was undertaken for studies that reported outcomes in older adults (aged ≥ 65 years).

RESULTS: After screening 1,635 studies, 19 trials with 2,178 patients (mean age 63 years (18 to 98), 74% female) were included. Seven studies reported outcomes in older patients (n = 773). There were statistical but not clinically significant differences favouring surgery for PRWE at three months (mean difference (MD) -8.70, 95% CI -14.45 to -2.95; p = 0.003) and 12 months (MD -2.96, 95% CI -5.15 to -0.77; p = 0.008). There was a statistical but not clinically significant difference in DASH at three months (MD -10.58, 95% CI -13.15 to -8.01; p < 0.00001) and 12 months (MD -4.17, 95% CI -6.05 to -2.30; p < 0.001) favouring surgery. There was no difference in complications (odds ratio (OR) 0.95, 95% CI 0.52 to 1.76; p = 0.880). For older adults, there was no difference in the PRWE at three months (MD -8.53, 95% CI -18.13 to 1.07; p = 0.080) or 12 months (MD -2.13, 95% CI -4.60 to 0.33; p = 0.090), with no difference in complications (OR 0.73, 95% CI 0.21 to 2.49; p = 0.620).

CONCLUSION: Operative management of adult dorsally displaced distal radius fractures was associated with superior functional outcomes according to the PRWE and DASH, but whether these are clinically meaningful is debatable. However, in older adults there was no significant or clinically meaningful benefit of surgery.

PMID:41147259 | DOI:10.1302/2633-1462.610.BJO-2025-0098.R1

Biol Rev Camb Philos Soc. 2025 Oct 28. doi: 10.1111/brv.70090. Online ahead of print.

ABSTRACT

A series of terminological, technical, conceptual, and statistical challenges present themselves when trying to study correlations between measures of performance abilities (what an animal can do) and behavioural traits (what an animal chooses to do). We attempt to synthesise literature on this topic, with a specific focus on locomotor performance and behavioural traits measured with standardised tests. We argue that measures of forced performance (e.g. endurance on a motorised treadmill) and voluntary behaviour (e.g. wheel running) often fall along a continuum, sometimes grading into each other. On the performance end of the continuum, tests should measure what an animal can do when motivation is maximal and/or it is given no choice but to exert itself maximally. On the behavioural end of the continuum, tests should capture what animals choose to do of their own free volition, with no experimental attempt to affect motivation. Hence, performance tests attempt to eliminate variation in motivation by forcing all individuals to be maximally motivated, whereas variation in motivation is an inherent component of all behavioural tests. In some cases, however, differentiating between measures of performance versus behaviour can seem almost arbitrary. Moreover, individuals may consistently differ in how willing they are to ‘perform’ even when ‘forced’ to do so. We compiled studies reporting any association (covariation, correlation or linear regression) between putative measures of locomotor performance and behaviour in various taxa. The vast majority of those studies report phenotypic correlations, and only a handful have reported genetic correlations or explored potential correlated responses to selection on performance or behaviour. To our knowledge, this is the first global overview of how locomotor performance and behaviour covary in animals, and we believe that our synthesis will be useful to guide future research on locomotor performance and its relationship with other ecologically relevant traits. For example, we argue that a multi-level (co)variance partitioning approach is necessary to gain insights into the importance of how motivation differs across levels (e.g. among- versus within-individual variation, genetic versus environmental variation). Finally, we outline a multitude of compensation and co-specialisation mechanisms that may occur between performance and behaviour, and propose future avenues for research that include selection and manipulative studies to help identify the role of correlational selection, individual experience, and predation detectability on the relationships between behaviour and performance.

PMID:41147254 | DOI:10.1111/brv.70090

Pediatr Pulmonol. 2025 Oct;60(10):e71284. doi: 10.1002/ppul.71284.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the risk factors for chronic coughing in children diagnosed with mycoplasma pneumoniae pneumonia (MPP) and provide a reference for a foundation for clinical diagnosis and therapy.

METHODS: A retrospective analysis was conducted by gathering pertinent clinical data from children with MPP who were hospitalized in the First Affiliated Hospital of Zhengzhou University. Relevant clinical data were collected during their hospitalization. At least 4 weeks after discharge from the hospital, the children were followed up by telephone and outpatient clinic to determine whether they had developed chronic cough. The number of sequential courses of azithromycin and the duration of the out-of-hospital nebulizer treatment were recorded. Results 28 cases (14.9%) with chronic cough among the 188 children with MPP were included in the case group, while 160 cases (85.1%) were included in the control group. Age, C reactive protein (CRP), CT feature, Mycoplasma antibody titers, the number of sequential courses of azithromycin and the number of days of nebulization therapy in the case group were statistically different from those in the control group (p < 0.05). Through logistic regression analysis, we found that the history of atopic constitution, serum IgE levels, the number of sequential courses of azithromycin, and the number of days of nebulization therapy influenced chronic cough in MPP children. (p < 0.05).

CONCLUSION: Our findings indicate a potential association between atopic constitution and the development of chronic cough in MPP children, and suggest that sequential azithromycin and nebulization therapy might help reduce the likelihood of chronic cough.

PMID:41147253 | DOI:10.1002/ppul.71284

Pediatr Pulmonol. 2025 Oct;60(10):e71191. doi: 10.1002/ppul.71191.

ABSTRACT

BACKGROUND: Perfluorooctanoic acid (PFOA) is widely used in daily life; however, research has shown its immune suppression effects. This study aimed to investigate the association between prenatal exposure to PFOA and allergic diseases in children.

METHODS: A prospective birth cohort study involving 648 pregnant women was conducted. Prenatal information was collected through interviews with the women and from medical records. Umbilical cord blood was collected at birth, and concentration of PFOA was measured and genotype of IL-13 rs20541 was detected. Children were followed at 6, 12 and 24 months and information on the development of allergic diseases was recorded. Multivariate logistic regression analysis was used to examine the association between PFOA and allergic diseases. Stratified analysis was performed based on child sex and genotype of IL-13 rs20541.

RESULTS: In multivariate adjusted models, the highest PFOA quartile was associated with increased odds of atopic dermatitis (AD) (OR: 1.66, 95% CI: 1.09-2.55), wheezing (OR: 4.06, 95% CI: 1.30-12.68), and allergic diseases (OR: 1.71, 95% CI: 1.15-2.54). Among females, the highest PFOA quartile was associated with higher odds of AD (OR: 2.25, 95% CI: 1.20-4.23) and allergic diseases (OR: 1.93, 95% CI: 1.07-3.46). Although IL-13 rs20541 alone was not associated with allergic outcomes, children with the GG genotype of IL-13 rs20541 and the highest PFOA quartile have higher odds of AD (OR: 2.82, 95% CI: 1.41-5.67), wheezing (OR: 15.16, 95% CI: 1.38-166.59), and allergic diseases (OR: 2.42, 95% CI: 1.27-4.61).

CONCLUSIONS: Prenatal exposure to PFOA is associated with an increased risk of allergic diseases in early childhood, especially for the female children and those with the GG genotype of IL-13 rs20541.

PMID:41147248 | DOI:10.1002/ppul.71191

Psychol Med. 2025 Oct 28;55:e324. doi: 10.1017/S0033291725102146.

ABSTRACT

BACKGROUND: Anorexia nervosa has potential to influence the development and function of the gastrointestinal system. We assessed the association between maternal anorexia nervosa and risk of gastrointestinal morbidity in offspring.

METHODS: We analyzed a longitudinal cohort of 1,269,370 children born in Quebec, Canada, between 2006 and 2022. The exposure was maternal anorexia nervosa. The outcome was hospitalization for pediatric gastrointestinal disorders, including hypertrophic pyloric stenosis, inflammatory bowel disease, and other digestive morbidity. Follow-up ranged from 1 to 17 years. We used adjusted Cox regression models to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between maternal anorexia nervosa and pediatric gastrointestinal disorders.

RESULTS: A total of 2,447 children (0.2%) had a mother with anorexia nervosa. By age 17 years, the cumulative incidence of gastrointestinal disorders was higher among children whose mothers had anorexia nervosa than other children (165.7 vs. 129.4 per 1,000). Compared with no anorexia, maternal anorexia nervosa was associated with a greater risk of any childhood gastrointestinal disorder (HR: 1.42, 95% CI: 1.26-1.61), particularly hypertrophic pyloric stenosis (HR: 2.51, 95% CI: 1.35-4.66), inflammatory bowel disease (HR: 2.46, 95% CI: 1.67-3.64), and rectal hemorrhage (HR: 3.46, 95% CI: 1.97-6.09). Children whose mothers developed anorexia nervosa after age 20 years or were hospitalized more than once for anorexia had the greatest risk of gastrointestinal morbidity. The associations were not explained by digestive birth defects.

CONCLUSION: Maternal anorexia nervosa is associated with pediatric gastrointestinal disorders that could potentially be mitigated with psychosocial support, nutritional rehabilitation, and breastfeeding.

PMID:41147221 | DOI:10.1017/S0033291725102146

Acta Cardiol. 2025 Oct 28:1-12. doi: 10.1080/00015385.2025.2576446. Online ahead of print.

ABSTRACT

BACKGROUND: Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is increasingly used for the treatment of surgical bioprosthetic valve degeneration (sBVD).

METHODS: We investigated clinical outcomes and hemodynamic valve performance in all consecutive patients undergoing ViV-TAVI for sBVD in a single centre and assessed differences in patients who received a balloon-expandable (BEV) versus self-expandable valve (SEV) at 1, 6 and 12 months (m), and annually thereafter.

RESULTS: Between 25 November 2011 and 4 September 2023, 86 patients (mean age 80.3 ± 6.6y; 53.5% female; median STS score 5.1% (3.7%;8.6%) underwent ViV-TAVI with BEV (n = 53) or SEV (n = 33). Overall, the cumulative incidences of all-cause and cardiovascular mortality at 12 m were 7.4% (3.4%;15.8%) and 3.6% (0.9%; 9.3%), respectively (comparison of SEV versus BEV within the first year: p = 0.253 and p = 0.168, and comparison for the entire follow-up (median 2.6 (0.9;4.6) years): p = 0.962 and p = 0.942). Aortic valve area (AVA) and peak and mean transprosthetic gradients (TPG) improved significantly from baseline to 1, 6 and 12 m follow-up (p < 0.001 for all). Peak and mean TPG were 10.5 (1.8;19.2) and 7.1 (1.6;12.7) mmHg lower in SEV as compared with BEV at 1 m (p = 0.019 and 0.012, respectively). Similarly, AVA of SEV was 0.23 (0.03;0.44) and 0.54 (0.28;0.81) cm² larger as compared with BEV at 1 and 6 m (p = 0.027 and p < 0.001, respectively). No significant differences in hemodynamic valve performance between BEV and SEV were observed during further follow-up.

CONCLUSION: ViV-TAVI is a safe and effective treatment for patients presenting sBVD. Improved hemodynamic valve performance with SEV over BEV observed during early follow-up did not translate into long-term lower mortality rates.

PMID:41147217 | DOI:10.1080/00015385.2025.2576446

Can J Psychiatry. 2025 Oct 28:7067437251389872. doi: 10.1177/07067437251389872. Online ahead of print.

ABSTRACT

ObjectivesThe objectives of this study were to quantify the associations between preterm birth and adolescent-to-adult psychiatric disorders in the Quebec (Canada) population and to determine whether sex and socioeconomic status (SES) modified this relationship.MethodsThis was an observational cohort study using administrative data from the province of Quebec, Canada. All eligible children born preterm between 1976 and 1995 were identified (N = 100,040) and matched 1:2 with term-born children. Individuals were followed from age 11 years until either incident diagnosis of a psychiatric disorder (attention-deficit/hyperactivity disorder [ADHD], psychosis, bipolar disorder, anxiety, or depression), death, or December 2019. Preterm birth was considered as a binary (<37 weeks gestational age) and categorical exposure (extreme, <28; very, 28-31; moderate-to-late, 32-36 weeks gestational age), in addition to continuous gestational age in weeks. Cox proportional hazard models were applied. Effect-modifying roles of sex and SES were investigated in interaction analyses.ResultsCompared to term-born children, those born preterm had a higher risk of all outcomes, with magnitudes ranging from HR 1.16 for ADHD (95% confidence interval 1.13, 1.19) to 1.05 for anxiety (1.04, 1.07). A dose-response relationship was observed, with increasing risks of ADHD, psychosis, and anxiety as the degree of preterm birth increased. Despite some statistically significant associations, there was no clinically significant evidence of effect modification by sex or SES.ConclusionsChildren born preterm had an increased risk of psychiatric disorders in adolescence-to-adulthood, with similar risks across sexes and socioeconomic strata of the population. Policies for early and continued mental health surveillance in this susceptible group are important to initiate appropriate interventions.

PMID:41147193 | DOI:10.1177/07067437251389872

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Nov;39(11):1038-1043. doi: 10.13201/j.issn.2096-7993.2025.11.008.

ABSTRACT

Objective:To investigate the clinical efficacy of robotic surgery via the bilateral axillo-breast approach（BABA） in lateral lymph node dissection for papillary thyroid carcinoma（PTC）. Methods:Clinicopathological records of 324 PTC patients receiving unilateral neck dissection in Tianjin Medical University Cancer Institute and Hospital from December 2020 to November 2024 were retrospectively analyzed. Of these patients, 108 underwent robotic surgery via BABA（robotic group）, while the remaining patients underwent conventional open surgery（open group）. The extent of lateral neck lymph node dissection included level Ⅱ, Ⅲ and Ⅳ. The differences in surgical indexes, postoperative complication rates and cosmetic outcomes of incisions were compared between two groups. Results:All study subjects completed the operation successfully, and there was no conversion in the robotic group. The average age of patients in the robotic group was lower than that in the open group, and the proportion of female patients was higher in the robotic group compared to the open group（P<0.05）. Patients in the robotic group had a greater number of dissected lymph nodes in level ⅡB and higher cosmetic scores（P<0.05）. There were no statistically significant differences between the two groups in the average dissection time of lateral cervical lymph nodes, the number of dissected lymph nodes and metastatic lymph nodes in level ⅡA, Ⅲ, and Ⅳ, average postoperative drainage volume, average postoperative hospital stay, and postoperative complication rates（P>0.05）. Conclusion:The application of robotic surgical system via BABA in lateral neck lymph node dissection for PTC is safe and feasible, with superior advantages in level ⅡB dissection and better postoperative cosmetic outcomes.

PMID:41147177 | DOI:10.13201/j.issn.2096-7993.2025.11.008

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Nov;39(11):1022-1027. doi: 10.13201/j.issn.2096-7993.2025.11.005.

ABSTRACT

Objective:To evaluate the feasibility, safety, and short-term efficacy of robot-assisted unilateral axillary approach for partial or total thyroidectomy without inflation. Methods:A retrospective analysis was performed on the clinical data of 98 patients who underwent gasless unilateral axillary approach robot-assisted resection of bilateral thyroid lesions at Sun Yat-sen University Cancer Center between October 2022 and October 2024. Perioperative indicators were recorded and compared among patients undergoing different surgical approaches（total thyroidectomy vs. bilateral partial thyroidectomy） and with different body mass index（BMI） values, including operative time, intraoperative blood loss, number of lymph nodes dissected, incidence of postoperative hoarseness, incidence of postoperative hypocalcemia, and other postoperative complications. Results:A total of 98 patients were included, of whom 78.57% were female, with a median age of 39 years（interquartile range[IQR]: 35-49） and a median BMI of 24.08 kg/m²（IQR: 21.43-25.98）. The median intraoperative blood loss was 32.14 mL（IQR: 20.00-50.00）, the median operative time was 130.0 minutes（IQR: 104.80-150.30）, and the median hospital stay was 2.01 days（IQR: 1.00-2.00）. The most common postoperative complication was transient hypocalcemia, with an incidence of 16.32%. There were no cases of permanent recurrent laryngeal nerve palsy or conversion to open surgery. Compared with the non-total thyroidectomy group, the total thyroidectomy group had a significantly longer operative time（135.10±33.28 min vs 120.30±30.53 min, P=0.033）. Subgroup analysis based on BMI showed no statistically significant differences in operative time, hospital stay, drainage volume, or incidence of hypocalcemia between patients with BMI≥25 kg/m² and those with BMI<25 kg/m². Conclusion:The gasless unilateral axillary approach for robot-assisted partial or total thyroidectomy demonstrates favorable safety, cosmetic outcomes, and feasibility. Appropriate selection of surgical techniques and meticulous protection of critical structures during the procedure can further reduce the risk of complications and optimize therapeutic outcomes.

PMID:41147174 | DOI:10.13201/j.issn.2096-7993.2025.11.005

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Nov;39(11):1009-1015. doi: 10.13201/j.issn.2096-7993.2025.11.003.

ABSTRACT

Objective:To compare the efficacy of gasless robotic surgery via transaxillary approach and combined axillary-retroauricular approach for unilateral N1b PTC, and to explore the safety and effectiveness of gasless robotic surgery via transaxillary approach for unilateral N1b PTC. Methods:Unilateral N1b PTC patients who underwent surgery in the Department of Otolaryngology, Sun Yat Sen Memorial Hospital, Sun Yat sen University between July 2016 and December 2024 were included and analyzed. According to the inclusion and exclusion criteria and the differences of surgical approaches, the patients were divided into the transaxillary approach（TA） group and the combined axillary-retroauricular approach（TARA） group. The demographic data, operation time, intraoperative blood loss, postoperative drainage volume, postoperative complications, shoulder function evaluation, postoperative visual analogue scale（VAS） of neck aesthetics and recurrence of the two groups were statistically analyzed. Results:A total of 88 patients undergoing gasless robotic surgery were included in this study, including 23 cases in the TA group and 65 cases in the TARA group. The proportion of males in the TA group was significantly higher than that in the TARA group（56.5% vs 21.5%, χ²=9.776, P=0.002）. The total operation time in the TA group was significantly lower than that in the TARA Group（180.00[155.00, 220.00]min vs 220.00[177.50, 272.50]min, z=-2.775, P=0.006）, and the postoperative blood loss in the TA group was significantly lower than that in the TARA Group（30.00[20.00, 50.00]ml vs 50.00[30.00, 60.00]ml, Z=-2.127, P=0.033）. The proportion of area Ⅱ-Ⅴ in the TA group and the TARA group was 87.0% and 70.8%, respectively, and there was no significant difference between the two groups（P>0.05）. There was no significant difference in lateral cervical lymph node dissection and central lymph node dissection between the two groups（P>0.05）. During the follow-up period, no recurrence was found in the two groups, and there was no significant difference in the incidence of complications between the two groups（P>0.05）. According to the stratification of dynamic recurrence risk assessment, it can be seen that the proportion of curative effect satisfaction in the TA group was as high as 95.7%, and that in the TARA group was as high as 81.5%, with no significant difference between the two groups. There was no significant difference in VAS score of neck, Constant Shoulder Score and NDⅡ scale between the two groups（P>0.05）. Conclusion:Gasless robotic surgery via transaxillary approach for unilateral N1b PTC is safe and feasible, and the amount postoperative lymph node acquisition is equivalent to that of combined axillary-retroauricular approach, which can provide a new choice for the treatment of unilateral N1b PTC patients.

PMID:41147172 | DOI:10.13201/j.issn.2096-7993.2025.11.003