Nevin Manimala

Surg Innov. 2026 Jan 3:15533506251414954. doi: 10.1177/15533506251414954. Online ahead of print.

ABSTRACT

BackgroundEarly innovations are often disruptive but gain traction when the benefits become evident. EXtended Reality (XR) has recently gained momentum for surgical training. XR involves a head-mounted display (HMD) blending physical and digital worlds for enhanced visualization, communication, and understanding. To understand its potential impact, the receptiveness of plastic surgeons was assessed for its usefulness and usability.MethodsPlastic surgeons watched XR interventions and completed a survey assessing applications for remote consultation, intra-operative education, and pre-operative planning. Responses were analyzed using descriptive statistics and categorical inferential testing, with group differences assessed using Fisher’s exact test on dichotomized Likert responses.ResultsEleven attending and ten resident physicians (21/44, 48%) responded to the survey. Attendings perceived greater usefulness of XR for virtual consultation than residents (91% vs 50%), with a near-significant trend (P = 0.056) and higher reported mean usefulness and usability scores. Residents more often anticipated need for technical support during virtual consultation (60% vs 27%). Both groups strongly endorsed XR for intra-operative education. Willingness to use and optimism were high among both groups. For pre-operative planning, both groups perceived XR as useful, though usability concerns were prominent, including moderate perceived complexity and anticipated need for technical support particularly among residents (89% vs 70%).ConclusionAttendings were more receptive than residents to integrating XR in plastic surgery training with residents reporting greater cognitive load. Residents valued improved intra-operative visibility and noted the Hawthorne effect. Selecting high-value, usable XR applications while minimizing trainee role stress is essential for advancing residency education.

PMID:41483385 | DOI:10.1177/15533506251414954

J Robot Surg. 2026 Jan 3;20(1):134. doi: 10.1007/s11701-025-03109-3.

ABSTRACT

The objective of this study is to comprehensively describe the use of robotic surgery for the excision of thyroglossal duct cysts (TGDCs) in the literature. PubMed, Scopus, Cochrane Library, and EMBASE databases were searched. Screening, selection, data extraction, and quality analysis were performed by two independent authors using pre-defined criteria. Conflicts were resolved by independent senior authors. Descriptive statistics were used to summarize the data. From 25 unique articles, 14 articles were selected, describing 26 distinct patients with lingual (n = 16), suprahyoid (n = 1), or infrahyoid (n = 9) TGDCs treated with robotic surgery. The median age was 11 years (IQR = 17). A simple transoral approach was performed for all lingual TGDCs (n = 16). Suprahyoid and infrahyoid TGDCs were treated using transvestibular sublingual (n = 1), postauricular (n = 8), and bilateral axillary-breast (n = 1) approaches. No intraoperative complications were reported. Post-operative complications included minor bleeding (n = 1), oral-cutaneous fistula (n = 1), nerve weakness (n = 1), and seroma (n = 1). No recurrences were reported across a median follow-up of 16 months (IQR = 7.5). The current available evidence is limited to small case series and reports. This study demonstrates low complication rates, no reported recurrences, and favorable recovery in patients undergoing TGDC excision, supporting the role of robotic surgery as a safe and effective option in select cases.

PMID:41483345 | DOI:10.1007/s11701-025-03109-3

Environ Monit Assess. 2026 Jan 2;198(1):75. doi: 10.1007/s10661-025-14937-z.

ABSTRACT

This study evaluated contamination by ten heavy metals (Mo, Hg, Cr, Cu, Pb, Zn, As, Cd, Ni, Mn) in soils from an abandoned paint factory in Kaifeng City. Pollution levels were assessed using multiple indices, including the single-factor index, geo-accumulation index, Nemerow index, and potential ecological risk index. Source apportionment was performed using the absolute principal component score, multiple linear regression (APCS-MLR) model, and the positive matrix factorization (PMF) model. The results revealed significant variation in mercury (Hg) contamination, with a coefficient of variation of 436%, while other heavy metals showed moderate variation (10-35%). Pollution assessment identified Hg and Cu as the primary pollutants, with Hg showing severe contamination (Nemerow index P_N > 3). Source apportionment from both models identified five distinct pollution sources. This study underscored the importance of integrating source apportionment with ecological risk assessment to inform remediation strategies for abandoned industrial sites.

PMID:41483343 | DOI:10.1007/s10661-025-14937-z

Biol Trace Elem Res. 2026 Jan 2. doi: 10.1007/s12011-025-04919-0. Online ahead of print.

ABSTRACT

Elasmobranchs play crucial ecological roles and exhibit high biological diversity, yet their physiology, especially regarding contaminant regulation, remains poorly understood. In this sense, the pancreas, a vital organ for digestion and hormonal balance, is still severely understudied in ecotoxicological assessments concerning this group This study investigated, for the first time, total and subcellular concentrations of metals and metalloids by inductively coupled plasma mass spectrometry (ICP-MS) in the pancreatic tissue of five threatened elasmobranch species along the coast of Rio de Janeiro, Brazil. Species-specific bioaccumulation patterns were observed: Narcine brasiliensis exhibited the highest contamination, accumulating six elements, while Dasyatis hypostigma showed high Pb, Rb, Se and Ti levels. Zapteryx brevirostris exhibited the highest concentrations of Hg and V, while Atlantoraja castelnaui and Squatina guggenheim displayed high levels of Mn and Co, respectively. Subcellular analyses revealed that, in most species, metal concentrations associated with detoxification proteins (e.g., metallothioneins) were lower than total concentrations, suggesting either limited detoxification capacity, such as insufficient synthesis or metallothionein binding, or saturation of detoxification sites, implying maximum metal-binding capacity. Molar ratio assessments indicated potential protective interactions involving essential elements like Cu, Fe, Mn, and Zn, although these defenses do not always seem to be sufficient. Additionally, statistically significant associations such as Zn-As and Fe-Ti, among others, highlight potential competitive or antagonistic interactions affecting metal bioavailability. These findings suggest that the pancreas may be more vulnerable to metal toxicity than previously assumed. Overall, this study provides novel insights into metal handling in elasmobranchs and highlights the importance of including subcellular metal partitioning in future environmental exposure and physiological risk assessments in marine predators.

PMID:41483332 | DOI:10.1007/s12011-025-04919-0

Int Microbiol. 2026 Jan 2. doi: 10.1007/s10123-025-00773-1. Online ahead of print.

ABSTRACT

Marine sponges rely on their intricate and varied bacterial communities to sustain their ecological balance and health. The structure and role of bacterial communities are affected by environmental factors and sponge species. One ecological function of symbiotic bacteria is to prevent the formation of biofilms by pathogenic bacteria that could potentially compromise sponges’ health. This study investigates the antibiofilm activities of symbiotic bacteria isolated from seagrass associated sponges residing under dynamic conditions. Bacteria were isolated from various sponge species from seagrass ecosystem and assessed for their capacity to inhibit biofilm-forming bacteria discovered on submerged wood and fiber panels in contaminated marine habitats. A double-layer experiment was conducted utilizing Zobell 2216E media to evaluate antagonism among 44 bacterial isolates derived from nine sponge species. Twenty-five isolates exhibited inhibitory activity against five biofilm-forming bacteria, with FP2 being the most substantially inhibited strain. Eight symbiotic bacteria exhibited high to very high antibiofilm activity. Statistical analysis revealed groupings of bacteria with similar inhibition patterns, indicating a potential association with specific inhibitory mechanisms. The 16 S rRNA sequencing research revealed that the symbiotic bacteria are categorized into the Firmicutes and α- and γ-Proteobacteria groups, with potential unique strains identified. The findings suggest that bacteria from seagrass-associated sponges and their secondary metabolites could aid in the development of compounds for biofilm prevention and management.

PMID:41483287 | DOI:10.1007/s10123-025-00773-1

Qual Life Res. 2026 Jan 3;35(1):19. doi: 10.1007/s11136-025-04149-w.

ABSTRACT

PURPOSE: While some studies report improved outcomes following exercise-based interventions, the overall findings regarding their impact on individuals with lower limb amputation (LLA) remain inconsistent. Therefore, there is a need to synthesize the available evidence. In this regard, this systematic review and meta-analysis aimed to clarify the effects of organized physical activity on quality of life (QoL) and phantom limb pain (PLP) in adults with LLA.

METHODS: This review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD42024582703). Eight databases were searched in November 2024, including PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, SPORTDiscus, ICI World of Papers, and ClinicalTrials.gov. Search terms combined concepts related to amputation, physical activity, quality of life, and phantom limb pain. Studies were included if they examined adults aged 18-60 with lower limb amputation and reported outcomes on quality of life or phantom limb pain following structured physical activity interventions. Only studies using validated outcome measures were considered.

RESULTS: Six studies met the inclusion criteria for the systematic review. Three studies (reporting four independent effect sizes) were included in the meta-analysis of QoL outcomes. The pooled effect size was small and not statistically significant (SMD = -0.06, 95% CI: -0.29 to 0.16; p = 0.58), with no observed heterogeneity (I² = 0%). Narrative synthesis indicated that most studies found either non-significant or short-term improvements in QoL. Only one study reported a reduction in phantom limb pain (PLP; NPRS: 9 to 2), precluding a meta-analysis for this outcome due to insufficient data.

CONCLUSIONS: Current evidence does not provide statistically significant support for improvements in QoL following organized physical activity among adults with lower-limb amputation, while effects on PLP remain unclear due to limited and heterogeneous data. Further high-quality research using standardized, context-sensitive outcome measures and well-defined intervention protocols is needed. A more person-centered and contextually grounded understanding of QoL may help capture meaningful recovery outcomes in this population.

PMID:41483283 | DOI:10.1007/s11136-025-04149-w

Environ Monit Assess. 2026 Jan 2;198(1):74. doi: 10.1007/s10661-025-14892-9.

ABSTRACT

China’s coastal regions are facing an evolving air pollution pattern characterized by the joint occurrence of fine particulate matter (PM_2.5) and ozone(O₃). Rapid urban expansion has reduced ecological land, weakening its capacity to act as a “sink” for atmospheric pollutants. This study aims to evaluate the coupling coordination of P-O synergistic pollution and to quantify the “sink” role of ecological land. The Coupling Coordination Degree (CCD) model was applied to evaluate the P-O synergy. Spatial econometric models were then employed to investigate the “sink” function of ecological land in mitigating P-O pollution and associated spatial spillover effects, and the Geographical Detector model was employed to assess the interactive influence of multiple factors. Results show: (1) Significant north-south disparities exist in P-O CCD, exhibiting strong positive spatial autocorrelation. (2) FOREST (λ = -2.19, P < 0.05), GRASS (λ = -9.44, P < 0.01), and FARM (λ = -1.30, P < 0.1) effectively suppress P-O pollution, with FOREST and GRASS demonstrating the strongest sink capacity. FARM shows mixed effects, indicating its net ecological function depends on management quality. (3) PRE (λ_direct = -1.73***, λ_indirect = -3.15***) and SEI (λ_direct = -5.56, λ_indirect = -93.5**) significantly influence regional P-O spatial spillover effects, while ecological land’s impact is primarily localized. (4) Meteorological factors exhibit stronger interactions with other drivers; ecological land is the most explanatory factor for P-O synergy. These findings highlight that optimizing land-use structure and ecological management can serve as a practical pathway for synergistic air pollution control and sustainable coastal development.

PMID:41483263 | DOI:10.1007/s10661-025-14892-9

Eur J Pediatr. 2026 Jan 3;185(1):49. doi: 10.1007/s00431-025-06704-6.

ABSTRACT

PURPOSE: To describe the sociodemographic and epidemiological characteristics and healthcare utilization patterns-primary healthcare (PHC) use, emergency department (ED) visits, and hospital admissions-of children under 5 years of age born in Portugal between July 1, 2010, and June 30, 2021, and diagnosed with TB during the same period.

METHODS: This is a quantitative, observational cohort study of 58 children diagnosed with TB and reported to the National Epidemiological Surveillance System (SINAVE) before age 5. Data were obtained through linkage of five population-based databases. Descriptive statistics and bivariate analyses were conducted. Incidence rates of PHC, ED visits, and hospital admissions were calculated per 1000 person-days.

RESULTS: Most TB cases (81.0%) were diagnosed between ages 1 and 5; 55.2% were male, and 72.2% resided in metropolitan areas. Over half (58.6%) were unvaccinated with BCG. Unvaccinated children were diagnosed earlier than vaccinated peers (p < 0.01), though no significant differences were found in the clinical presentation of TB, risk factors, or healthcare utilization. Pulmonary TB was most common (51.7%), and 68.4% of children were hospitalized. PHC services were underutilized (32.7%), while ED visits were more frequent, primarily for infectious and respiratory conditions. One child died, with TB diagnosed post-mortem.

CONCLUSIONS: TB in young children remains a public health concern in Portugal, especially in unvaccinated populations. Strengthening PHC access and preventive care is essential to improve early detection and outcomes.

WHAT IS KNOWN: • TB causes substantial morbidity and mortality, particularly in children under 5 years of age. • Pediatric TB remains underdiagnosed and underrepresented in research, surveillance, and national policies.

WHAT IS NEW: • BCG vaccination was associated with later onset of TB. • Children under five with TB represent a particularly vulnerable group; thus, it is critical to promote preventive care to ensure early diagnosis and effective follow-up.

PMID:41483248 | DOI:10.1007/s00431-025-06704-6

Neurol Sci. 2026 Jan 2;47(1):70. doi: 10.1007/s10072-025-08730-6.

ABSTRACT

BACKGROUND: The incidence of acute ischemic stroke (AIS) is increasing among young to middle-aged adults (18-64 years), posing substantial socioeconomic and healthcare challenges. This study aimed to evaluate the diagnostic and predictive value AHR, Klotho, and sdLDL-C in AIS and across different TOAST etiological subtypes in this age group.

METHODS: We retrospectively enrolled young to middle-aged patients with first-ever AIS and age- and sex-matched stroke-free controls. All participants underwent DWI and additional vascular assessments, including MRA, CTA, and/or DSA. Clinical characteristics, imaging findings, and laboratory parameters were statistically analyzed. Patients were classified into TOAST subtypes for etiological analysis.

RESULTS: Multivariate logistic regression identified male sex, DBP, FPG, LDL-C, and DWM as independent risk factors for AIS. The most common TOAST subtype was SAO, followed by SUE and LAA. Compared to controls, AIS patients exhibited significantly higher AHR and sdLDL-C levels and lower Klotho levels (all P < 0.001). ROC analysis demonstrated that the combined use of AHR, Klotho, and sdLDL-C had high diagnostic accuracy for AIS (AUC = 0.971), with the highest predictive value observed for LAA subtype (AUC > 0.9).

CONCLUSION: In young to middle-aged adults, male sex, elevated DBP, FPG, LDL-C, and DWM are independent risk factors for AIS. AHR and sdLDL-C are positively associated with AIS risk, while Klotho is inversely associated. The combined biomarker panel (AHR, Klotho, and sdLDL-C) demonstrates strong diagnostic utility, particularly for identifying the LAA subtype. These findings provide valuable insight into early risk stratification and classification of AIS in younger populations.

PMID:41483236 | DOI:10.1007/s10072-025-08730-6

Int J Biometeorol. 2026 Jan 3;70(1):4. doi: 10.1007/s00484-025-03077-1.

ABSTRACT

The aim of this study was evaluating the effect of peloidotherapy, included in the postoperative rehabilitation, on functional outcomes in patients who have undergone surgical treatment for rotator cuff tears (RCTs) and superior labrum anterior-posterior SLAP tears, and to assess the short-term clinical outcomes of the early rehabilitation protocol. The study was prospective, randomized, controlled, and single-blind. Sixty patients were sequentially enrolled and randomly divided into two groups (30 each) using a computer-generated random number table. Assessments were performed by a blinded researcher, and statistical analysis was conducted by a blinded biostatistician. Group 1 received peloidotherapy(44-45 °C), TENS, and exercise, while Group 2 received a hot pack, TENS, and exercise. Patients were evaluated using VAS, SPADI, and goniometer measurements before treatment and after. Intra-group analyses showed significant decreases in pain-activity/rest VAS, and SPADI scores, increases in all shoulder ROM measures. Between groups, flexion, abduction, and adduction differed significantly, while other shoulder movements and pain-activity/rest VAS, and SPADI scores showed no significant differences. Comparison of difference scores showed no significant changes except for adduction, which differed significantly between groups. A significant between-group difference was observed only in the number of patients achieving MCID for disability SPADI. The addition of peloidotherapy to the rehabilitation program after arthroscopic RCTs and SLAP tear repair has been shown to have similar effects to hot pack application. An early rehabilitation protocol using peloidotherapy and physiotherapy may improve upper extremity performance and quality of life by speeding up functional recovery.

PMID:41483235 | DOI:10.1007/s00484-025-03077-1