Nevin Manimala

Surg Laparosc Endosc Percutan Tech. 2025 Jan 14. doi: 10.1097/SLE.0000000000001356. Online ahead of print.

ABSTRACT

BACKGROUND: Peroral endoscopic myotomy (POEM) is a well-established endoscopic treatment for achalasia, utilizing an endoscopic knife for dissection. Recently, new knives with an integrated water-jet (WJ) function have been introduced. This study aims to compare the technical, perioperative, and late postoperative outcomes between WJ knives and conventional (C) knives, which lack the WJ function, through a pairwise meta-analysis of published comparative studies.

METHODS: We conducted a systematic literature review following PRISMA guidelines to identify studies directly comparing knives with versus without a WJ function in POEM for achalasia. A random-effects model was employed, using odds ratios for dichotomous data and mean differences for continuous data as effect size metrics.

RESULTS: The use of WJ knives demonstrated statistically significant reductions in the mean number of intraoperative instrument exchanges, mean intraoperative use of coagulation forceps, and operative times compared to the use of C knives. There were no significant differences in terms of the incidence of adverse events, subcutaneous emphysema, or mean hospital length of stay (LOS). Clinical success, defined as a postoperative Eckardt score <3, mean postoperative Eckardt scores, and the incidence of GERD requiring proton pump inhibitors (PPI) also showed no significant differences.

CONCLUSIONS: The use of water-jet (WJ) knives demonstrates comparable efficacy to conventional (C) knives, with superior efficiency reflected in reduced operative time and fewer intraoperative instrument exchanges. In addition, in terms of safety, the lower use of coagulation forceps with WJ knives suggests reduced intraoperative bleeding. However, no significant differences were observed between the groups in terms of length of stay (LOS) and adverse events, despite a trend toward reduction. A larger number of studies with greater sample sizes is required to better assess potential differences in safety between the use of WJ and C knives.

PMID:39812005 | DOI:10.1097/SLE.0000000000001356

Disabil Rehabil. 2025 Jan 15:1-23. doi: 10.1080/09638288.2024.2443040. Online ahead of print.

ABSTRACT

PURPOSE: This systematic review examined studies that addressed physiotherapy intervention approaches to the Quality of Life (QoL) of people with Cerebral Palsy (CP).

MATERIALS AND METHODS: We conducted a comprehensive search strategy in five databases (PEDro, PubMed, Web of Science, Scopus, and Google Scholar) until 12 February 2024. We assessed the included studies’ methodological quality and statistical description using the PEDro scale. We performed a meta-analysis using random-effect models to synthesize the results of different physiotherapy interventions and their impact on QoL.

RESULTS: We included 37 studies that met the eligibility criteria, involving people with CP aged between 18 months and 53 years across all levels of the Gross Motor Function Classification System (n = 1541). The included studies present a considerable variation in scales, duration, types of therapies, and number of sessions. The meta-analysis demonstrated significant standardized mean differences in favor of alternative physiotherapy compared to conventional physiotherapy, considering a single general index of QoL.

CONCLUSION: Findings from the included studies indicate that alternative physiotherapy can improve the QoL for people with CP, but the results vary. A personalized, comprehensive approach is essential, emphasizing high-frequency, guided activities. More rigorous research is needed for those with GMFCS levels IV and V.

PMID:39811998 | DOI:10.1080/09638288.2024.2443040

Vet Med Sci. 2025 Jan;11(1):e70214. doi: 10.1002/vms3.70214.

ABSTRACT

Family poultry farming plays a crucial role in ensuring protein availability and household income, particularly in low-income families. This study investigates the knowledge, attitudes and practices of family poultry farmers regarding poultry diseases, biosecurity and vaccinations. The research involved surveying 150 farmers in a selected area in Sri Lanka’s western province, revealing significant knowledge gaps, particularly in understanding poultry diseases, their causes, transmission pathways and potential impacts on humans. Most respondents demonstrated a lack of familiarity with biosecurity practices, with only a small fraction accurately identified recommended measures. Among the total respondents, only 16.7% were familiar with the term ‘biosecurity’. Additionally, only 29.3% recognized that family poultry could pose a threat to public health. A significant majority (84.67%) admitted to not knowing which diseases could be effectively prevented through vaccination, and 80% of respondents had never vaccinated their birds. These findings highlight the challenges faced by family poultry farmers due to their limited understanding of crucial aspects of poultry management. The study underscores the need for government intervention and policy development to address these issues. Education and training programmes are essential to enhance farmers’ awareness regarding disease control, biosecurity measures and the benefits of vaccination.

PMID:39811996 | DOI:10.1002/vms3.70214

Surg Laparosc Endosc Percutan Tech. 2025 Jan 13. doi: 10.1097/SLE.0000000000001353. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Several studies have hypothesized that sparing the oblique/sling fibers during posterior peroral endoscopic myotomy (POEM) may reduce the incidence of gastroesophageal reflux disease (GERD) and reflux esophagitis without compromising the established safety and efficacy of the procedure. This study compares perioperative, postoperative motility-related, and postoperative GERD-related outcomes between posterior oblique/sling fibers-sparing POEM (OFS-POEM) and conventional posterior POEM through a pairwise meta-analysis of comparative studies.

METHODS: We conducted a systematic literature review following PRISMA guidelines to identify articles directly comparing posterior OFS-POEM with conventional posterior POEM. A pairwise meta-analysis was performed using a random-effects model. Effect sizes were calculated as odds ratios for dichotomous data and mean differences for continuous data.

RESULTS: No significant differences were observed in perioperative outcomes, including mean gastric myotomy length, mean operative time, and incidence of adverse events. Similarly, no significant differences were noted in postoperative motility-related outcomes, such as mean Eckardt score and mean integrated relaxation pressure. However, a statistically significant reduction in the incidence of symptomatic GERD was observed in favor of OFS-POEM, with a number needed to treat (NNT) of 10 (95% CI: 6-49). Interestingly, no significant differences were found in the incidence of objectively diagnosed postoperative GERD, such as the number of patients with DeMeester scores >14 or the incidence of reflux esophagitis.

CONCLUSIONS: This study suggests that OFS-POEM may reduce the incidence of symptomatic GERD following POEM, without affecting the incidence of GERD diagnosed by pH studies (DeMeester score >14) or by endoscopy (reflux esophagitis). Future studies with larger sample sizes are needed to further investigate the impact of OFS-POEM on GERD incidence as determined by pH studies and endoscopic findings. Given the limitations of this study, no definitive conclusions can be drawn. Multicenter randomized controlled trials with larger sample sizes are required to reach more reliable conclusions. Furthermore, stratifying data according to the type and class of achalasia would provide valuable information on whether there are differences in outcomes among the various types and classes of achalasia.

PMID:39811987 | DOI:10.1097/SLE.0000000000001353

OTJR (Thorofare N J). 2025 Jan 15:15394492241311004. doi: 10.1177/15394492241311004. Online ahead of print.

ABSTRACT

Despite documented benefits for development, children are engaging in considerably fewer risky play activities. Research on parent gender and children’s risky play is inconsistent. Gender and cultural context shape how individuals perceive and tolerate children’s risky play. Little research exists on gender disparities in approaches to risky play in Eastern cultures, including Saudi Arabia. The study’s objective was to examine gender variations in Saudi parents’ willingness and tolerance for children’s risky play. It included 85 parents: 41 fathers and 44 mothers. Differential Item Functioning analysis revealed a statistically significant difference between mothers and fathers on three Factors Affecting Tolerance of Risk in Play Scale items. While interaction effects and predictors were not significant (p = .22-.97), the overall multiple regression model significantly predicted parents’ risk tolerance (p = .04). Within the context of other factors, gender appeared to play a complex and indirect role in determining parents’ risk tolerance.

PMID:39811976 | DOI:10.1177/15394492241311004

Ann Surg. 2025 Jan 15. doi: 10.1097/SLA.0000000000006631. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the impact of parathyroid gland autotransplantation on the restoration of parathyroid function in patients who are hypoparathyroid after thyroidectomy.

BACKGROUND DATA: Hypoparathyroidism post-thyroidectomy arises when all parathyroid glands are devascularized or injured. Autotransplantation of compromised parathyroids aims to preserve their function and prevent permanent hypoparathyroidism. Despite routine use, comprehensive evidence on the efficacy of parathyroid autotransplantation remains limited.

METHODS: A retrospective analysis was conducted on 549 patients who underwent total or completion thyroidectomy from December 2015 to June 2023. Surgical outcomes of patients with and without parathyroid autotransplantation were compared. A subgroup analysis included patients with post-anesthesia care unit (PACU) parathyroid hormone (PTH) levels below 10 units. Statistical analyses included the Chi-squared test and multivariable analysis.

RESULTS: Of the 549 patients, 152 (27.7%) had parathyroid autotransplantation and 397 (72.3%) did not. The groups were similar in demographics and underlying thyroid etiologies. No significant difference was found in intraoperative parathyroid identification rates (P=0.25). Postoperatively, autotransplanted patients had a higher incidence of transient symptomatic hypocalcemia at 2 weeks (38.0% vs. 19.3%, P<0.001). Multivariable regression showed a higher frequency of postoperative transient hypocalcemia with autotransplantation (IRR=1.90, 95% CI: 1.42-2.54, P<0.001). Among patients with PACU PTH<10 units, recovery rates of parathyroid function were similar between treatment groups (82.2% vs. 82.5%, P=0.46). Long-term follow-up showed comparable low incidence of parathyroid insufficiency in both groups (5.3% vs. 3.8%, P=0.46).

CONCLUSIONS: Parathyroid autotransplantation does not enhance recovery in hypoparathyroid patient’s post-thyroidectomy and does not significantly alter outcomes among patients with PACU PTH<10 .

PMID:39811957 | DOI:10.1097/SLA.0000000000006631

Pathog Glob Health. 2025 Jan 15:1-2. doi: 10.1080/20477724.2025.2453698. Online ahead of print.

NO ABSTRACT

PMID:39811948 | DOI:10.1080/20477724.2025.2453698

J Agric Food Chem. 2025 Jan 15;73(2):1694-1702. doi: 10.1021/acs.jafc.4c09288. Epub 2024 Dec 30.

ABSTRACT

This study has developed a pressure sensor array based on four functionalized DNA-nanoenzymes with catalase-like activity for multiple detections of foodborne pathogens through a portable pressure manometer. Benefiting from functionalization of 4-mercaptophenylboronic acid and β-mercaptoethylamine, the diversity of nonspecific interactions between four DNA-nanoenzymes and each of the nine bacteria leads to differences in pressure response patterns by catalyzing H₂O₂ to generate exclusive “fingerprints”. As effective statistical tools for processing multivariate data, principal component analysis and hierarchical clustering analysis are employed to identify nine foodborne pathogens by analyzing pressure response patterns. Furthermore, the as-prepared sensor array can discriminate different mixtures of bacteria and achieve quantitative detection, with an average detection limit of 10² and 10⁴ CFU mL^-1 for Gram-positive and Gram-negative bacteria, respectively, demonstrating its desirable practicality and satisfactory accuracy for real sample detection. This study expands insights into multiple analyses of foodborne pathogens for food safety monitoring.

PMID:39811932 | DOI:10.1021/acs.jafc.4c09288

Cancer Med. 2025 Jan;14(2):e70606. doi: 10.1002/cam4.70606.

ABSTRACT

BACKGROUND: This study investigated and compared the impact of financial toxicity (FT) on the health-related quality of life (HRQoL) and financial well-being of cancer patients and survivors in the United Kingdom (UK) and United States (US).

METHODS: UK & US participants (n = 600) completed an online questionnaire that consisted of a validated FT instrument (COmprehensive Score for financial Toxicity-COST), a standardised HRQoL instrument (EQ-5D-5L) and questions related to their financial well-being. Tobit regression models and descriptive statistics plus χ² tests were used to analyse the association between FT and (i) HRQoL whilst controlling for sociodemographic characteristics; and (ii) financial well-being.

RESULTS: In the UK, health utilities of participants with no assessed experience of FT, mild FT, and moderate/severe FT were 0.81, 0.66, and 0.41, respectively, compared to 0.88, 0.71, and 0.53 in the US. Among those with moderate/severe FT, US participants had significantly higher health utilities compared to their peers in the UK (Mann Whitney test, p = 0.0369). In a pooled analysis of UK and US and after controlling for sociodemographic and clinical characteristics, mild and moderate/severe FT was negatively associated with health utilities (β coff = -0.13, 95% CI: -0.18, -0.08 and β coff = -0.28, 95% CI: -0.34, -0.21, respectively). Over half (54%) of US participants with FT were in debt with median (IQR) debt at I$11,500 (23,000), compared to 32% in the UK with median (IQR) debt at I$ 7200 (12,960). US participants with FT were 2.48 times more likely to be in debt than UK participants with FT (OR = 2.48, 95% CI: 1.46-4.21).

CONCLUSIONS: FT is associated with poorer financial well-being and HRQoL among cancer patients/survivors in the US and UK. The impact of FT on financial well-being is larger in the US while the impact on HRQoL is worse in the UK. Further studies using prospective data are required to investigate the nature and extent of these relationships.

PMID:39811923 | DOI:10.1002/cam4.70606

Integr Cancer Ther. 2025 Jan-Dec;24:15347354251313534. doi: 10.1177/15347354251313534.

ABSTRACT

BACKGROUND: Adherence in rehabilitation services includes attending appointments, regularly performing prescribed exercises, and correct exercise execution. The Exercise Adherence Rating Scale (EARS) has been adapted into several languages, but there is lack of a standardized tool for various Indian languages and cultural contexts, particularly for use with cancer survivors. With the anticipated 57.7% rise in cancer cases by 2040, this study aims to address this gap.

AIMS AND OBJECTIVES: To cross-culturally adapt EARS to Kannada (EARS-Kn) and evaluate its validity and reliability amongst HNC survivors enrolled in the Multimodal Oncology Rehabilitation Exercise-MORE^© Program.

METHODOLOGY: Following Beaton guidelines, the EARS tool was adapted to Kannada. 34 HNC survivors engaged in the MORE^© program. Internal consistency (Cronbach’s ⍺) and construct validity (Exploratory Factor Analysis, EFA) were assessed. The Receiver Operating Curve (ROC) determined cut-off scores, sensitivity and specificity of the EARS-Kn.

RESULTS: The EARS-Kn demonstrated a Cronbach’s-⍺ value of .93. The EFA revealed a one-factor solution with eigenvalues exceeding one and 70.1% loading. The area under the curve (AUC) was 0.908. A cut-off score of 17 was established, with 95.83% sensitivity and 80% specificity.

CONCLUSION: The EARS-Kn version showed strong validity and reliability among Kannada-speaking HNC survivors, indicating its potential to enhance the understanding of exercise adherence among them. Future studies could explore the EARS-Kn version among diverse populations prescribed various rehabilitation regimes. Studies could also further investigate psychometric properties of the EARS in different Indian languages among cancer survivors, which would help improve survivorship outcomes.

PMID:39811882 | DOI:10.1177/15347354251313534