Nevin Manimala

J Robot Surg. 2026 Mar 5;20(1):318. doi: 10.1007/s11701-026-03243-6.

NO ABSTRACT

PMID:41784855 | DOI:10.1007/s11701-026-03243-6

Int J Colorectal Dis. 2026 Mar 5;41(1):76. doi: 10.1007/s00384-026-05110-0.

ABSTRACT

PURPOSE: Magnetoelectric biofeedback therapy (MEBFT) is an emerging intervention for moderate rectocele-associated obstructed defecation syndrome (ODS); however, its efficacy and mechanisms remain unclear. This study compared MEBFT with conventional biofeedback therapy (BFT) and developed a 3D high-resolution anorectal manometry (HR-ARM)-based predictive model for clinical decision-making.

METHODS: In this prospective, single-blind, randomized controlled trial, 68 female patients with defecography-confirmed moderate rectocele-associated ODS were treated in the outpatient department of Tianjin Union Medical Center from January 2019 to June 2024). Patients were randomly assigned in a 1:1 ratio to either the MEBFT or BFT group. Primary outcomes included 3D HR-ARM parameters, Glazer surface electromyography, and patient-reported outcomes (Cleveland Clinic Constipation and Patient Assessment of Constipation Quality of Life scores) at baseline and 3 months. The secondary outcomes included predictive indicators derived from the Hosmer-Rothman model and treatment response stratification.

RESULTS: MEBFT significantly improved fast-twitch fiber recruitment, anorectal function, and quality of life compared to BFT (all P < 0.01). The Hosmer-Rothman model identified a negative MRP-MTV interaction (synergy index = 0.20), with the R₁₁ phenotype (MRP < 80 mmHg-MTV < 135 cc) predicting an 82.35% response to MEBFT after 3 months of treatment (area under the curve [AUC] = 0.72). Phenotypic stratification-guided management: R₁₁ for MEBFT, R₀₀ (elevated MRP-MTV) for surgical evaluation, and R₁₀/R₀₁ for extended MEBFT with surgical backup.

CONCLUSIONS: MEBFT demonstrated superior clinical effectiveness, anorectal functional recovery, and quality of life compared with BFT after 3 months of treatment. The exploratory Hosmer-Rothman model may provided a moderate-accuracy phenotype-based approach using 3D HR-ARM parameters to stratify treatment response and optimize the individualized management of moderate rectocele-associated ODS.

TRIAL REGISTRATION: 1. Date of registration (needs to be before the Date of the First Patient): December 26, 2023. 2. Date of initial participant enrollment: January 9, 2019. 3. Clinical trial identification number: ChiCTR2300079173. 4. URL of the registration site: http://www.chictr.org.cn/.

PMID:41784838 | DOI:10.1007/s00384-026-05110-0

Amino Acids. 2026 Mar 5. doi: 10.1007/s00726-026-03507-3. Online ahead of print.

ABSTRACT

Amino acid metabolic (AAM) reprogramming is a key characteristic of gastric cancer (GC) cells metabolic remodeling, which regulates cell growth, survival, immune cell activation and function to affect tumor immune escape. This study aims to systematically investigate AAM reprogramming in gastric cancer (GC) and construct prognostic model, and validate gene signatures for predictive value and clinical decision-making. This study leveraged data from TCGA and GEO to construct a prognostic model related to AAM and assess its clinical relevance in GC. We identified differentially expressed genes and conducted GO, GSEA, and GSVA enrichment analyses, along with constructing PPI networks and interaction networks of mRNA-miRNA, mRNA-TF, and mRNA-RBP. Additionally, immune infiltration analysis was performed and the relationships between eight hub-type amino acid metabolism-related genes (AAMRGs) and immune cells was investigated using scRNA-seq datasets. Lastly, we validated the elevated expression of these eight genes in GC cells through PCR. The study constructed a prognostic model for GC based on AAMRGs, identifying 16 key genes: ACLY, ADH4, COL1A1, F2, GADL1, GAMT, HBB, KYNU, MRI1, MTHFR, NR1D1, PDK4, SLC1A7, SLC25A15, SLC52A3, and SYCE2. Statistical analysis showed that 14 of these genes showed significant differential expression between tumor and normal tissues. Furthermore, the model demonstrated strong correlations with OS outcomes. Immune infiltration analysis indicated that various immune cell types were significantly associated with the expression of 8 hub genes, highlighting their potential role in the tumor microenvironment and immune response modulation. Furthermore, elevated expression of these genes in GC cells was validated through PCR, highlighting their relevance as potential biomarkers and therapeutic targets. Our AAMRGs prognostic model reveals AAMRGs as independent prognostic factors for GC, highlighting their association with prognosis and immune cell infiltration. These findings provide important insights for improving survival outcomes and advancing immunotherapy strategies in GC.

PMID:41784817 | DOI:10.1007/s00726-026-03507-3

Wien Klin Wochenschr. 2026 Mar 5. doi: 10.1007/s00508-026-02722-y. Online ahead of print.

ABSTRACT

BACKGROUND: Emergency physician-staffed emergency medical services (EMS) in Austria frequently attend low priority calls, raising concerns about over-triage and future workforce sustainability.

OBJECTIVE: To quantify the proportion of emergency physician-attended calls that could have been managed by advanced emergency medical technicians (AEMT), with or without telemedical physician support, and evaluate current AEMT practice and training needs.

METHODS: This prospective, nationwide audit collected data from public physician-staffed EMS in Austria over a 24‑h period. Emergency physicians documented call characteristics, NACA (National Advisory Committee for Aeronautics) severity scores, AEMT presence, actual and potential EMT or AEMT interventions, accuracy of severity assessment and their judgement regarding the necessity of on-scene physician involvement.

RESULTS: Out of 149 physician-staffed EMS, 88 (59.1%) participated recording 313 calls and 273 emergency calls, 25 interhospital transfers and 15 telemedical emergency physician consultations were included. Emergency physicians assessed that 53.4% (95% confidence interval, CI 46.8-60.0%) of emergency calls and 48.0% (95% CI 28.4-67.6%) of interhospital transfers could have been managed by AEMTs. Approximately one third of these would have required telemedical physician support. The AEMTs arrived on the scene before emergency physicians in 75.1% of emergency calls and correctly assessed disease severity in 88.4% of cases and one or more additional interventions could have been set by AEMTs before emergency physician arrival in 48.0% of emergency calls. Most physicians supported expanding AEMT competencies and telemedical physician services.

CONCLUSION: The results of this nationwide audit suggest that more than half of emergency calls and interhospital transfers attended by emergency physicians in Austria could have been managed by AEMTs with or without telemedical emergency physician support.

PMID:41784793 | DOI:10.1007/s00508-026-02722-y

Eur Radiol. 2026 Mar 5. doi: 10.1007/s00330-026-12425-7. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify a quantitative surrogate parameter for the embolic endpoint in genicular artery embolization (GAE).

MATERIALS AND METHODS: Digital subtraction angiography (DSA) images were fused and converted into color maps. Using segmentation software, blush size was measured before and after embolization, and blush reduction ratio (BRR) was calculated. Osteoarthritis severity was graded on radiographs, and clinical outcome was evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6 weeks, 3 months, and 6 months. Embolized vessels and embolic volume were recorded. Blush size and BRR were compared between osteoarthritis grades and across embolized vessels.

RESULTS: GAE using 100-300 µm permanent microspheres was performed in 90 patients with mild to severe osteoarthritis and 23 patients with pain after total knee replacement (post-TKR) (404 vessels). The median number of vessels embolized per session was 4 (range: 1-6) with a median total embolic volume of 3.5 mL (1.1-8.0 mL). Pre-embolization blush size (+ 1116 mm²/osteoarthritis grade; p < 0.0001) and embolic volume (+ 1.1 mL/OA grade; p < 0.0001) increased with higher osteoarthritis grade and post-TKR. Blush size significantly decreased after embolization (p < 0.0001) with a median BRR of 0.81 (0.62-0.94). No significant differences in BRR were observed between osteoarthritis grades and different vessels. All KOOS subscales improved significantly at each follow-up (p < 0.0001).

CONCLUSION: Segmentation of blush size enables quantitative assessment of embolic endpoints across all genicular arteries and osteoarthritis grades, including post-TKR cases. “Pruning” corresponds to a blush size reduction of 80%. Higher osteoarthritis grades are associated with larger blush areas, requiring higher embolic volumes to achieve comparable embolic endpoints.

KEY POINTS: Question Standardized, quantitative assessment of embolic endpoints in GAE is lacking, as the angiographic endpoint “pruning” has so far been defined only subjectively. Findings Segmentation of angiographic blush using color-coded maps enables objective quantification of embolic endpoints. With increasing osteoarthritis grade, baseline blush size and embolic volume increase, while an 80% blush reduction defines the endpoint “pruning.” Clinical relevance Objective blush quantification improves the reproducibility of embolic endpoint assessment in GAE and supports individualized embolization strategies across disease severity and vascular territories.

PMID:41784792 | DOI:10.1007/s00330-026-12425-7

Analyst. 2026 Mar 5. doi: 10.1039/d5an01340b. Online ahead of print.

ABSTRACT

Small extracellular vesicles (sEVs) hold immense potential for liquid biopsy given the wealth of biological information they carry. Currently, the clinical application of these methods is limited due to their low abundance and the complexities associated with traditional isolation techniques. To address this, we developed a strategy integrating cholesterol-mediated capture with a Self-Protected DNAzyme Walker for the rapid and simultaneous specific isolation and quantification of small extracellular vesicles (sEVs). Upon specific binding to CD63, the blocker strand is released, which activates the DNAzyme catalytic core, leading to substrate cleavage, which triggers the specific release of sEVs from magnetic beads and the generation of a fluorescent signal. Importantly, the circular DNA Shield design provides remarkable stability to the system by safeguarding the DNAzyme core from nuclease degradation. Furthermore, the cyclic cleavage mechanism allows for highly sensitive detection, achieving a limit of detection (LOD) as low as 361 particles per μL. In addition, by leveraging the lipid bilayer structure for sEV enrichment, this strategy effectively eliminates interference from free proteins. Furthermore, the clinical feasibility of this assay was validated by successfully distinguishing Stage I breast cancer patients from healthy individuals with high statistical significance (p < 0.001), highlighting its promise for early cancer diagnosis. This work presents a robust paradigm for sEV analysis and lays a solid foundation for their downstream biomedical applications.

PMID:41784788 | DOI:10.1039/d5an01340b

Med Biol Eng Comput. 2026 Mar 5. doi: 10.1007/s11517-026-03542-y. Online ahead of print.

NO ABSTRACT

PMID:41784751 | DOI:10.1007/s11517-026-03542-y

Health Promot Int. 2026 Mar 2;41(2):daag025. doi: 10.1093/heapro/daag025.

ABSTRACT

Promoting environmentally sustainable diets for children is crucial for human and planetary health now and for future generations. Much research has examined parents’ roles in shaping children’s dietary behaviours from a nutrition viewpoint, but there is little evidence regarding whether and how parents consider environmental sustainability in feeding their children. This study primarily aimed to understand parental perceptions, current practices, motivation, and self-efficacy regarding environmentally sustainable diets for children. A cross-sectional online survey was conducted among Australian parents of children aged 2-8 years (n = 316), recruited via social media and a university website. The survey included closed-ended and open-ended questions, with quantitative data analysed using descriptive statistics and chi-square tests, while thematic analysis was applied to open-ended responses. Australian parents’ perceptions aligned with many aspects of environmentally sustainable diets, with the majority highlighting that providing local and seasonal foods aligns with such a diet. Most parents were already engaging in multiple sustainable food provisioning and purchasing behaviours (60%-90%), such as providing fruit and vegetables in season (95%) and avoiding buying food without knowing how it will be used (90%). Although fewer parents engaged in behaviours such as providing fruits and/or vegetables from a home or community garden (60%) and actively searching for products in degradable, compostable, or recyclable packaging (65%), there was high motivation and self-efficacy to adopt them. Understanding perceived enablers and barriers to parents providing children with sustainable diets is an important next step in designing interventions to support parents in providing healthy and sustainable diets for their children.

PMID:41782177 | DOI:10.1093/heapro/daag025

J Am Chem Soc. 2026 Mar 4. doi: 10.1021/jacs.5c21756. Online ahead of print.

ABSTRACT

Synthesis at extreme conditions enables access to nitrogen-rich carbon-nitrogen anions that cannot be obtained at ambient conditions. Here, through a direct reaction between Eu(N₃)₂ and EuC₂ with Fe in a laser-heated diamond anvil cell (DAC) at 50(3) GPa, we synthesized the first inorganic hydrogen-free pyronitridocarbonate, Eu₄Fe_x(C₂N₅)₂, x = 0.864(6), featuring novel highly charged [C₂N₅]^7- anions, along with the first stoichiometric oxygen-free rare-earth metal guanidinate Eu₅(CN₃)₃. The crystal structures of both compounds were determined via synchrotron single-crystal X-ray diffraction (SCXRD) and fully corroborated by density functional theory (DFT) calculations. Eu₄Fe_x(C₂N₅)₂ was found to be recoverable at pressures close to ambient. Keeping the sample at ambient conditions for 1 day leads to splitting of half of the [C₂N₅]^7- units in Eu₄Fe_x(C₂N₅)₂ into the guanidinate [CN₃]^5- and carbodiimide [CN₂]^2- anions. The statistical analysis of the multigrain SCXRD data and DFT-based electronic structure analysis well defined the chemical nature of the bonding in [C₂N₅]^7- and [CN₃]^5- anions. This study provides a clear synthetic pathway to a new class of inorganic nitridocarbonates.

PMID:41782174 | DOI:10.1021/jacs.5c21756

Aust Endod J. 2026 Mar 4. doi: 10.1111/aej.70070. Online ahead of print.

ABSTRACT

This in vitro study investigated the antibiofilm efficacy of calcium silicate-based, Simvastatin, Levofloxacin and calcium hydroxide intracanal medicaments against mature Enterococcus faecalis biofilm. Ninety dentine specimens were inoculated with Enterococcus faecalis biofilm for three weeks and divided into five groups (n = 18): (1) calcium silicate-based; (2) Simvastatin; (3) Levofloxacin; (4) calcium hydroxide (CH); (5) positive control, no medicament. After two weeks of intracanal medicament application, live/dead bacterial cells were assessed using confocal laser scanning microscopy. The results revealed a statistically significant difference in the percentage of dead bacteria of the four tested groups compared to the positive control group (H = 30.45, p < 0.001). The calcium silicate-based group recorded the highest median (IQR) percentage of dead bacteria at 56.33 (10.03), followed by Simvastatin 44.88 (7.30), CH 41.70 (12.53), Levofloxacin 35.99 (3.78), and the positive control group 3.61 (1.01). These findings suggest that these intracanal medicaments demonstrate promising antibiofilm activity, with further investigations needed.

PMID:41782171 | DOI:10.1111/aej.70070