Nevin Manimala

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

Glob Chang Biol. 2025 Oct;31(10):e70574. doi: 10.1111/gcb.70574.

ABSTRACT

Global gridded soil temperature datasets are important to understand and explain spatial patterns and processes in many life and environmental sciences, but products based on in situ measurements are still available to a very limited extent. Global maps of soil temperature at a 1-km² resolution for two depth levels of 0-5 cm and 5-15 cm were therefore an important step in bridging this gap. However, there are on average 26% of suspicious grid cells, and 7%-46% for individual considered soil bioclimatic variables, that show reversed patterns between the two depth levels in terms of soil temperature physics, with more pronounced temperature amplitudes, minima, and maxima at the deeper level, which has no reasonable physical explanation. This mismatch is most probably due to the fact that soil temperature grids for the two depth levels were generated independently using machine-learning models based on distinctive and spatially averaged sets of in situ soil temperature measurements for differing time periods. While the application potential of the maps remains enormous, and they can still be used for most soil-related applications, it can definitely be recommended that the two depth levels be used separately. The study also suggests that data consistency should be prioritized over maximizing the volume of data used when producing soil temperature grids at multiple depth levels using statistical learning methods based on in situ measurements.

PMID:41147127 | DOI:10.1111/gcb.70574

J Adv Nurs. 2025 Oct 28. doi: 10.1111/jan.70321. Online ahead of print.

ABSTRACT

AIM (S): To investigate the frequency and associated factors of interruptions initiated by human and environmental sources during the medication administration process among nurses in South Korea.

DESIGN: A cross-sectional descriptive study.

METHODS: Data were collected from January to March 2022 through an online survey administered to nurses working in tertiary hospitals in South Korea. The survey assessed interruptions during the medication administration process, nursing work environments and organisational culture. Descriptive statistics and regression analysis were used to identify factors associated with interruptions.

RESULTS: Human-initiated interruptions were more frequent than those initiated by environmental sources. Human-initiated interruptions increased with a higher patient load and a relation-oriented organisational culture but decreased with adequate staffing and resources, as well as an innovation-oriented culture. Environment-initiated interruptions were more frequent in settings with a task-oriented culture and less frequent among female nurses.

CONCLUSION: The findings highlight the importance of understanding the distinct characteristics of interruptions and developing targeted strategies based on their sources and contributing factors. Creating supportive environments and fostering an organisational culture that actively prevents unnecessary interruptions are essential for enhancing medication safety and workflow efficiency.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: To apply these findings in clinical practice, it is necessary to allocate staffing resources appropriately to reduce interruptions. Providing education on the importance of maintaining uninterrupted medication administration processes is essential to reduce human-initiated interruptions.

IMPACT: This study provides practical evidence that organisational culture and staffing are associated with interruptions in clinical nursing practice. Nurse managers should apply these findings by promoting staffing adequacy and fostering a collaborative, innovative environment that encourages continuous improvement and openness to change. Tailored strategies that reflect the specific characteristics of different types of interruptions can help reduce their occurrence and improve medication safety.

REPORTING METHOD: STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:41147089 | DOI:10.1111/jan.70321

Pulm Circ. 2025 Oct 26;15(4):e70184. doi: 10.1002/pul2.70184. eCollection 2025 Oct.

ABSTRACT

The resistance-compliance (RC) relationship between pulmonary vascular resistance (PVR) and pulmonary arterial compliance (PAC) provides an integrative measure of global right ventricular (RV) afterload. However, debate persists regarding the clinical utility of PAC calculated using the empiric formula (PAC_empiric), and the ideal method for calculating PAC. We analysed haemodynamic and pulmonary pressure waveform data from 156 patients with pulmonary hypertension (PH). PAC was calculated using three methods: PAC_empiric, as well as two established waveform analysis methods, area-under-the-curve (PAC_AUC), and diastolic decay (PAC_DD). Generalized linear mixed models were used to evaluate the relationship between PVR and PAC across these three methods. Model performance was assessed using Akaike and Bayesian Information Criteria (AIC/BIC). The diagnostic performance of each method was evaluated using ROC analysis. Cox regression was applied to assess the association with long term mortality. All three PAC methods demonstrated a strong inverse hyperbolic correlation with PVR. PAC_empiric provided stronger model performance (AIC -504.3; R² = 0.968), and best discriminated PH subtypes (AUC = 0.91), outperforming PAC_AUC (AUC = 0.88) and PAC_DD (AUC = 0.75). PAC_empiric was also a stronger predictor of mortality than PAC_AUC, PAC_DD or PVR (c-statistic = 0.747, compared to 0.737, 0.709 and 0.741 respectively). PAC_empiric is a robust and accessible method for assessing the pulsatile component of RV loading. This study supports its use as a physiologically meaningful parameter that together with PVR provides a comprehensive estimation of global RV afterload.

PMID:41147032 | PMC:PMC12554385 | DOI:10.1002/pul2.70184

Vet Anim Sci. 2025 Oct 9;30:100519. doi: 10.1016/j.vas.2025.100519. eCollection 2025 Dec.

ABSTRACT

Non-essential metals and metalloids are known to induce oxidative stress in exposed organisms, often leading to cellular damage and systemic toxicity. While chelation therapy remains the primary treatment for metal toxicity, its application is limited by side effects. L-ascorbic acid (L-AA), a widely available antioxidant, has emerged as a promising nutritional intervention for mitigating metal-induced oxidative stress. Dogs, whose blood lead levels (BLLs) closely mirror those of humans, have been utilized as sentinel species in environmental toxicology studies. This study aimed to evaluate the therapeutic potential of L-AA in dogs residing in Kabwe, Zambia, a former mining town where remediation of heavy metal contamination is ongoing. The reported BLLs in Kabwe dogs ranged from 0.43 µg/dL to 123.5 µg/dL. A total of 22 dogs (10 females and 12 males) received oral L-AA supplementation daily for 14 days. Blood samples were collected on Day 1 of L-AA administration and Day 14 to assess biochemical and toxicological changes. Post-treatment analysis revealed statistically significant reductions in plasma malondialdehyde, cortisol, blood urea nitrogen, and creatinine levels, as determined by Student’s t-test and Wilcoxon signed-rank test. Additionally, δ-aminolaevulinic acid dehydratase activity was significantly elevated, indicating improved oxidative status. These findings support the efficacy of L-AA in attenuating oxidative stress associated with metal and metalloid exposure, even in the absence of exposure cessation. Interestingly, Pb levels declined predominantly in dogs younger than 24 months. Furthermore, reductions in Zn and Cu commonly linked to L-AA administration were observed exclusively in male dogs, suggesting a sex-specific response.

PMID:41147016 | PMC:PMC12554065 | DOI:10.1016/j.vas.2025.100519

Asia Pac J Sports Med Arthrosc Rehabil Technol. 2025 Oct 17;42:74-80. doi: 10.1016/j.asmart.2025.09.004. eCollection 2025 Oct.

ABSTRACT

PURPOSE: The purpose of this study was to compare the healing rate of meniscal repair concomitant with anterior cruciate ligament (ACL) reconstruction and isolated meniscal repair based on Intrameniscal signal intensity (IMSI).

METHODS: A total of 368 patients who underwent meniscus repair between March 2011 and July 2017 by an experienced single surgeon were enrolled. 228 patients were divided into the meniscus repair concomitant with ACL reconstruction (group A, n = 171) and isolated meniscal repair group (group B, n = 57). Magnetic resonance imaging (MRI) was performed preoperatively and 12 months postoperatively, measurements were conducted from the most prominent slice of meniscal tear (PSMT). IMSI of the PSMT was measured with the free line region-of-interest (ROI) tool in a picture archiving and communication system.

RESULTS: Except for time of accident, no significant differences were found in terms of age, body mass index, posterior slope angle, or varus angle between two groups. There were statistically significant differences of post-operative adjusted mean IMSI of patients between the two groups using ANCOVA. The corrected postoperative adjusted mean IMSI in the coronal view of group A was an estimated mean (SD) of 1.44(0.08), and in group B was an estimated mean (SD) of 2.55(0.15). All the P-values were less than 0.05, which was the same compared with MRI values for healed meniscus.

CONCLUSIONS: IMSI is a simple and conventional parameter for the assessment of meniscal healing. The healing rate of meniscal repair concomitant with ACL reconstruction compared with isolated meniscal repair using IMSI was similar to that of MRI reading. Thus, concomitant ACL reconstruction significantly improves the healing process of meniscus.

LEVEL OF EVIDENCE AND STUDY DESIGN: Case control study.

PMID:41147015 | PMC:PMC12554083 | DOI:10.1016/j.asmart.2025.09.004

Ther Adv Infect Dis. 2025 Oct 21;12:20499361251386681. doi: 10.1177/20499361251386681. eCollection 2025 Jan-Dec.

ABSTRACT

BACKGROUND: Tuberculosis (TB) remains a global public health priority, with 10.5 million new cases and 1.5 million deaths reported in 2023. Current diagnostic methods face limitations in sensitivity, biosafety, and accessibility, particularly in low-resource settings.

OBJECTIVE: This study evaluates the diagnostic accuracy of a novel, Polymerase Chain Reaction (PCR) platform (Orange G3 TBC), comparing it with the WHO-endorsed GeneXpert Ultra system in Oruro, Bolivia.

DESIGN: We conducted a randomized, double-blind study.

METHODS: The study included 71 clinical samples (67 sputum samples and 4 cerebrospinal fluid samples) from patients with presumptive TB. All samples were tested with GeneXpert Ultra and the Orange G3 TBC platform, which incorporates a unique biosafe processing system. Statistical analysis included sensitivity, specificity, predictive values (positive predictive value (PPV) and negative predictive value (NPV)), likelihood ratios (LR+ and LR-), and correlation measures.

RESULTS: Orange G3 TBC demonstrated strong performance metrics compared to GeneXpert Ultra: sensitivity = 90%, specificity = 97%, diagnostic efficiency = 96%, PPV = 82%, and NPV = 98%. Statistical analysis showed a high correlation between the two methods (Pearson’s correlation = 0.834, Kappa = 0.832, LR+ = 27.3, LR- = 0.103).

CONCLUSION: The Orange G3 TBC platform offers comparable diagnostic accuracy to GeneXpert Ultra. The system is adaptable to resource-limited settings, making it a viable alternative for TB diagnosis in endemic regions.

PMID:41147006 | PMC:PMC12553880 | DOI:10.1177/20499361251386681

PeerJ. 2025 Oct 23;13:e20239. doi: 10.7717/peerj.20239. eCollection 2025.

ABSTRACT

BACKGROUND: Visual impairment, including low vision and blindness, is an important global health concern. In Saudi Arabia, research on vision screening prevalence and its predictors is limited. This study aimed to determine the prevalence of vision screening and identify associated factors among Saudi residents attending primary healthcare settings.

METHODS: A cross-sectional survey was conducted from March to July 2023, involving 14,239 participants from 48 randomly selected primary healthcare centers in Riyadh. Data were collected electronically from participants aged 18 years and older, using a validated questionnaire covering sociodemographic characteristics, health-related behaviors, and comorbidities. Vision screening (yes/no) was the outcome of interest, and predictors were identified using multiple logistic regression. All statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) software.

RESULTS: The mean age of the population sample was 59.7 years ± SD 16.6 years, 56.6% were female, and 65.3% were married. The overall prevalence of vision screening was 9.1%. Multivariable analysis revealed that higher education (AOR 0.65-0.67, 95% CI [0.50-0.84] for up to high school; [0.52-0.87] for college/university; [0.44-0.76] for others) and marriage (AOR 0.81, 95% CI [0.70-0.94]) were associated with lower odds of vision screening. Conversely, unemployment (AOR 1.28, 95% CI [1.12-1.46]), exercise (AOR 1.29, 95% CI [1.14-1.47]), diabetes (AOR 1.49, 95% CI [1.24-1.80]), and obesity (AOR 1.39, 95% CI [1.11-1.75]) were associated with higher odds (all p < 0.05). Age, sex, insurance coverage, smoking, and hypertension did not reach statistical significance.

CONCLUSION: Overall, the prevalence of vision screening among the Saudi residents was low. This study identified key sociodemographic and health-related predictors of vision screening among Saudi residents. Targeted interventions are needed to improve screening rates, particularly among underutilizing groups such as those with higher education, married individuals, and employed individuals. Future research should qualitatively explore underlying reasons for these disparities to inform effective and culturally sensitive strategies.

PMID:41147000 | PMC:PMC12554312 | DOI:10.7717/peerj.20239