Nevin Manimala

Langenbecks Arch Surg. 2025 Nov 10;411(1):7. doi: 10.1007/s00423-025-03906-2.

ABSTRACT

BACKGROUND: Perioperative nutrition is a cornerstone of enhanced recovery in gastrointestinal cancer surgery, with international guidelines recommending early oral intake and standardized screening. This study aimed to assess current perioperative nutrition practices in German surgical departments and evaluate their alignment with guideline-based recommendations.

METHODS: A nationwide cross-sectional survey was conducted between September 18, 2024, and January 2, 2025, involving surgical departments that perform major gastrointestinal cancer resections. The 93-item anonymous questionnaire addressed pre- and postoperative nutrition strategies related to esophagectomy, gastrectomy, pancreatoduodenectomy and colorectal resections. Descriptive statistics were used to analyse the responses.

RESULTS: A total of 263 hospitals participated in the survey. More than one-third of hospitals (35.1%) reported no routine preoperative malnutrition screening and only 6.7% performed a structured nutritional assessment. There was no consistent agreement on postoperative feeding strategies including the timing of oral intake especially in upper gastrointestinal surgery. Nasogastric tubes were routinely placed postoperatively in 66 .1% of gastrectomies, 63.5% of esophagectomies, and 64.6% of pancreatoduodenectomies, but timing of postoperative removal varied widely. Hospitals with higher levels of care (e.g. university or maximum care hospitals) were significantly more likely to perform routine malnutrition screening (p = 0.002) and to allow early drinking after colorectal surgery (p < 0.001). The presence of structured nutrition support teams was associated with higher rates of guideline-compliant preoperative screening (76.3% vs. 47.4%; p < 0.001).

CONCLUSION: Perioperative nutrition practices in German gastrointestinal cancer surgery vary considerably and often deviate from established guidelines.These findings underline the need for greater standardization and broader adoption of evidence-based perioperative nutrition strategies to ensure optimal patient outcomes.

PMID:41212414 | DOI:10.1007/s00423-025-03906-2

Eur J Pediatr. 2025 Nov 10;184(12):744. doi: 10.1007/s00431-025-06608-5.

ABSTRACT

Intracerebral abscesses, although rare in children, represent the most frequent intracranial suppurative infection in children They typically present insidiously and can cause serious complications. Advances such as imaging-guided aspiration and prolonged antibiotics with good central nervous system penetration have improved clinical management. This study presents our single-centre experience over more than three decades, evaluating the impact of evolving therapeutic strategies on outcomes in children. We retrospectively analysed all patients admitted to our centre with confirmed brain abscesses between January 1988 and April 2020. Clinical details, surgical techniques, antibiotic management, and outcomes were collected from clinical charts. Patients were divided into two periods: A (1988-2005) and B (2006-2020). Statistical analysis compared clinical characteristics and outcomes between the two periods. Thirty-two children were included (mean age 5.4 ± 4.4 years): 18 in Period A and 14 in Period B, with positive cultures in 19. Twelve fully recovered, while 20 experienced clinical, radiological, or electroencephalographic sequelae. Younger patients had more severe disease: with larger abscesses under 4.9 years (p = 0.009); and multiple abscesses under 2 years (p < 0.001). Patients with sequelae were younger (p = 0.012), had Intraventricular Rupture of Brain Abscess, IVROBA, (p = 0.002), and multiple abscesses (p = 0.018). Comparing periods, baseline characteristics and corticosteroid administration were similar. IVROBA occurred only in Period A (7/18; p = 0.010). From 2006, management transitioned entirely to stereotactic aspiration with prolonged antibiotics, reducing clinical (p = 0.019) and radiological sequelae (p = 0.005). Mortality was 6.5% overall, occurring only in Period A.

CONCLUSION: Younger children are at higher risk of severe intracerebral abscesses and poorer prognosis. Introduction of standardised protocols including minimally invasive neurosurgery and prolonged antibiotic therapy has led to marked improvements, contributed to a significant reduction in both clinical and radiological sequelae, and effectively eliminated mortality in recent years.

WHAT IS KNOWN: • Intracerebral abscesses in paediatric population are rare. • Younger age is associated with more severe disease.

WHAT IS NEW: • Based on over three decades of single-center experience, the adoption of standardized protocols integrating microbiological evaluation, less invasive neurosurgical techniques, and optimized antibiotic regimens has significantly improved outcomes, virtually eliminating mortality.

PMID:41212413 | DOI:10.1007/s00431-025-06608-5

RSC Adv. 2025 Nov 7;15(51):43322-43333. doi: 10.1039/d5ra05719a. eCollection 2025 Nov 6.

ABSTRACT

Point-of-care (PoC) detection of antibodies in blood enables rapid, on-site diagnosis. However, these devices often face challenges related to user variability due to the requirement of multiple manual operations. To address this issue, we designed and developed a disposable microfluidic device that requires minimal user input for rapid detection of SARS-CoV-2 antibodies (ABs) in total blood and antigens associated with blood types. Here, we present a passive pressure-driven pumping technique that rapidly mixes blood samples with reagents, delivering results within three minutes. The device requires 15 μL of capillary blood and can detect SARS-CoV-2 ABs across a concentration range of 0 to 60 μg mL^-1. Additionally, we demonstrated the versatility of the microfluidic device by implementing blood typing functionality, highlighting its potential for broader serological testing applications. We also developed a support vector machine (SVM) algorithm as a proof-of-concept to demonstrate the potential application of machine learning (ML)-based analysis to complement visual interpretation of results. We evaluated the performance and predictive accuracy of the SVM model and compared it to human interpretations. The analysis showed that the SVM model achieved a statistically significant improvement in predicting varying degrees of agglutination when compared to human interpretation. This device addresses the need for a user-friendly, rapid COVID-19 AB testing solution and blood-typing assay and also provides a model for the future development of diagnostic devices that are integrated with ML models for improved diagnostic accuracy and accessibility in both clinical and non-clinical environments.

PMID:41209517 | PMC:PMC12593424 | DOI:10.1039/d5ra05719a

Alpha Psychiatry. 2025 Oct 21;26(5):47535. doi: 10.31083/AP47535. eCollection 2025 Oct.

ABSTRACT

BACKGROUND: The purpose of this study was to investigate the incidence of comorbid type 2 diabetes mellitus (T2DM) and its associated risk factors in adult patients with severe mental disorders (SMD) who were admitted to the Affiliated Brain Hospital of Guangzhou Medical University.

METHODS: We conducted a retrospective analysis of the clinical data of adult patients with SMD admitted to our hospital. The research comprised 5964 adult inpatients with SMD. Data were collected from 1 January 2023, to 31 December 2023. The collected data encompassed demographic details, classifications of mental disorders, hospitalization records, concomitant conditions, and pertinent laboratory findings. We performed descriptive and inferential statistical analyses to assess the prevalence of T2DM and identify associated risk factors.

RESULTS: Patients with SMD had a 10.14% frequency of concurrent T2DM. In this patient cohort, our study found that age, body mass index (BMI), hypertension, triglyceride levels and apolipoprotein B levels were important risk factors for T2DM.

CONCLUSION: The results show that T2DM is much more common in people with SMD and suggest that several clinical and demographic traits may increase the chance of developing this condition. Extensive screening and targeted treatments are necessary for this vulnerable group.

PMID:41209502 | PMC:PMC12593731 | DOI:10.31083/AP47535

Alpha Psychiatry. 2025 Sep 23;26(5):46810. doi: 10.31083/AP46810. eCollection 2025 Oct.

ABSTRACT

BACKGROUND: Mental disorders (MDs) are associated with prostate cancer (PCa) outcomes, but the results reported by different studies are inconsistent. Our aim was to explore the causal relationship between 10 MDs and PCa using bidirectional two-sample Mendelian randomization (MR) and multivariable MR (MVMR) analysis.

METHODS: Our study was based on summary data from genome-wide association studies (GWAS) of PCa and 10 major MDs in the European population. The genetic locus data used in the analysis included variants associated with PCa and the 10 MDs. Causal estimates were calculated using the inverse-variance weighted (IVW) method, and sensitivity MR techniques, including Cochran’s Q test, MR-Egger regression, and MR pleiotropy residual sum and outlier (MR-PRESSO), were employed to evaluate potential horizontal pleiotropy and heterogeneity. All statistical analyses were conducted using R software.

RESULTS: Our study did not find a causal relationship between PCa and the 10 MDs. In reverse MR analysis, a causal association between insomnia and PCa was found only for insomnia, which reduced PCa risk (odds ratio [OR], 0.9706; 95% confidence interval [CI], 0.9468-0.9951; p = 0.0188). However, after MVMR adjustment for habits (cigarette smoking, alcohol intake, coffee intake, and tea intake), this causal relationship no longer existed (OR, 1.011; 95% CI, 0.932-1.096; p = 0.795).

CONCLUSION: This study demonstrated a negative correlation between insomnia and PCa from a genetic perspective. However, such results may be mediated by lifestyle habits and therefore need to be interpreted with caution.

PMID:41209499 | PMC:PMC12593758 | DOI:10.31083/AP46810

Toxicol Rep. 2025 Oct 16;15:102144. doi: 10.1016/j.toxrep.2025.102144. eCollection 2025 Dec.

ABSTRACT

Genotoxicity evaluations are essential components of the safety assessment for compounds intended for ingestion. Kaurenoic acid, a naturally occurring diterpene, is found in various plant species that are under investigation for potential therapeutic and sweetening properties. Salmonella typhimurium strains TA1535, TA1537, TA98 and TA100 and Escherichia coli strain WP2uvrA were treated with kaurenoic acid using the Ames plate incorporation and pre-incubation methods. Up to eight dose levels were tested, with and without metabolic activation using 10 % rat liver S9 mix with standard co-factors. Kaurenoic acid did not induce an increase in revertant colony frequency at any dose level under either condition indicating a lack of mutagenic activity. Additionally, genotoxic potential was evaluated in human peripheral blood lymphocytes via the in vitro micronucleus assay. Duplicate cultures were treated with kaurenoic acid at four dose levels with exposure conditions including a 4-hour exposure with or without 2 % S9 and a 24-hour exposure without S9. While kaurenoic acid exhibited marked toxicity, it did not produce any statistically significant increase in micronucleated binucleate cells. The assay included a dose that induced approximately 55 ± 5 % cytostasis, consistent with current OECD guidelines. Under the conditions of these studies, kaurenoic acid demonstrated no evidence of mutagenicity, clastogenicity, or aneugenicity. When considered with existing literature, the current findings support the conclusion that kaurenoic acid does not pose a genotoxic risk.

PMID:41209491 | PMC:PMC12593435 | DOI:10.1016/j.toxrep.2025.102144

Pain Rep. 2025 Nov 5;10(6):e1359. doi: 10.1097/PR9.0000000000001359. eCollection 2025 Dec.

ABSTRACT

INTRODUCTION: Offset analgesia (OA), an endogenous pain inhibition after an abrupt decrease in noxious stimulation, provides a paradigm to study dynamic interaction between ascending and descending pain pathways. Previous studies assumed that this interaction follows deterministic dynamics. In contrast, a recent perspective views pain perception as a Bayesian process: a statistically optimal updating of pain predictions based on noisy sensory input.

OBJECTIVES: We examined whether OA is driven by a deterministic interaction between ascending and descending pathways, or by a Bayesian process in which the brain updates pain perception by combining expectations with incoming signals.

METHODS: We modified the conventional OA paradigm by adding high-frequency noise after an abrupt decrease in noxious stimulation and measured pain intensity responses in healthy participants. Pain reports were analyzed using 2 computational models: a deterministic dynamic equation model and a recursive Bayesian integration model. Hypothesis testing was conducted using model selection.

RESULTS: Offset analgesia was observed after reduction of noxious stimuli, but pain was disinhibited by high-frequency disturbances. The deterministic model predicted unbounded oscillations depending on disturbance sequence, whereas the Bayesian model predicted gradual OA attenuation by filtering out noise. Model selection favored the Bayesian model.

CONCLUSION: The brain dissociates noise from primary signals, achieving stable pain perception even in the presence of noisy inputs. Thus, OA reflects a stochastic integration between prediction and observation, with noise magnitude modulating pain intensity. Clinically, these results suggest that enhancing endogenous pain inhibition for chronic pain may be achieved through interventions targeting noise recognition mechanisms.

PMID:41209484 | PMC:PMC12591703 | DOI:10.1097/PR9.0000000000001359

Transplant Direct. 2025 Nov 7;11(12):e1875. doi: 10.1097/TXD.0000000000001875. eCollection 2025 Dec.

ABSTRACT

BACKGROUND: Delayed graft function (DGF) in deceased-donor kidney transplantation increases morbidity, prolongs hospitalization, and increases healthcare costs. Hypothermic machine perfusion (HMP) has emerged as a promising strategy to reduce DGF; however, large-scale real-world data remain limited.

METHODS: We performed a retrospective cohort analysis using the Scientific Registry of Transplant Recipients (2014-2024), including adult dialysis-dependent recipients of deceased-donor kidneys preserved using either static cold storage (SCS) or HMP. The primary outcome was DGF, defined as dialysis requirement within 7 d posttransplant. A matched-pairs analysis was conducted using kidneys from the same donor.

RESULTS: The overall cohort included 59 859 recipients (46.8% SCS, 53.2% HMP), with 2208 matched pairs identified. In the overall cohort, HMP grafts had longer cold ischemia times and a higher kidney donor risk index. They were more frequently obtained from older and donation after circulatory death donors. Although the overall DGF incidence was higher with HMP (34.4% versus 30.9%, P < 0.001), matched-pairs analysis revealed significantly lower DGF rates with HMP (29.8% versus 36.1%, P < 0.001). Adjusted analyses identified HMP as protective against DGF (overall cohort odds ratio, 0.71; 95% confidence interval, 0.66-0.78; paired cohort OR, 0.68; 95% CI, 0.50-0.93). Additional modifiable risk factors include prolonged cold ischemia time, higher recipient body mass index, and longer dialysis duration.

CONCLUSIONS: This real-world study demonstrates that HMP is associated with a significant reduction in DGF risk in kidney transplantation compared with SCS, supporting its broader implementation and targeted management of modifiable risk factors.

PMID:41209481 | PMC:PMC12594304 | DOI:10.1097/TXD.0000000000001875

Genus. 2025;81(1):32. doi: 10.1186/s41118-025-00273-0. Epub 2025 Nov 7.

ABSTRACT

This contribution explores the division of paid and unpaid labour among same-sex couples in Italy relying on primary data collected via an online survey. The (non-probabilistic) sample consists of 190 respondents, mainly women (n = 138), in a co-residing same-sex couple at the survey date. Results from descriptive statistics reveal a general pattern of equal division of both paid and unpaid labour among the majority of couples in our sample-a result which aligns with previous research based on different countries. Same-sex partners in our sample tend to share domestic and childcare chores equally, even when paid labour is not equally shared. This result contrasts markedly with the gender division found among different-sex partners in Italy from existing empirical studies, especially among parents. Finally, we find that in those same-sex couples where the division of childcare is unbalanced, care tasks tend to be skewed towards the respondent irrespective of their relationship to the child, unlike prior international studies suggesting a higher involvement in care tasks for the birth or biological parent.

PMID:41209477 | PMC:PMC12594702 | DOI:10.1186/s41118-025-00273-0

Front Vet Sci. 2025 Oct 24;12:1629328. doi: 10.3389/fvets.2025.1629328. eCollection 2025.

ABSTRACT

INTRODUCTION: The sodium-to-potassium (Na:K) ratio is commonly used as a screening criterion for hyponatremic and/or hyperkalemic hypoadrenocorticism (HA), a serious endocrine disorder in dogs characterized by non-specific clinical signs and variable laboratory findings. A Na:K ratio below 27 typically prompts further investigation through adrenal function tests. However, previous studies suggest that serum K levels may increase with age, even in otherwise healthy dogs. The objective of this study is to evaluate the influence of age on the Na:K ratio, in order to determine whether age-related changes could impact the reliability of this ratio as a screening tool in adult and senior dogs.

MATERIALS AND METHODS: We analyzed biochemical and hematological data from 208 dogs, aged 5-16 years, enrolled in a longitudinal research project of general canine population. The data included their medical history before the control visit and during the 12-month follow-up period.

RESULTS: The prevalence of dogs with a Na:K ratio ≤ 27 was found to be 2.4 ± 2.7% in dogs under 10 years and 12.8±7.0% in those over 10 years. None of the dogs with Na:K ratio ≤ 27 had clinical suspicion of HA, either at the time of initial evaluation or during the 6-months follow-up period. Serum K levels showed a modest but statistically significant age-related increase of 0.22 ± 0.05 mEq/L every 5 years, while Na levels remained stable. As a result, the Na:K ratio declined by 1.5 ± 0.3 points every 5 years. Serum K was moderately correlated with the plateletcrit (PCT) (r = 0.39, p-value < 0.00001) and PCT was found to increase by 5.9% ± 1.6% every 5 years. It was estimated that each 10% increase in PCT corresponded to 0.142 ± 0.027 mEq/L rise in serum K.

DISCUSSION: The prevalence of dogs with a Na:K ratio ≤ 27 increases with age, reducing the specificity of this threshold for diagnosing HA in older dogs-particularly when Na levels are within the normal range. This decline is due largely, though not exclusively, to age-related increases in PCT, as platelets release K during clotting.

PMID:41209463 | PMC:PMC12593493 | DOI:10.3389/fvets.2025.1629328