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Nevin Manimala Statistics

Use of Augmented Reality for Training Assistance in Laparoscopic Surgery: Scoping Literature Review

J Med Internet Res. 2025 Jan 28;27:e58108. doi: 10.2196/58108.

ABSTRACT

BACKGROUND: Laparoscopic surgery training is a demanding process requiring technical and nontechnical skills. Surgical training has evolved from traditional approaches to the use of immersive digital technologies such as virtual, augmented, and mixed reality. These technologies are now integral to laparoscopic surgery training.

OBJECTIVE: This scoping literature review aimed to analyze the current augmented reality (AR) solutions used in laparoscopic surgery training.

METHODS: Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a scoping review using 4 databases: Scopus, IEEE Xplore, PubMed, and ACM. Inclusion and exclusion criteria were applied to select relevant articles. Exclusion criteria were studies not using AR, not focused on laparoscopic surgery, not focused on training, written in a language other than English, or not providing relevant information on the topics studied. After selecting the articles, research questions (RQs) were formulated to guide the review. In total, 2 independent reviewers then extracted relevant data, and a descriptive analysis of the results was conducted.

RESULTS: Of 246 initial records, 172 (69.9%) remained after removing duplicates. After applying the exclusion criteria, 76 articles were selected, with 25 (33%) later excluded for not meeting quality standards, leaving 51 (67%) in the final review. Among the devices analyzed (RQ 1), AR video-based devices were the most prevalent (43/51, 84%). The most common information provided by AR devices (RQ 1) focused on task execution and patient-related data, both appearing in 20% (10/51) of studies. Regarding sensorization (RQ 2), most studies (46/51, 90%) incorporated some form of sensorized environment, with computer vision being the most used technology (21/46, 46%) and the trainee the most frequently sensorized element (41/51, 80%). Regarding training setups (RQ 3), 39% (20/51) of the studies used commercial simulators, and 51% (26/51) made use of artificial models. Concerning the evaluation methods (RQ 4), objective evaluation was the most used, featured in 71% (36/51) of the studies. Regarding tasks (RQ 5), 43% (22/51) of studies focused on full surgical procedures, whereas 57% (29/51) focused on simple training tasks, with suturing being the most common among the latter (11/29, 38%).

CONCLUSIONS: This scoping review highlights the evolving role of AR technologies in laparoscopic surgery training, although the impact of optical see-through devices remains unclear due to their limited use. It underscores the potential of emerging technologies such as haptic feedback, computer vision, and eye tracking to further enhance laparoscopic skill acquisition. While most relevant articles from other databases were included, some studies may have been missed due to the specific databases and search strategies used. Moreover, the need for standardized evaluation metrics is emphasized, paving the way for future research into AR’s full potential in laparoscopic skill acquisition.

PMID:39874568 | DOI:10.2196/58108

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Nevin Manimala Statistics

Digital Information Exchange Between the Public and Researchers in Health Studies: Scoping Review

J Med Internet Res. 2025 Jan 28;27:e63373. doi: 10.2196/63373.

ABSTRACT

BACKGROUND: Information exchange regarding the scope and content of health studies is becoming increasingly important. Digital methods, including study websites, can facilitate such an exchange.

OBJECTIVE: This scoping review aimed to describe how digital information exchange occurs between the public and researchers in health studies.

METHODS: This scoping review was prospectively registered and adheres to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Eligibility was defined using the population (public and researchers), concept (digital information exchange), and context (health studies) framework. Bibliographic databases (MEDLINE, PsycINFO, CINAHL, and Web of Science), bibliographies of the included studies, and Google Scholar were searched up to February 2024. Studies published in peer-reviewed journals were screened for inclusion based on the title, abstract, and full text. Data items charted from studies included bibliographic and PCC (Population, Concept, and Context) characteristics. Data were processed into categories that inductively emerged from the data and were synthesized into main themes using descriptive statistics.

RESULTS: Overall, 4072 records were screened, and 18 studies published between 2010 and 2021 were included. All studies evaluated or assessed the preferences for digital information exchange. The target populations included the public (mainly adults with any or specific diseases), researchers, or both. The digital information exchange methods included websites, emails, forums, platforms, social media, and portals. Interactivity (ie, if digital information exchange is or should be active or passive) was addressed in half of the studies. Exchange content included health information or data with the aim to inform, recruit, link, or gather innovative research ideas from participants in health studies. We identified 7 facilitators and 9 barriers to digital information exchange. The main facilitators were the consideration of any stakeholder perspectives and needs to clarify expectations and responsibilities, the use of modern or low-cost communication technologies and public-oriented language, and continuous communication of the health study process. The main barriers were that information exchange was not planned or not feasible due to inadequate resources, highly complex technical language was used, and ethical concerns (eg, breach of anonymity if study participants are brought together) were raised. Evidence gaps indicate that new studies should assess the methods and the receiver (ie, public) preferences and needs that are required to deliver and facilitate interactive digital information exchange.

CONCLUSIONS: Few studies addressing digital information exchange in health studies could be identified in this review. There was little focus on interactivity in such an exchange. Digital information exchange was associated with more barriers than facilitators, suggesting that more effort is required to improve such an exchange between the public and researchers. Future studies should investigate interactive digital methods and the receiver preferences and needs required for such an exchange.

PMID:39874566 | DOI:10.2196/63373

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Nevin Manimala Statistics

The Use of Acellular Dermal Matrix May Not Increase 30-Day Complications in Direct-to-Implant Breast Reconstruction: A Multi-institutional Analysis of 10,177 Cases

Ann Plast Surg. 2025 Jan 27. doi: 10.1097/SAP.0000000000004234. Online ahead of print.

ABSTRACT

BACKGROUND: Direct-to-implant (DTI) breast reconstruction offers immediate aesthetic and psychological benefits, but the role of acellular dermal matrix (ADM) remains debated. Using a multi-institutional database, this study evaluates and compares outcomes between ADM-assisted and non-ADM DTI procedures.

METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2022 was queried to identify female patients who underwent DTI breast reconstruction for oncological purposes. Patients were divided into 2 groups: DTI breast reconstruction with ADM and without. Thirty-day postoperative complications were compared using multivariate analysis and propensity score matching.

RESULTS: Among 10,177 patients, 45% (n = 4605) underwent ADM-assisted DTI, while 55% (n = 5572) had non-ADM DTI. While both groups showed comparable mean ages (ADM: 52 ± 12 years vs non-ADM: 51 ± 11 years; P = 0.190), ADM patients were significantly less likely to present with comorbidities such as obesity (ADM: 21.5% vs non-ADM: 26%; P < 0.001), hypertension (20.5% vs 2.6%; P = 0.01), diabetes (4.8% vs 5.1%; P = 0.002), and smoking history (6.4% vs 10.1%; P < 0.001). Still, surgical complication rates were comparable (ADM: 4.7%, non-ADM: 5.5%; P = 0.08), including superficial infections (2.0% vs 2.4%; P = 0.19), deep infections (0.6% vs 0.9%; P = 0.17), wound dehiscence (0.8% vs 1.0%; P = 0.24), and bleeding (0.6% vs 0.7%; P = 0.54). Medical complications were generally rare and also showed no significant differences (ADM: 1.4%, non-ADM: 1.7%; P = 0.27). Confounder-adjusted multivariable analysis and propensity score matching confirmed no increased risk of surgical (odds ratio 0.93, 95% confidence interval 0.75-1.16, P = 0.52) or medical complications (odds ratio 0.87, 95% confidence interval 0.59-1.26, P = 0.46).

CONCLUSIONS: The use of ADM in DTI breast reconstruction is not associated with a higher risk of short-term complications, supporting its continued use in clinical practice. This information is crucial for surgeons and patients in making informed decisions regarding the incorporation of ADM in DTI breast reconstruction.

PMID:39874559 | DOI:10.1097/SAP.0000000000004234

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Comparative Postoperative Complications of Acellular Dermal Matrix and Mesh Use in Prepectoral and Subpectoral One-Stage Direct to Implant Reconstruction: A Retrospective Cohort Study

Ann Plast Surg. 2025 Jan 27. doi: 10.1097/SAP.0000000000004233. Online ahead of print.

ABSTRACT

BACKGROUND: One-stage direct-to-implant (DTI) breast reconstruction is increasingly popular with the use of prepectoral reconstruction leading to increased demand for structural scaffolds. It is vital to determine if differences in safety profiles exist among scaffolds.

METHODS: We performed a retrospective cohort study of consecutive patients in our breast cancer center undergoing DTI reconstruction. Outcomes relating to postoperative infections, wound complications, and implant related complications were extracted. Outcomes were grouped into major, minor, and long-term complications. Univariate and multivariate analysis determined outcome differences and accounted for confounding variables.

RESULTS: Two hundred forty-two patients (404 breasts) underwent DTI reconstruction. One hundred ninety-two breasts were reconstructed with FlexHD Pliable Preformed (PP; MTF Biologics, Edison, NJ), 122 with AlloDerm Ready To Use (RTU; Allergan Aesthetics, Irvine, CA), 22 with DermACELL (LifeNet Health, Virginia Beach, VA), 21 with Galaflex (Galatea Surgical, Lexington, MA), 22 with Meso BioMatrix (MTF Biologics), and 25 with autologous dermal flaps alone. Univariate analysis demonstrated statistically significant differences among scaffolds in the incidence of cellulitis treated with oral antibiotics, capsular contracture, explantation for capsular contracture, seroma requiring operative drainage, minor complications, and long-term complications. On multivariate regression, FlexHD PP had reduced rates of capsular contracture, explantation for capsular contracture, minor complications, and long-term complications compared to AlloDerm RTU. Reconstruction with Galaflex had increased rates of capsular contracture when compared to FlexHD PP.

CONCLUSIONS: Certain structural scaffolds have differing safety profiles that should be considered when selecting, which product to use in DTI reconstruction.

PMID:39874556 | DOI:10.1097/SAP.0000000000004233

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The Pharmacology of Aid in Dying: From Database Analyses to Evidence-Based Best Practices

J Palliat Med. 2025 Jan 28. doi: 10.1089/jpm.2024.0379. Online ahead of print.

ABSTRACT

Background: Medical aid in dying is legal in 10 states plus Washington DC, covering 22% of the U.S. population. Much has been written about the ethics of aid in dying, but little about evidence-based care, especially the medications used. We investigated the efficacy of four commonly used aid-in-dying medication protocols-using the time to sleep and time to death as proxies for efficacy. Methods: We performed an independent, secondary analysis on deidentified data from four organizations, comparing four different medication protocols. Descriptive statistics for time to sleep and time to death for the different medication protocols were calculated. Medication protocols included one sedative and three sedative/cardiotoxin combinations. Results: We analyzed data from 3332 death reports covering 2009 to 2023, comparing a single sedative medication protocol with three different sedative/cardiotoxin combinations. The sedative alone yielded the most rapid median time to death of 0.4 hours, but with days-long outliers. Two of the sedative/cardiotoxin combinations yielded median times to death of 0.8 hours. But from 2018 to 2023, as the medication combinations shifted, the mean time to death declined while the median remained relatively steady-confirming that these combinations reduced the incidence of longer deaths (especially extreme outliers). Conclusion: This first-time analysis of aid-in-dying medication protocols showed that while a sedative alone had the best median time to death, the most recent sedative/cardiotoxin protocol had an acceptable median time to death of 0.8 hours, but with fewer prolonged-death outliers.

PMID:39874553 | DOI:10.1089/jpm.2024.0379

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Nevin Manimala Statistics

Assessing Readability of Patient Education Materials on Adult-Acquired Buried Penis

Ann Plast Surg. 2025 Jan 27. doi: 10.1097/SAP.0000000000004229. Online ahead of print.

ABSTRACT

INTRODUCTION: Adult-acquired buried penis (AABP) is an increasingly prevalent condition characterized by the penis “buried” in prepubic/suprapubic tissue. AABP affects urinary and sexual function, hygiene, and psychosocial well-being. Because many affected individuals are unfamiliar with the condition or hesitant to seek medical help, accessible, high-quality patient education materials (PEMs) are necessary. The American Medical Association recommends that PEMs be written at or below a 6th-grade reading level. This study aimed to assess the readability of the most easily accessible AABP PEMs.

METHODS: After disabling user account information, the top 10 results for “buried penis treatment” from 3 search engines were collected. Academic journal articles, advertisements, and pediatric PEMs were excluded. Plain texts without graphics and extraneous information were copied to the Readability Test Tool (WebFX, Harrisburg, PA) to generate readability scores. Descriptive statistics were used to analyze the data.

RESULTS: The top 10 results for each search engine, excluding duplicates, resulted in 12 unique articles. Of 5 readability tests used by the Readability Test Tool, the mean grade level necessary to comprehend resource content was 12.3, or about a 12th-grade level. The mean age estimated for understanding was 17.7, or an age range of 17-18 years old. Complex words comprised on average, 16.6% of a resource’s material.

CONCLUSIONS: This study emphasizes the inadequate readability of current PEMs for AABP. The readability for most accessible materials exceeds the recommended reading level of at or below 6th grade. Providers should aim to publish easily comprehensible online PEMs to promote patient awareness and comprehension.

PMID:39874550 | DOI:10.1097/SAP.0000000000004229

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Examining the Impact of Adverse Childhood Experiences and Active Coping in Black Older Adults: A Mixed Methods Study

Res Gerontol Nurs. 2025 Jan 30:1-11. doi: 10.3928/19404921-20250122-01. Online ahead of print.

ABSTRACT

PURPOSE: To gain a deeper understanding of Black older adults’ (aged ≥65 years) experiences with adverse childhood experiences (ACEs), including racism, and their use of active coping throughout their life course.

METHOD: Qualitative interviews were conducted with 21 Black older adults followed by administration of the First 18 Years Survey (measuring ACEs) and the John Henryism Active Coping Scale. Qualitative data were analyzed using thematic narrative analysis. Quantitative data were analyzed using descriptive statistics. Qualitative and quantitative data were integrated using a triangulation process.

RESULTS: Four major themes emerged from the qualitative data. Participants reported experiencing pervasive racism throughout their lives. Quantitative results indicated participants experienced fewer ACEs and made high use of active coping. Triangulation indicates qualitative findings and explains the quantitative results.

CONCLUSION: Although participants faced ACEs including racism, they found strategies to help them actively cope. [Research in Gerontological Nursing, xx(x), xx-xx.].

PMID:39874546 | DOI:10.3928/19404921-20250122-01

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DO-GMA: An End-to-End Drug-Target Interaction Identification Framework with a Depthwise Overparameterized Convolutional Network and the Gated Multihead Attention Mechanism

J Chem Inf Model. 2025 Jan 28. doi: 10.1021/acs.jcim.4c02088. Online ahead of print.

ABSTRACT

Identification of potential drug-target interactions (DTIs) is a crucial step in drug discovery and repurposing. Although deep learning effectively deciphers DTIs, most deep learning-based methods represent drug features from only a single perspective. Moreover, the fusion method of drug and protein features needs further refinement. To address the above two problems, in this study, we develop a novel end-to-end framework named DO-GMA for potential DTI identification by incorporating Depthwise Overparameterized convolutional neural network and the Gated Multihead Attention mechanism with shared-learned queries and bilinear model concatenation. DO-GMA first designs a depthwise overparameterized convolutional neural network to learn drug representations from their SMILES strings and protein representations from their amino acid sequences. Next, it extracts drug representations from their 2D molecular graphs through a graph convolutional network. Subsequently, it fuses drug and protein features by combining the gated attention mechanism and the multihead attention mechanism with shared-learned queries and bilinear model concatenation. Finally, it takes the fused drug-target features as inputs and builds a multilayer perceptron to classify unlabeled drug-target pairs (DTPs). DO-GMA was benchmarked against six newest DTI prediction methods (CPI-GNN, BACPI, CPGL, DrugBAN, BINDTI, and FOTF-CPI) under four different experimental settings on four DTI data sets (i.e., DrugBank, BioSNAP, C.elegans, and BindingDB). The results show that DO-GMA significantly outperformed the above six methods based on AUC, AUPR, accuracy, F1-score, and MCC. An ablation study, robust statistical analysis, sensitivity analysis of parameters, visualization of the fused features, computational cost analysis, and case analysis further validated the powerful DTI identification performance of DO-GMA. In addition, DO-GMA predicted that two drug-protein pairs (i.e., DB00568 and P06276, and DB09118 and Q9UQD0) could be interacting. DO-GMA is freely available at https://github.com/plhhnu/DO-GMA.

PMID:39874533 | DOI:10.1021/acs.jcim.4c02088

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Nevin Manimala Statistics

Training Load, Official Match Locomotor Demand, and Their Association in Top-Class Soccer Players During a Full Competitive Season

J Strength Cond Res. 2025 Feb 1;39(2):249-259. doi: 10.1519/JSC.0000000000004995.

ABSTRACT

Riboli, A, Nardi, F, Osti, M, Cefis, M, Tesoro, G, and Mazzoni, S. Training load, official match locomotor demand, and their association in top-class soccer players during a full competitive season. J Strength Cond Res 39(2): 249-259, 2025-To examine training load and official match locomotor demands of top-class soccer players during a full competitive season and to evaluate their association. Twenty-five top-class soccer players competing in UEFA international competitions were included. The season was divided into 2 different categories: 2 matches (M2) or 3 matches (M3) in 8 days. Starters and nonstarters were classified. Total distance (TD), high-speed running (HSR, 15-20 km·h-1), very high-speed running (VHSR, 20.1-24 km·h-1), sprint (SPR, >24.1 km·h-1), and accelerations/decelerations (Acc + Dec, >3 m·s2) were recorded. Trivial to moderate differences (p < 0.05) in training load between M2 and M3 were found: HSR, VHSR, and SPR were higher in M2 than M3, whereas TD and Acc + Dec were higher in M3 than M2. Week-by-week variability in training load ranged from ∼16 to ∼59% depending on metrics. Official match locomotor demands were similar (p > 0.05) in M2 and M3 with ∼5 to ∼29% match-to-match variability depending on metrics. Total load (i.e., training plus match loads) was higher (p < 0.05, ES: 0.75/1.61) in starters than nonstarters, because of a higher match load and no difference in the training load. Very high-speed running and SPR accumulated during training sessions were largely to very largely (r = 0.60 to 0.72) associated with TD, HSR, VHSR, and Acc + Dec covered during official match; VHSR and TD during training were largely to very largely (r = 0.57 and 0.71) associated with SPR and Acc + Dec during official match. In conclusion, (a) congested periods seemed to not affect official match locomotor performance; (b) practitioners may consider high week-by-week workload variability for individualizing training prescriptions, especially for nonstarters; and (c) the VHSR and SPR accumulated during training were associated with the official match locomotor demands, and it may be considered for maximizing performance.

PMID:39874527 | DOI:10.1519/JSC.0000000000004995

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Dysmenorrhea, Premenstrual Syndrome, and Lifestyle Habits in Young University Students in Spain: A Cross-Sectional Study

J Nurs Res. 2025 Feb 1;33(1):e374. doi: 10.1097/jnr.0000000000000657.

ABSTRACT

BACKGROUND: Menstruation is a physiological process that may be accompanied by pain, headache, edema, emotional changes, and other symptoms, all of which affect quality of life. Although the results of some studies indicate lifestyle habits can affect the menstrual cycle and associated symptoms, few have investigated this issue, and even fewer have explored the impact of these symptoms on quality of life, in Spanish women.

PURPOSE: The objectives of this study were to determine the prevalence of dysmenorrhea and premenstrual syndrome (PMS) among students at a Spanish university, assess the impact of these conditions on quality of life, and analyze the relationship among lifestyle habits, dysmenorrhea, and PMS.

METHODS: A cross-sectional study was carried out on 743 women enrolled at the University of Extremadura in the 2021-2022 academic year. Data related to the menstrual cycle, pain, and PMS-related physical and emotional symptoms were collected. Quality of life related to menstruation was evaluated using the CVM-22 scale. Lifestyle data collected included adherence to a Mediterranean diet (PREDIMED [Prevención con Dieta Mediterránea] questionnaire), level of physical activity (International Physical Activity Questionnaire), and alcohol and tobacco consumption (Alcohol, Smoking, and Substance Involvement Screening Test Version 3). Also, other clinical data were recorded.

RESULTS: In terms of the sample, the median age was 21 (19-23) years, the prevalence of dysmenorrhea was 57.9%, 92.7% reported premenstrual physical symptoms, and 55.6% reported experiencing premenstrual emotional changes. Having a low level of adherence to a Mediterranean diet was associated with the presence of dysmenorrhea, with an adjusted odds ratio (aOR) of 1.47 (95% CI [1.06, 2.03]). Having a low level of physical activity was strongly associated with the presence of premenstrual physical symptoms, with an aOR of 5.89 (95% CI [1.71, 20.26]). Also, an association was found between tobacco use and premenstrual emotional changes, with an aOR of 2.02 (95% CI [1.25, 3.25]). Furthermore, dysmenorrhea and PMS were both associated with a low quality of life, with pain and emotional changes being the most significantly associated factors, with ORs of 16.25 (95% CI [10.36, 25.47]) and 26.73 (95% CI [16.46, 43.40]), respectively.

CONCLUSIONS: Similar to previous studies, the findings of this study indicate a high prevalence of dysmenorrhea and PMS among young university students in western Spain, with both of these symptoms impacting quality of life significantly and negatively. In addition, lifestyle habits, diet, physical activity, and tobacco use seem to influence the occurrence of these symptoms. Promoting lifestyle changes may be an effective strategy to reduce the incidence of dysmenorrhea and PMS and improve the quality of life of young women.

PMID:39874525 | DOI:10.1097/jnr.0000000000000657