Tag: nevin manimala

Cureus. 2025 Sep 11;17(9):e92103. doi: 10.7759/cureus.92103. eCollection 2025 Sep.

ABSTRACT

Introduction Blunt abdominal trauma (BAT) is a major cause of morbidity and mortality, most frequently resulting from road traffic accidents and falls. Focused assessment with sonography in trauma (FAST) is a rapid, non-invasive, bedside imaging technique used to detect intra-abdominal free fluid. While FAST is widely accessible and radiation-free, its diagnostic accuracy varies with time and clinical context. This study is aimed to evaluate the diagnostic accuracy of serial FAST performed at 4, 8, and 12 hours after injury, using contrast-enhanced computed tomography (CECT) whole abdomen as the reference. Materials and methods This was a prospective observational study, conducted at the Department of General Surgery, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India, between April 2024 and April 2025. A total of 132 adult patients presenting with BAT in emergency were enrolled based on strict inclusion and exclusion criteria. FAST was performed at 4, 8, and 12 hours post-injury. Diagnostic performance was assessed by comparing FAST findings with CECT results in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results Liver injuries were the most common (37.12%), followed by splenic and gastrointestinal injuries (18.18% each). Sensitivity of FAST improved from 64.4% at 4 hours to 76.3% at 8 hours and 88.1% at 12 hours. Specificity also increased from 64.3% to 85.7% across the same intervals. PPV remained consistently high (>93%), whereas NPV increased from 17.6% to 46.2%. The diagnostic improvement over time was statistically significant (p < 0.05 for 8 and 12 hours). Conclusion Serial FAST enhances diagnostic accuracy in BAT, particularly when performed at delayed intervals. While a positive FAST is highly predictive of injury, a negative FAST, especially at earlier time points, should be interpreted with caution. Integration of serial FAST into trauma protocols can improve injury detection and clinical outcomes.

PMID:41084686 | PMC:PMC12515346 | DOI:10.7759/cureus.92103

J Assist Reprod Genet. 2025 Oct 13. doi: 10.1007/s10815-025-03706-z. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to compare clinical pregnancy rate after IUI-D in heterosexual couples (HC), lesbian couples (LC), and single women (SW).

METHODS: This retrospective multicentric study was conducted in two university-based ART centers in France in all consecutive IUI-D cycles performed after stimulation with gonadotropins in 2021-2023. The primary outcome was clinical pregnancy rate (CPR). Cumulative clinical pregnancy rate was also calculated. Comparisons were made between groups taking HC as the control group and adjusting for age.

RESULTS: A total of 962 patients undergoing 2737 IUI-D cycles were included in the analysis, 234 HC women (24.3%), 478 LC women (49.7%), and 250 (30%) single women (SW). SW were significantly older than HC and LC. Clinical pregnancy rate (CPR) per cycle was significantly lower in LC and SW than in HC in univariate analysis. Age was negatively associated with clinical pregnancy. After adjusting for age, no statistically significant relationship was found between category and clinical pregnancy (p = 0.07). Cumulative clinical pregnancy rates (CCPR) and the average number of cycles required to achieve pregnancy were not significantly different between HC, LC and SW.

CONCLUSIONS: This first study conducted in France after change in law allowing ART access for LC and SW confirms that CPR after IUI-D is not significantly associated with relationship status after adjusting for age.

PMID:41083664 | DOI:10.1007/s10815-025-03706-z

Clin Transl Oncol. 2025 Oct 13. doi: 10.1007/s12094-025-04068-9. Online ahead of print.

ABSTRACT

PURPOSE: Recent studies have suggested a change in the epidemiologic pattern of testicular germ-cell tumors (TGCTs) and advances in therapeutic strategies have led to significant changes in their treatment over the last decades. Treatment guidelines for early-stage testicular cancer recommend de-escalation of therapy by the adoption of surveillance strategies. This study aimed to describe trends in TGCTs diagnosed over the last 30 years at our center and evaluate the impact of evolving treatment strategies.

METHODS: We retrospectively analyzed 277 TGCT patients treated from 1994 to 2023. Clinical characteristics, treatment patterns, and outcomes were assessed across three 10-year periods. Survival and relapse rates were estimated using Kaplan-Meier methods; significance was set at p < 0.05.

RESULTS: A significant increase in incidence was observed (p < 0.05), along more stage I diagnoses (p < 0.05) and older age at diagnosis, including a higher proportion aged ≥ 40 years (p < 0.001). Seminoma incidence doubled, while non-seminoma remained stable. In stage I disease, the use of active surveillance increased significantly, while adjuvant chemotherapy declined (p < 0.0005). Recurrence rates slightly decreased but were not statistically significant. Cause-specific 10-year survival improved from 95% to 97.2%, with overall survival stable at ~ 94%. The risk of second primary malignancies was notable, including contralateral testicular cancer (2.9%) and second malignant neoplasms (SMNs) (5.0%). A substantial burden of non-cancer-related causes of death were also observed.

CONCLUSIONS: A real increase in the incidence of TGCTs and age at diagnosis was confirmed. These trends highlight a shift toward less aggressive treatment while maintaining excellent outcomes. However, the notable occurrence of SMNs and non-cancer mortality underscores the need for long-term follow-up that includes survivorship care beyond oncological monitoring.

PMID:41083654 | DOI:10.1007/s12094-025-04068-9

Breast Cancer. 2025 Oct 13. doi: 10.1007/s12282-025-01791-7. Online ahead of print.

ABSTRACT

AIMS: Autoimmune rheumatological diseases (ARDs) have historically represented an absolute or relative contraindication for radiotherapy (RT) due to increased RT-related toxicity and the potential exacerbation of rheumatologic disease. ARDs are more frequent in females (F:M 4:1). Breast cancer (BC) is the most common malignancy, accounting alone for 31% of female cancers. This study compared acute and late cutaneous toxicity in ARDs and non-ARDs population undergoing adjuvant breast RT.

METHODS: Data of patients with BC and ARDs treated between 2013 and 2023 were retrospectively reviewed. The ARDs group was compared with a control group in a 1:2 ratio, homogeneous by age, type of treatment, RT total doses and fractionations, and target volumes’ prescription. Acute and late toxicity were recorded using RTOG scales.

RESULTS: We included 44 women with ARDs (median age 61 years) and 88 woman (median age 62 years) as control group. In ARDs group, the most used RT schedules were conventional fractionation (72.7%), while hypofractionation schedule (40-44 Gy) was administered in 12 patients (27.3%). In the control group, 64 patients (72.7%) received RT with conventional fractionation and 24 patients (27.3%) hypofractionation (40-44 Gy). Overall acute skin toxicity rate was 80.4% in the control group vs 86.4% in the ARDs group (p = 0.681). Specifically, G2 toxicity was 22.0% in the control group vs 31% in the ARDs group, while G3 acute toxicity was 2.3% in both groups. Overall late skin toxicity was 21.6% in the control group vs 27.3% in ARDs group (p = 0.067). Statistically significant difference was observed in late G2 toxicity with a 0% rate in the control group vs 6.8% in the experimental group (p = 0.035), respectively.

CONCLUSIONS: ARDs do not seem to represent an absolute or relative contraindication in BC RT in terms of acute and late cutaneous toxicity. Hypofractionated schedule showed less toxicities in both group and, particularly, in ARDs group.

PMID:41083653 | DOI:10.1007/s12282-025-01791-7

Sci Rep. 2025 Oct 13;15(1):35690. doi: 10.1038/s41598-025-19472-y.

ABSTRACT

The aim of the study was to assess Life’s Essential 8 (LE8) trajectories by glycemic status change and examine their association with diabetes progression risk in young adults with prediabetes (preDM). We used the Coronary Artery Risk Development in Young Adults study (CARDIA) Year 7-30 data to estimate trends of LE8 scores among preDM participants (impaired fasting glucose, impaired oral glucose tolerance, and/or HbA1c 5.7-6.4%) by status of progression, consistent preDM, and regression. We used logistic regression to evaluate the progression risk with LE8. Among 974 preDM participants, 34% progressed to diabetes, 28% remained preDM, and 38% regressed to euglycemia. Over a mean follow-up of 13 years, the progression group had the greatest decline in LE8 scores. Ideal LE8 scores (vs. moderate or poor) were associated with a 40-90% reduction in the progression risk. In conclusion, maintaining optimal cardiovascular health may prevent diabetes progression among young adults with preDM.

PMID:41083649 | DOI:10.1038/s41598-025-19472-y

Sci Rep. 2025 Oct 13;15(1):35664. doi: 10.1038/s41598-025-19658-4.

ABSTRACT

Privacy protection is a critical concern when dealing with sensitive survey questions. Conventional randomized response (RR) models frequently fall short in providing respondents with adequate secrecy when assessing important parameters like the probability of success p and the probability of truthfulness T. This study proposes an improved RR technique that addresses these drawbacks by providing better privacy protections and enabling the simultaneous calculation of T and π.The advantage of the proposed model is that it applies a two-stage randomization process, which estimates both T and π thereby offering enhanced protection for privacy. The proposed method is first initially developed using simple random sampling and builds upon a two-stage RR approach described in previous research. It is then expanded to include stratified random sampling in order to make it more applicable to survey designs that are more intricate. The methodology is derived analytically and evaluated with respect to computing efficiency and algebraic measures. The suggested model increases the overall quality and reliability of the survey data by reducing respondent reluctance and producing more accurate parameter estimations, as shown by efficiency comparisons with current methods. Additionally, without sacrificing the accuracy of the statistical estimates, the approach improves respondent participation. Simulations using different fixed values of n, π, and T show that the suggested model continuously performs better than traditional techniques in terms of reducing variance and protecting privacy under both simple and stratified sampling. These findings show that it is a useful, statistically sound method for carrying out surveys on delicate subjects, guaranteeing data quality and respondent protection.

PMID:41083641 | DOI:10.1038/s41598-025-19658-4

Sci Rep. 2025 Oct 13;15(1):35665. doi: 10.1038/s41598-025-19639-7.

ABSTRACT

Studies document independent effects of prenatal air pollution exposure and social environmental factors, including neighborhood safety, on childhood asthma development with documented sex-specific effects. Further research examining these factors jointly is needed. We examined associations between prenatal residence-level daily fine particulate matter (PM_2.5) exposure and child asthma, considering effect modification by a validated Neighborhood Sentiment and Safety Index (NSSI) and child sex. Participants were mothers and full-term (> 37 weeks gestation) singleton-born children from two Boston-area pregnancy cohorts. The Asthma Coalition on Community, Environment and Social Stress (ACCESS) project enrolled 955 pregnant women between August 2002 and July 2009.The Programming of Intergenerational Stress Mechanisms (PRISM) study recruited 390 pregnant women from March 2011 to December 2013. Bayesian distributed lag interaction models (BDLIMs) were implemented to estimate associations between child asthma incidence and daily average maternal PM_2.5 exposure across gestation. Effect modification by NSSI and child sex was examined using a BDLIM comparing models with and without effect modification. Women were primarily minorities (29% black, 47% Hispanic) reporting less than a high school education (54%). Children were followed 15.1 ± 3 years; 204 (17%) developed asthma. In the overall sample (n = 1,178), increased PM_2.5 exposure between 21 and 27 weeks gestation was associated with increased odds of asthma in children born to women in the high NSSI group (NSSI ≥ 75th percentile representing safer neighborhoods). Both boys and girls were at higher risk of asthma when considering joint effects. These data add to a growing literature highlighting the need to consider both chemical toxins and psychosocial factors operating in communities to better elucidate which factors are driving respiratory health effects. A singular focus on changes to mitigate air pollution may not have high impact on improving respiratory health, particularly in historically under-resourced areas where effects may be more highly driven by social determinants.

PMID:41083639 | DOI:10.1038/s41598-025-19639-7

Sci Rep. 2025 Oct 13;15(1):35695. doi: 10.1038/s41598-025-19671-7.

ABSTRACT

Nurse burnout is an escalating global concern and is often intensified by exposure to workplace violence (WPV). However, the psychological and behavioral pathways linking WPV and burnout remain insufficiently characterized. This study aimed to develop and test a model to examine the associations between WPV and nurse burnout; we tested statistical indirect paths via resilience and emotional labor and a conditional role of perceived organizational support. A cross-sectional survey was conducted from March to May 2025 among 549 clinical nurses from eight tertiary hospitals in Sichuan Province, China. Data were collected using structured questionnaires distributed via the Wenjuanxing online platform, covering demographic characteristics, WPV, resilience, emotional labor, burnout, and perceived organizational support. All statistical analyses were conducted in IBM SPSS Statistics 26.0. Indirect and moderation analyses were estimated in PROCESS v4.1 (Models 6 and 86) with 5,000 bootstrap resamples to obtain bias-corrected 95% confidence intervals; estimates are interpreted as associations. For the 549 participants, the MBI-HSS burnout score was 55.45 ± 21.31. Hierarchical regression showed that WPV was positively associated with burnout (β = 0.269, p < 0.001). Analyses indicated statistical indirect associations via resilience (β = 0.092, 95%CI 0.064-0.123) and via emotional labor (β = 0.031, 95%CI 0.012-0.053), and a significant sequential indirect pathway (β = 0.024, 95%CI 0.014-0.036). The interaction between emotional labor and perceived organizational support (POS) was significantly and negatively associated with burnout (β=-0.114, 95%CI – 0.185 to – 0.042), and POS conditioned the strength of the indirect associations. WPV was associated with higher burnout among nurses, with statistical indirect paths via lower resilience and higher emotional labor demands. A sequential indirect pathway was observed.Higher perceived organizational support was associated with attenuation of the positive association between emotional labor and burnout.Hospital managers are encouraged to implement comprehensive interventions focused on violence prevention, emotional labor training, and the development of organizational support systems.

PMID:41083622 | DOI:10.1038/s41598-025-19671-7

Sci Rep. 2025 Oct 13;15(1):35620. doi: 10.1038/s41598-025-19524-3.

ABSTRACT

This study examined the prevalence of comorbid depression and anxiety in Chinese patients with temporomandibular disorders (TMDs), and their associations with pain intensity, sleep propensity, oral behaviors, jaw function, and oral health-related quality of life (OHRQoL). It also evaluated the likelihood of different TMD subtypes among individuals with no depression or anxiety (NC), depression alone (DA), anxiety alone (AA), and comorbid conditions (CC). Participants recruited from a dental hospital completed a survey comprising sociodemographics, the Diagnostic Criteria for TMDs (DC/TMD) Symptoms Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, Numerical Pain Rating Scale, Epworth Sleepiness Scale, Oral Behaviors Checklist, Jaw Functional Limitation Scale-8, and the Oral Health Impact Profile for TMDs. Clinical examinations followed the DC/TMD protocol, classifying individuals into intra-articular (IT), pain-related (PT), or combined (CT) TMDs. Statistical analyses included chi-square tests, non-parametric methods, and multinomial logistic regression (α = 0.05). Among 798 participants (mean age 29.8 years [SD 10.7]; 79.6% women), 48.0%, 10.8%, 7.9%, and 33.3% had NC, DA, AA, and CC, respectively. Significant differences were observed in pain intensity (CC/AA/DA > NC), sleep propensity (CC/DA > AA/NC), jaw overuse behavior (CC > AA/NC; DA > NC), jaw functional limitation (CC > DA > NC; AA > NC), and OHRQoL (CC > AA > DA > NC). Moderate correlations were observed between jaw functional limitation and OHRQoL across groups, with additional links to pain intensity in DA and AA (r_s = 0.43-0.54). In adjusted models, DA was associated with greater odds of CT (OR 2.26; 95% CI 1.19-4.27), and CC with higher odds of PT (OR 1.72; 95% CI 1.02-2.89) and CT (OR 1.78; 95% CI 1.14-2.77). Comorbid depression and anxiety were linked to increased pain, sleep propensity, oral behaviors, jaw dysfunction, and poorer OHRQoL, reinforcing the need for integrated psychological care.

PMID:41083621 | DOI:10.1038/s41598-025-19524-3

Surg Endosc. 2025 Oct 13. doi: 10.1007/s00464-025-12271-6. Online ahead of print.

ABSTRACT

BACKGROUND: Minimally invasive surgery is the standard of care for general surgical procedures. While use continues to grow, current platforms are hindered by prolonged operative times, high costs, steep learning curves, and lack of surgeon autonomy, which restricts expansion and practicality in high-volume and ambulatory surgery centers. Our goal was to evaluate the safety and feasibility of a novel AI-powered robotic platform to perform solo surgery.

METHODS: An IDEAL framework 2a prospective, multi-center observational study was performed on consecutive patients planned for solo abdominal surgery using the Maestro™ robotic system (Moon Surgical SAS, Paris, France) from 10/2023 to 4/2025. Preoperative, intraoperative, postoperative, and device-specific variables were evaluated. Descriptive statistics were used to summarize outcome measures.

RESULTS: Forty-five procedures were performed by five surgeons. Patients had a mean age of 55.3 (SD 18.1) years and a mean BMI of 29.4 (8.1) kg/m². The cohort was 1/3 male and 2/3 female. The main indications for operation were cholecystitis (n = 17, 37.8%), obesity (n = 10, 22.1%), and inguinal hernia (n = 11, 24.4%). The most common cases were cholecystectomy (n = 17, 37.8%), inguinal hernia (n = 11, 24.4%), and sleeve gastrectomy (n = 5, 11.1%). The mean total room time was 95.5(SD 38.3) minutes, the mean operative time was 43.6(SD 30.6) minutes, and the mean robotic setup time was 6.1(SD 4.1) minutes. One case required conversion to multiport laparoscopy (2.2%). No cases required insertion of additional ports or a bedside assistant. The mean length of stay was < 1 (SD 1.3) day. There was minor morbidity in 3 (6.6%) patients, but no readmissions, reoperations, or mortality. There were no device-related adverse events.

CONCLUSION: This IDEAL 2a investigation showed the Maestro platform was safe and feasible for performing solo surgery, with acceptable safety and technical outcomes in routine and complex procedures. There is potential to improve operating room workflow and surgeon autonomy, with controlled studies to follow.

PMID:41083613 | DOI:10.1007/s00464-025-12271-6