Tag: nevin manimala

World J Surg Oncol. 2025 Oct 8;23(1):360. doi: 10.1186/s12957-025-04021-8.

ABSTRACT

BACKGROUND: Preoperative localization of pulmonary nodules is crucial for sublobar resection under thoracoscopy; however, controversy persists over the optimal localization method in terms of accuracy and safety. This study evaluates a novel technique integrating indocyanine green (ICG) with medical adhesive for pulmonary nodule localization.

MATERIALS AND METHODS: In this single-center retrospective cohort, 168 consecutive patients (188 pulmonary nodules ≤ 2 cm) undergoing preoperative localization followed by uniportal thoracoscopic resection (July 2023 to June 2024) were divided into two groups: ICG combined with medical adhesive group (n = 86) versus medical adhesive group (n = 82). Localization outcomes, related complications, surgical and pathological outcomes were compared between the two groups.

RESULTS: There were no deaths or serious complications. All nodules were successfully resected thoracoscopically. The combined group demonstrated a shorter operative duration than the medical adhesive group (46.3 ± 6.7 min vs. 53.1 ± 5.9 min, P < 0.001). No statistically significant differences were identified in surgical type, length of stay, duration of drain tube retention, and total postoperative drainage volume between the two groups (P > 0.05).

CONCLUSION: The combined use of ICG and medical adhesive for preoperative localization in uniportal thoracoscopic sublobar resection of small pulmonary nodules reduces operative time compared with medical adhesive positioning and demonstrates favorable safety profiles.

PMID:41063249 | DOI:10.1186/s12957-025-04021-8

Nutr Metab (Lond). 2025 Oct 8;22(1):116. doi: 10.1186/s12986-025-01003-1.

ABSTRACT

BACKGROUND: Although nutritional support is crucial in intensive care, the impact of protein intake remains unclear, emphasizing the need for further randomized controlled trials. This study aimed to evaluate the effects of high-protein versus conventional-protein nutritional support on clinical outcomes in critically ill patients, with 60-day mortality as the primary endpoint.

METHOD: In this double-blind, two-arm, parallel-group randomized controlled trial, 56 adult patients admitted to the intensive care unit [1] were enrolled. Participants received either high-protein support (2.2 g/kg/day, actual body weight [ABW]) or conventional-protein support (1.0 g/kg/day, ABW) for 12 days. Both groups targeted 25 kcal/kg/day energy intake. Patients and data analysts were blinded. Mortality was assessed at ICU discharge, on days 28 and 60, and at hospital discharge. Hospital mortality was defined as any death occurring during the hospital stay, including both the ICU and post-ICU periods. Mid-arm circumference (MAC) was measured as an indicator of muscle attenuation.

RESULTS: Mean protein intake was 1.67 ± 0.33 vs. 0.93 ± 0.10 g/kg/day in high- vs. conventional-protein groups (P < 0.05). In-hospital mortality was significantly lower in the high-protein group (8 patients [28.6%]) compared to the conventional-protein group (16 patients [57.1%]; adjusted P = 0.049). Although 60-day mortality was also lower in the high-protein group (28.6% vs. 53.6%), the difference did not reach statistical significance (adjusted P = 0.07). A significant reduction in MAC attenuation was observed in the high-protein group (P < 0.001).

CONCLUSION: High-protein intake (1.67 g/kg/day) significantly reduced in-hospital mortality and improved preservation of muscle mass. Although 60-day mortality reduction was not significant, the trend suggests a meaningful benefit warranting further study.

IRCT REGISTRATION ID: IRCT20180619040151N4.

PMID:41063248 | DOI:10.1186/s12986-025-01003-1

Int J Equity Health. 2025 Oct 8;24(1):256. doi: 10.1186/s12939-025-02619-8.

ABSTRACT

BACKGROUND: Conflict-related sexual violence (CRSV) remains a critical public health and human rights issue across Africa, affecting vulnerable populations including women, children, and marginalized groups. This study explores the patterns and dynamics of CRSV across 54 African countries between 2020 and 2024.

METHODS: Secondary, de-identified data were sourced from the Global Health Data Exchange (GHDx). Descriptive statistics were conducted using IBM SPSS v27 to determine the trends in types of sexual violence and perpetrators. Pearson’s chi-square (χ²) and Fisher-Freeman-Halton tests were used to assess associations between variables. Count data panel regression using Stata 15 was applied to examine factors associated with both the frequency and mortality outcomes of CRSV.

RESULTS: Rape was the most prevalent form of sexual violence reported across the study period. Militants and national military forces were identified as leading perpetrators. Significant associations were found between types of sexual violence and perpetrator categories (χ²=208.209, p < 0.05), as well as between violence type and victim status (χ²=11.351, p = 0.040). Regression results revealed that perpetrators such as civilians (β = 0.897) and militants (β = 0.610) were more likely to be involved in multi-victim incidents. Sexual violence involving civilians was significantly associated with increased deaths (β = 1.342).

CONCLUSION: CRSV in Africa is widespread and patterned by conflict dynamics and perpetrator type. These findings call for the strengthening of survivor-centered policy responses, improved data systems, and legal accountability mechanisms to address CRSV as a barrier to peace and development.

PMID:41063245 | DOI:10.1186/s12939-025-02619-8

BMC Med Ethics. 2025 Oct 8;26(1):129. doi: 10.1186/s12910-025-01296-0.

ABSTRACT

The EU Clinical Trials Regulation (CTR) was introduced to harmonize clinical trial evaluations across Member States while upholding participant protection and ethical integrity. This study analyzes 6740 Requests for Information (RFIs) issued by Belgian Medical Research Ethics Committees (MRECs) across 266 trial dossiers evaluated between 2017 and 2024, spanning both the CTR pilot phase and the initial CTIS implementation. Using framework content analysis, we examined the number and content of RFIs in relation to trial outcomes, sponsor type (commercial vs. non-commercial), and the MREC’s role as Reporting Member State (RMS) or Member State Concerned (MSC).Results show a decline in total RFIs over time, mainly due to a reduction in typographical and linguistic remarks, yet significant variability persists in the formulation and scope of ethical feedback. While statistical and methodological concerns remained central in Part I evaluations, RFIs increasingly addressed newer challenges such as decentralized trials, e-consent, and data collection on ethnicity. Part II RFIs continued to focus heavily on informed consent documents. We further observed that MSCs raised fewer RFIs than RMSs for Part I, prompting reflection on the necessity and efficiency of full multi-state review in this section.The study also highlights a growing emphasis on regulatory compliance-sometimes at the expense of ethical deliberation-and the limited authority of policy advisors to correct inconsistencies, despite their expertise. We recommend clearer guidance, formalized roles for policy advisors in quality control, improved pre-submission processes, and limited direct communication between MRECs and sponsors. These findings support ongoing efforts to improve ethics review efficiency and quality under the CTR, with broader relevance for harmonization across Europe.

PMID:41063237 | DOI:10.1186/s12910-025-01296-0

AIDS Res Ther. 2025 Oct 8;22(1):101. doi: 10.1186/s12981-025-00753-5.

ABSTRACT

This study examines the prevalence of Human immunodeficiency virus (HIV) in Mizoram, Northeast India, with a focus on age-group transmission routes and gender-specific prevalence. According to data from the ART Plus Centre at Civil Hospital Aizawl (January-December 2023), men were more likely to be infected with HIV, with the 26-35 age group being the most affected. Heterosexual transmission and intravenous drug use (IDU) were shown to be the most common modes of transmission. Gender and age variations were identified by statistical analysis using SPSS^® (V 27.0), highlighting the need for focused interventions. To effectively combat the HIV epidemic in this area, gender-specific policies, harm reduction strategies, and stigma reduction measures are essential.

PMID:41063233 | DOI:10.1186/s12981-025-00753-5

Int J Paediatr Dent. 2025 Oct 8. doi: 10.1111/ipd.70041. Online ahead of print.

ABSTRACT

Probiotics have demonstrated Streptococcus mutans (SM) suppression. This in vitro study compared the SM inhibition capacity of bovine infant formula supplemented with Lacticaseibacillus rhamnosus Gorbach Goldin (LGG) probiotic to a plain formulation.

METHODS: Two bovine-based infant formulas, Similac Advance Optigro (formula non-probiotic, FNP) and Enfamil Nutramigen LGG (formula with probiotic, FWP) were compared. The formulas were reconstituted at different concentrations (0.1×, 0.5×, 1×, and 2×). LGG (ATCC BAA-3227) suspensions were used as positive controls. All assays were inoculated with SM, spiral plated (n = 8) onto selective Mitis Salivarius Agar plates, and incubated at 37°C for 96 h. SM growth was enumerated in colony-forming units (CFU). Multivariate analysis of variance was performed to assess concentration-dependent effects and statistical significance (α = 0.05).

RESULTS: FWP recorded less SM growth than FNP at the 0.5×, 1.0×, and 2.0× concentrations (ANOVA p < 0.001). FWP concentration was negatively correlated to SM growth (p < 0.001, r = -0.864), whereas FNP showed strong positive trends (p < 0.001, r = 0.821). MANOVA tests confirmed that both group and concentration affect SM growth (p < 0.001).

CONCLUSION: Commercial probiotic-enriched infant formula effectively suppresses SM growth in vitro. The observed suppression of SM growth in this study provides evidence for this dietary intervention’s anticariogenic potential.

PMID:41063228 | DOI:10.1111/ipd.70041

BMC Oral Health. 2025 Oct 8;25(1):1559. doi: 10.1186/s12903-025-06871-w.

ABSTRACT

BACKGROUND: The use of sedation in the field of pediatric dentistry is becoming increasingly prevalent. While general anesthesia is perceived as a safer alternative, the appropriate use of sedatives, in conjunction with a well-trained team, can effectively mitigate the risks associated with sedation. Our study aims to identify safe drug combinations for prolonged sedation.

METHODS: This study was conducted in the Operating Room of the Faculty of Dentistry at Akdeniz University. It encompassed 126 patients, classified as ASA 1-2, aged between 3 and 12 years, who underwent dental treatment with sedation support in the Department of Pedodontics from May to December 2022. The patients were categorized into three groups: (1) Ketamine, (2) Propofol-Ketamine (PK), and (3) Dexmedetomidine-Ketamine (DK). During the procedures, vital signs, the requirement for additional doses, complications, and interventions were meticulously documented. Additionally, the Ramsay Sedation Score (RSS), dentist satisfaction during the procedure, recovery time, and Aldrete scores for the postoperative 1st and 2nd hours were also recorded.

RESULTS: There were no statistically significant differences between the groups in terms of age, gender, mean weight, and ASA. The minimum requirement for additional doses was recorded in the DK group. Respiratory depression, apnea, hypoxia, and related maneuvers were most frequently observed in the PK group. DK group had minimum requirement for airway suction event. Hypertension and tachycardia were most frequently observed in the K group, while hypotension and bradycardia were most frequently recorded in the DK group. PONV were most common in the K group in which high ketamine doses were administered. RSS was highest in the DK group. The longest recovery times were observed in the DK group. 1st hour Aldrete scores were lower in the DK group. Dentists reached the highest level of satisfaction in the DK group.

CONCLUSIONS: This retrospective study provides comparative insights into three sedation regimens for pediatric dental procedures. The dexmedetomidine-ketamine combination demonstrated superior intraoperative stability and fewer respiratory complications, though recovery was prolonged. These findings may guide clinicians in selecting appropriate sedation strategies to improve safety and procedural outcomes in cases involving shared airway management.

PMID:41063220 | DOI:10.1186/s12903-025-06871-w

Eur J Pain. 2025 Nov;29(10):e70146. doi: 10.1002/ejp.70146.

ABSTRACT

BACKGROUND AND OBJECTIVE: Chronic pain is a major global health challenge with substantial individual and societal burden. Epidemiological studies are essential for understanding the scale of the problem and identifying approaches to management. However, they reveal wide variation in reported prevalence, largely due to variations in defining and phenotyping of pain, with estimates spanning roughly 10%-50% depending on wording, recall period, severity thresholds, sampling and ascertainment mode. This paper discusses phenotyping approaches in pain epidemiology, highlighting the need for pre-specified, transparent case definitions with harmonisation to improve comparability and reproducibility across studies.

METHODS: We drew from epidemiological literature on chronic pain phenotyping, focusing on methodological approaches. Examples of successful phenotyping strategies from large cohorts and consortia were identified to illustrate scalable and reproducible methods.

RESULTS: We identified ‘broad and shallow’ versus ‘deep and narrow’ approaches to phenotyping, and how they form part of a pyramid model. We explored this further using neuropathic pain as a worked example, with reference to the International Association for the Study of Pain’s Special Interest Group on Neuropathic Pain (NeuPSIG) grading system for neuropathic pain and the Neuropathic Pain Phenotyping by International Consensus (NeuroPPIC) project, which aimed to offer a standardised and scalable phenotype suitable for epidemiological and genetic research. We also briefly reviewed other, modern approaches to phenotyping that have been developed, which combine large population samples, data integration and advanced statistical modelling, with the promise of enhanced comparability, and replication.

CONCLUSIONS: Consensus on phenotyping is needed. We have illustrated a structured, scalable approach to standardised phenotyping, supporting data integration, comparability and replication.

SIGNIFICANCE STATEMENT: This review highlights the critical importance of standardised phenotyping in chronic pain epidemiology. We introduce the pyramid model as a framework addressing key methodological gaps. Enabling scalable and reproducible phenotyping strengthens the foundation for future research and clinical translation, ultimately improving outcomes for people living with pain.

PMID:41063218 | DOI:10.1002/ejp.70146

Acta Neuropathol Commun. 2025 Sep 24;13(1):200. doi: 10.1186/s40478-025-02104-x.

ABSTRACT

Pituitary neuroendocrine tumors (PitNETs) represent the most prevalent category of neuroendocrine neoplasms. Contemporary classification paradigms emphasize transcription factor immunohistochemistry (IHC) as a cornerstone for molecular subtyping and risk stratification. However, the clinical adoption of this approach is hindered by the lack of standardized interpretative thresholds for antibody staining and limited global availability of specialized reagents, particularly in resource-limited settings. To address these challenges, we developed a semi-automated computational framework that predicts PitNET lineages directly from hematoxylin and eosin (H&E)-stained histology slides. The pipeline employs a dynamic confidence threshold: samples below this threshold undergo confirmatory IHC staining and manual pathological review, while those surpassing it are classified automatically. In prospective validation, this approach achieved a 68.9% reduction in diagnostic workload while maintaining 95.9% overall accuracy. Similar efficacy was observed in functional (74.4% workload reduction, 99.0% accuracy) and external (39.3% reduction, 95.1% accuracy) cohorts. Statistical analysis confirmed non-inferiority between semi-automated predictions and fully manual IHC-based evaluations in all the cohorts. Furthermore, we implemented a deep learning-based virtual IHC staining module, generating synthetic transcription factor images demonstrating high morphological concordance with ground-truth IHC slides. Notably, our computational analysis revealed distinct histomorphological correlates of lineages: SF1-lineage tumors exhibited homogeneous cellular architecture characterized by densely packed, compact cells with reduced cytoplasmic volume, whereas PIT1-lineage neoplasms displayed larger cells with expanded intercellular spacing and disorganized spatial arrangements.

PMID:41063205 | DOI:10.1186/s40478-025-02104-x

Trials. 2025 Oct 8;26(1):392. doi: 10.1186/s13063-025-09128-7.

ABSTRACT

BACKGROUND: After a severe acquired brain injury (sABI), individuals might experience mild-to-severe cognitive impairments. In these patients, cognitive rehabilitation is provided as early as possible, to take advantage of and guide brain plasticity. According to a restorative approach, traditional cognitive training (TCT) usually involves repeated paper-and-pencil exercises of increasing difficulty and targeting specific cognitive domains. Recently, some evidence supported the use of virtual reality (VR) for ABI rehabilitation, particularly focusing on stroke cases. Nonetheless, there is limited evidence in sABI and in different etiologies. The present multicenter randomized controlled trial aims at exploring the effectiveness, in terms of clinical-functional, neurophysiological, and biomarker changes, of a cognitive rehabilitation focused on executive functions performed by a non-immersive VR device, compared to TCT, in a cohort of patients with sABI.

METHODS: According to an a priori power analysis, 28 adult patients with sABI will be enrolled by 5 Italian neurorehabilitation units within the Fit for Medical Robotics ( https://www.fit4medrob.it/ ) Consortium. Patients will be randomly assigned to receive either 30 min of VR or TCT sessions each day throughout the trial. At study entry (T0), patients will undergo clinical-functional evaluation, neurophysiological assessments, and serum blood sampling. Thereafter, VR or TCT will be provided daily, five times per week, for 5 weeks (25 total treatment sessions). Clinical-functional and neurophysiological assessments will be repeated at the end of the treatment (T1). A follow-up evaluation will be performed after 1 month from T1 (T2). Statistical analyses will be conducted blindly, according to the intention-to-treat principle.

DISCUSSION: VR has recently been gaining popularity as a cognitive rehabilitation tool. Notwithstanding substantial evidence supporting the use of VR for ABI rehabilitation, there is limited evidence in sABI from traumatic or anoxic etiology. This multicenter pragmatic trial will provide new insights into the effectiveness of VR in sABI cognitive rehabilitation.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06474871. Registered on December 2, 2024.

PMID:41063192 | DOI:10.1186/s13063-025-09128-7