Tag: nevin manimala

Eur J Pediatr. 2025 Oct 7;184(11):660. doi: 10.1007/s00431-025-06531-9.

ABSTRACT

The increasing use of assisted reproductive technology has raised concerns about its long-term effects on offspring, including pubertal development. Evidence from large, population-based studies in non-Western countries remains limited. Using data from the Taiwan Birth Cohort Study, a nationally representative cohort of children born in 2005, we examined pubertal development at age 12 based on caregiver reports. Among 21,642 children with conception data, 172 were conceived via intrauterine insemination (IUI), 311 via in vitro fertilization (IVF), and 21,159 spontaneously (SC). Propensity score matching (1:1) yielded a final sample of 966 children. Ordinal logistic regression and parametric survival analysis assessed associations between conception method and pubertal milestones, including age at menarche. Among 966 matched children (546 boys, 420 girls), most associations between fertility treatments and pubertal development at age 12 were small and not statistically significant. Boys and girls conceived via IUI did not show a trend toward earlier or later puberty. In IVF-conceived children, odds ratios for pubertal development were near 1.0, not statistically significant and with wide 95% confidence intervals. No significant differences were found in age at menarche, either.

CONCLUSION: In this nationally representative cohort, we found no statistically significant differences in pubertal development or age at menarche by conception method at age 12. Continued follow-up is warranted to assess long-term reproductive outcomes.

WHAT IS KNOWN: • Children conceived through fertility treatment may be at risk for altered pubertal timing, but most existing evidence is from Western populations. • Prior large-scale studies suggest trends toward earlier puberty in IVF-conceived girls and later puberty in IVF-conceived boys.

WHAT IS NEW: • This study provides the first large-scale, nationally representative Asian evidence on the long-term pubertal outcomes of children conceived through fertility treatment, addressing a major geographic gap in the literature. • We did not detect statistically significant differences in pubertal stage or age at menarche at age 12 between children conceived via IUI/IVF and those conceived spontaneously.

PMID:41055806 | DOI:10.1007/s00431-025-06531-9

J Robot Surg. 2025 Oct 7;19(1):664. doi: 10.1007/s11701-025-02858-5.

ABSTRACT

Reducing surgical waiting lists remains a key national priority for healthcare systems such as the NHS in the UK. High-intensity theater (HIT) lists, designed to increase surgical throughput by optimizing theater time and perioperative care, have been proposed as a solution. However, comparative data evaluating their safety and efficiency remain limited. To evaluate the productivity and safety of robotic HIT operating lists for benign gynecological surgery, as compared to standard weekday NHS operating lists. This was a retrospective cohort study using a prospectively maintained hospital registry. Robotic gynecological procedures performed on five HIT lists between Nov 2023 and July 2024 were compared with standard elective NHS lists during the same period. Patient demographics, operative times, complication rates, and length of stay were analyzed. A total of 194 cases were included (164 standard, 30 HIT). Case complexity was lower in the HIT cohort (p = 0.049). Mean operative time was significantly reduced in the HIT group (72.5 vs. 129.3 min, p < 0.001), with no increase in postoperative complications (13% vs. 29%, p > 0.05). HIT patients had significantly shorter hospital stays (0.4 vs. 1.2 days, p < 0.001), and comparable rates of readmission and training case involvement. HIT robotic gynecological operating lists enable efficient, safe surgical care with shorter operative times and earlier discharge, without compromising training or patient safety. Wider adoption of this model may help to reduce NHS surgical backlogs and optimize theater utilization.

PMID:41055804 | DOI:10.1007/s11701-025-02858-5

Int Urol Nephrol. 2025 Oct 7. doi: 10.1007/s11255-025-04805-7. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate oncological outcome of external beam radiation therapy(EBRT) versus high-intensity focused ultrasound (HIFU) in patients with stage II prostate cancer.

MATERIALS AND METHODS: We retrospectively reviewed patients with stage II prostate cancer from the Chang Gung Research Database spanning the years 2005 to 2022. Inverse probability of treatment weighting (IPTW) method was performed to achieve baseline equivalence. Oncology outcomes including overall survival (OS) and cancer specific survival (CSS) were assessed using Kaplan-Meier curves before and after IPTW adjustment. Subgroup analysis of stage IIa, IIb, and IIc were also conducted. We use cox proportional hazards analyses to further evaluate the association between treatment and survival outcomes.

RESULTS: Total of 176 EBRT and 244 HIFU procedures were identified. EBRT group has higher overall mortality (9.2% compared to 16.7% after IPTW; standardized difference 0.224) and cancer specific mortality (5.4% compared to 9.2% after IPTW; standardized difference 0.144) after IPTW adjustment. An overall survival benefit is observed in the HIFU group for all stage II prostate cancer cases, with a particularly significant advantage in the stage IIa subgroup after IPTW adjustment (p = 0.032). Although the cancer-specific survival benefit slightly favors the HIFU stage IIa subgroup after IPTW adjustment, it does not reach statistical significance (p = 0.069). EBRT is associated with significantly worse OS compared to HIFU across univariate, multivariate, and IPTW-adjusted Cox regression models, with hazard ratios ranging from 2.03 to 2.63 (all p 0.05). However, for CSS, a significant difference was found only in the univariate model (HR = 2.38, p = 0.032), and this association was not maintained after adjustment.

CONCLUSIONS: HIFU demonstrates non-inferior overall survival and cancer specific survival compared to EBRT in patients with stage II prostate cancer, particularly in the stage IIa subgroup after more than 10 years of follow-up. Further randomized prospective studies are needed to evaluate the oncological outcomes of different prostate cancer treatment modalities.

PMID:41055797 | DOI:10.1007/s11255-025-04805-7

Laryngoscope. 2025 Oct 7. doi: 10.1002/lary.70163. Online ahead of print.

ABSTRACT

OBJECTIVES: Laryngology patient-reported outcome measures (PROMs) quantify symptoms related to voice, swallowing, and/or breathing. Vocal Cord Paralysis Experience (CoPE) is a PROM developed to evaluate disabilities associated with unilateral vocal fold paralysis (UVFP). The relationship between disease-specific and general symptom-based PROMs has not been previously studied in Laryngology. Correlations between CoPE and established Laryngology PROMs [e.g., Voice Handicap Index-10 (VHI-10), Eating Assessment Tool-10 (EAT-10), Dyspnea Index (DI)] assessed the role and added benefit of CoPE.

METHODS: Patients with UVFP at a tertiary Laryngology clinic completed CoPE, VHI-10, EAT-10, and DI during routine visits. Comparisons across PROMs were performed.

RESULTS: One hundred and eight unique data collection epochs were obtained from 80 patients (34 men, 46 women), mean age of 62.6 years. Mean scores were 43.4 ± 22 for CoPE, 21.2 ± 10.2 for VHI-10, 9.2 ± 8.5 for EAT-10, and 10.5 ± 9.9 for DI. Comparison of CoPE score to other Laryngology PROMS demonstrated statistically significant, positive correlations: CoPE versus VHI-10 (R = 0.596, p = 0.000), CoPE versus DI (R = 0.424, p = 0.000), and CoPE versus EAT-10 (R = 0.447, p = 0.000). CoPE subscale scores similarly demonstrated statistically significant, positive correlations: CoPE voice subscale versus VHI-10 (R = 0.641, p = 0.000) and CoPE swallowing subscale versus EAT-10 (R = 0.603, p = 0.000).

CONCLUSION: PROMs are critical for assessing UVFP-related functional impairments. CoPE does not appear to capture unique aspects of the UVFP experience not already covered by VHI-10, DI, and EAT-10. Furthermore, these commonly used Laryngology PROMs have broad utility across many pathologic conditions and can be implemented prior to diagnosis, offering psychometric advantages. Clinicians and researchers can confidently employ commonly used Laryngology PROMs or CoPE to report UVFP results.

PMID:41054944 | DOI:10.1002/lary.70163

Disabil Rehabil Assist Technol. 2025 Oct 7:1-13. doi: 10.1080/17483107.2025.2569791. Online ahead of print.

ABSTRACT

PURPOSE: Endometriosis is a common condition affecting around 10% of women of childbearing age worldwide. Currently, adapted physical activities (APA) are increasingly used in the context of chronic diseases, often in conjunction with digital devices to help overcome some of the barriers to regular practice. However, it is essential to examine the technological acceptability to optimise the future use of these devices. The main aim of this study is to analyse the intention of women with endometriosis to use digital tools offering physical activities and to identify the factors most likely to predict this intention.

MATERIALS AND METHODS: Participants completed an online survey, which included socio-demographic and medical questions, as well as subscales derived from the HITAM model on intention to use digital tools. The data were analysed using univariate and multivariate logistic regressions.

RESULTS AND CONCLUSION: A total of 313 women (Mean age = 34.4; SD = 8.69) met the inclusion and exclusion criteria. The statistical analyses showed that the intention to use a digital APA program was fairly high, with a preference for technologies that offer a high degree of freedom in practice. Analyses of the theoretical model showed in particular the importance of a favourable social discourse. The final model (perceived threat, norms, perceived ease of use, perceived usefulness, and age) explained 57.74% of the variance in intention. Findings should be interpreted with caution due to the self-selected online sample and the high dropout rate (899 incomplete responses).

PMID:41054937 | DOI:10.1080/17483107.2025.2569791

Head Neck. 2025 Oct 7. doi: 10.1002/hed.70066. Online ahead of print.

ABSTRACT

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy, with 50% of patients recurring. A subset of patients experience rapid recurrence (RR) postoperatively but prior to adjuvant therapy. This study identifies factors associated with RR and additional recurrence intervals: short-interval recurrence (SIR) and standard recurrence (SR).

METHODS: Retrospective 10-year review of 246 HNSCC patients undergoing surgery with adjuvant therapy. Recurrence was categorized as RR (prior to initiation of adjuvant therapy), SIR (≤ 6 months post-adjuvant therapy), and SR (> 6 months post-adjuvant therapy). Univariate analysis (UVA), multivariate analysis (MVA), and machine learning Random Forest models were employed to identify predictors of each recurrence interval.

RESULTS: Of the 246 patients, 89 recurred (45 SR, 27 SIR, 17 RR). On MVA, skin invasion (OR = 3.492, p = 0.039) was a unique predictor of RR. Random Forest feature importance also revealed skin invasion, along with nodal status, tobacco pack-years, and tumor size as predictors with strong performance (accuracy 93%, AUC 0.96, F1 0.93).

CONCLUSION: Skin invasion is a unique independent predictor of RR, confirmed by two statistical models. These patients warrant further study.

PMID:41054923 | DOI:10.1002/hed.70066

Am J Epidemiol. 2025 Oct 7:kwaf223. doi: 10.1093/aje/kwaf223. Online ahead of print.

ABSTRACT

Phenotype classification with electronic health record (EHR) data is increasingly performed with ML, however their performance in diverse populations remains understudied. We compared an ICD-based algorithm with an ML phenotyping pipeline to classify myocardial infarction (MI) in a general and self-reported Black population. We determined the impact of differential performance by replicating a published MI risk factor study with MI defined by the ICD or ML algorithms. Individuals followed in the Veterans Health Administration (VHA) EHR with data from 2002 to 2019 were examined: 11,523,175 Veterans, mean age 67.5 years, 93.8% male, 14.3% Black, 79.1% White. MI was classified using a published rule-based ICD algorithm and an ML pipeline, PheCAP which incorporates natural language processing. Algorithms were trained and validated against n=403 Veterans randomly selected and chart-reviewed for MI (gold standard), oversampled for self-reported Black. Among chart-reviewed Veterans, the ICD algorithm had high PPV and low sensitivity (all race, PPV:0.97, sensitivity:0.17; Black Veterans, PPV:0.94, sensitivity:0.24). PheCAP MI had good PPV and higher sensitivity (all race, PPV:0.90, sensitivity:0.66; Black, PPV:0.81, sensitivity:0.79). Applying PheCAP MI to the entire VHA population to classify MI provided increased power to replicate findings from the published MI risk factor study compared to the ICD algorithm.

PMID:41054913 | DOI:10.1093/aje/kwaf223

Nurs Crit Care. 2025 Nov;30(6):e70178. doi: 10.1111/nicc.70178.

ABSTRACT

BACKGROUND: Patients in the intensive care unit (ICU) require complex care with rapidly changing conditions, and missed nursing care (MNC) can lead to severe consequences. Investigating the current status and influencing factors of MNC in the ICU is essential to enhance patient safety, optimise care quality and improve nurse job satisfaction, providing evidence-based strategies for ICU nursing management.

AIMS: The aims of this study were to investigate the current status of MNC in ICU and to analyse its causes, providing insights to reduce missed care and improve the quality of nursing for critically ill patients.

STUDY DESIGN: This is a cross-sectional study, using convenience sampling, 191 ICU nurses from five tertiary hospitals in Sichuan Province were selected as participants from 1 June 2024 to 30 June 2024. Data were collected through a general information questionnaire and the Missed Nursing Care in Intensive Care Units Scale.

RESULTS: A total of 191 questionnaires were sent out in this survey, and finally, 185 were included for data analysis. The score for MNC in ICU was 72.14 ± 15.61 points. All nurses reported experiencing at least one instance of missed care during their shifts. The most frequently missed care items were as follows: assisting and guiding patients in early rehabilitation, analgesia and sedation management and psychosocial assessment of critically ill patients. Statistical analysis revealed that MNC in ICU was significantly influenced by nurses’ gender, education level, professional title, ICU type and patient load (p < 0.05). The score for reasons behind MNC was 63.24 ± 18.53 points. The primary contributing factors were as follows: heavy nurse workload, excessive patient transfers, high frequency of patient condition changes and emergency events. ICU type (Internal Medicine ICU/comprehensive ICU), patients load (≥ 4 patients/nurse) and characteristics (master’s degree and above, intermediate nurse) emerged as modifiable risk factors for MNC.

CONCLUSION: Missed nursing care occurs frequently in ICU and is influenced by multiple factors. These findings suggest that nursing administrators should ensure adequate nurse staffing levels and enhance training programmes on MNC awareness, and improve nurses’ understanding of this phenomenon. These measures would effectively reduce missed care occurrences and subsequently improve ICU nursing quality.

RELEVANCE TO CLINICAL PRACTICE: This study identifies missed nursing care (MNC) in intensive care units (ICUs), particularly in rehabilitation, pain management and psychosocial support.

KEY FINDINGS: Staffing/workload (≥ 4 patients/nurse) and unit type (medical/general ICUs) significantly increase MNC. Non-urgent but critical care (e.g., psychological support) is often deprioritised.

SOLUTIONS: Implement safe staffing ratios, train nurses on MNC consequences and optimise workflows (e.g., standardised handoffs).

PMID:41054904 | DOI:10.1111/nicc.70178

J Interpers Violence. 2025 Oct 7:8862605251378991. doi: 10.1177/08862605251378991. Online ahead of print.

ABSTRACT

Research on aggression towards family/caregivers in childhood and adolescence (AFCCA) is still emerging, particularly within the Canadian context. To better understand this behaviour, we examined potential changes in the severity and frequency of different AFCCA types as well as in caregiver-child relationships and disruptions to families’ lives during the COVID-19 pandemic. In this convergent/parallel mixed-method research study, 168 Canadian caregivers living with a young person who exhibited AFCCA completed an online survey that contained self-report questionnaires and open-ended questions. The sample consisted primarily of adoptive mothers. Descriptive and hybrid thematic analyses indicated that around half the sample reported an increase in the severity (verbal 43.9%, threats 39.8%, emotional/psychological 49.2%, physical 44.3%) and frequency (verbal 51.2%, threats 47.8%, emotional/psychological 54.6%, physical 48.3%) of most AFCCA types. The quality of the caregiver-child relationship also worsened significantly after the pandemic (t[115] = 3.5, p = .001). Qualitative analyses supported this finding. While there was no statistically significant difference in AFCCA-related disruptions to families’ lives during the pandemic, thematic analyses revealed increased caregiver disruptions to both personal aspects (e.g. self-care practices, alcohol/substance use) and professional obligations (e.g. missed work). This study underscores the need for sustained and accessible (online and in-person) supports that are grounded in intersectionality, responsive to families’ unique needs and sensitive to young people’s experiences with past adversity.

PMID:41054876 | DOI:10.1177/08862605251378991

Scand J Public Health. 2025 Oct 7:14034948251380639. doi: 10.1177/14034948251380639. Online ahead of print.

ABSTRACT

AIMS: The aim was to investigate short (1-3 days) sickness absence (SA) and remote work in 2019-2023 among a cohort of Finnish knowledge workers. A specific aim was to investigate the role of working hours and the associations between remote work and SA and if the associations would differ before, during, or after the COVID-19 pandemic.

METHODS: Employer-owned register data of 5535 knowledge workers for working hours (daily and weekly working hours), remote workdays/week, and short, 1-3 days, SA from 2019 to 2023 were investigated with a fixed-effects Poisson regression analysis for incidence rate ratios (IRRs) with 95% confidence intervals (95%CI).

RESULTS: The overall associations between remote work and short SA indicated that each 1-day increase in remote workdays was associated with higher odds of short SA (IRR 1.27, 95%CI 1.24, 1.30). The comparison across the years 2019-2023 showed varying associations. In the pre-pandemic year, 2019, there was no statistically significant association between remote workdays and short SA. Since 2021, doing no remote work has been associated with a lower likelihood of short SA. Instead, working remotely for 1-2 days or 3-5 days/week was associated with higher likelihood only when compared with no remote work.

CONCLUSIONS: Among knowledge workers, remote work seems related to short, 1-3 days of SA only after the COVID-19 pandemic. The possibility of working remotely might be an important factor in mitigating infections, while our results raise the assumption that presenteeism might be prevalent in remote work.

PMID:41054839 | DOI:10.1177/14034948251380639