Tag: nevin manimala

Sex Health. 2025 Dec 23;22(6):SH24236. doi: 10.1071/SH24236.

ABSTRACT

BACKGROUND: Congenital syphilis is a preventable disease and a direct reflection of rates of syphilis in the population. Between 2013 and 2022, Australia’s infectious syphilis notification rate increased six-fold in women. Between 2013 and 2022, 54% (n = 45) of congenital syphilis cases were reported in Aboriginal infants, and 61% (n = 11) of congenital syphilis-associated deaths between 2016 and 2022 occurred in Aboriginal infants. In 2018, Communicable Diseases Network Australia National Guidelines were updated, recommending syphilis serology testing five times for women during the perinatal period in outbreak areas. The aim of the study was to gain an understanding of the rates of perinatal syphilis serology testing, and to formulate recommendations on how syphilis serology testing can be improved for pregnant Aboriginal women in the Northern Territory.

METHODS: A retrospective audit of antenatal and postpartum episodes of care and syphilis serology testing of Aboriginal women who birthed a live born or stillborn baby was undertaken at four sites including three Northern Territory Health remote clinics and one Aboriginal Community Controlled Health Service. This was an audit of electronic medical records, between 1 May 2019 and 31 March 2021.

RESULTS: The study found that 94% (n = 358) and 93% (n = 357) of Aboriginal women had a first antenatal episode of care and first antenatal syphilis test, respectively. The proportion receiving syphilis serology decreased to a greater extent than the number of women attending antenatal episodes of care with increase in gestational age. Postpartum episodes of care were attended by 27% (n = 103) of Aboriginal women, with 29% (n = 112) having a postpartum syphilis test.

CONCLUSION: Pregnant Aboriginal women are attending for antenatal care; however, the majority are not having syphilis tests as per current guidelines. It is recommended that the primary healthcare sector implement a prompt system for syphilis serology testing, provide more opportunistic syphilis serology testing and monitor adherence to syphilis serology testing guidelines in pregnancy.

PMID:41243092 | DOI:10.1071/SH24236

Res Integr Peer Rev. 2025 Nov 17;10(1):24. doi: 10.1186/s41073-025-00183-x.

ABSTRACT

BACKGROUND: Research methodology education aims to equip students with the foundational knowledge of robust scientific practices, emphasizing deep understanding of scientific inquiry, integrity, and critical thinking in research practice. A literature review reveals that the observed diversity in research methods course design and instruction stems from a lack of consensus about the essential foundations required to critically engage with, design, and execute research in education. This is further compounded by a limited pedagogical innovation. However, no study has yet investigated how research methodology is taught and perceived across European universities. The objective of this study is to examine practices and attitudes regarding teaching research methodology in different European countries, across different disciplines and different training stages to identify commonalities and discrepancies.

METHODS: A cross-sectional survey was designed based on the Structure of Observed Learning Outcome (SOLO) taxonomy and further developed in several rounds of expert input and feedback, ensuring comprehensive inclusion of diverse teaching formats and assessment types. The survey was distributed to research methodology and non-research methodology higher education teachers across Europe through stratified and snowball sampling methods.

RESULTS: The survey was completed by 559 respondents across 24 countries and seven disciplinary categories. The findings identified a predominant reliance on traditional passive teaching formats, such as face-to-face or online lectures. Active methods such as flipped classroom (8.4% Bachelor, 4.8% Master, 2.3% PhD) and protocol writing (8.2% Bachelor, 6.6% Master, 3.9% PhD) were less frequently used. Written exams dominated assessment strategies at all levels. Across our stratification levels, all topics were rated very important, with hypothesis formulation, research integrity, and study design as the most necessary topics, while pre-registration, peer review, and data management plan were prioritized slightly less.

CONCLUSIONS: These findings reveal relative homogeneity in research methodology teaching across academic levels and disciplines in Europe. The persistence of passive teaching formats and the limited adoption of active methodologies reflects an untapped opportunity to improve the effectiveness of research methodology education in fostering critical thinking and ethical practices. Higher education institutions need to reevaluate research methodology curricula to better align with contemporary research demands.

PMID:41243091 | DOI:10.1186/s41073-025-00183-x

J Robot Surg. 2025 Nov 17;20(1):18. doi: 10.1007/s11701-025-02987-x.

ABSTRACT

BACKGROUND: Robotic surgery has revolutionized minimally invasive procedures by integrating advanced technology and improving outcomes. While adoption is increasing in East Asia, nationwide analyses across surgical specialties are limited. This study presents a 14-year analysis (2011-2024) of robotic surgery in Taiwan to elucidate trends on a national level and to provide insights to guide future surgical development and innovation.

MATERIALS AND METHODS: Data were collected from the Taiwan National Health Insurance Research Database from January 2011 to December 2024. Key metrics included the number and growth of certified robotic surgeons and the distribution of robotic surgical cases by specialty. Statistics with a focus on trend analysis were examined using Microsoft Excel^® (Microsoft 365).

RESULTS: Between 2011 and 2024, Taiwan saw a 13-fold increase (from 6 to 78) in da Vinci system installations and a rise in certified robotic surgeons from 38 to 697. Robotic case volume increased 23-fold (from 732 to 16,770). Urology remained dominant (43.1%), followed by gynecology (22.3%), general surgery (10.3%) and colorectal surgery (8.7%). Emerging adoption in otorhinolaryngology (8.0%), thoracic surgery (5.1%), and cardiovascular surgery (2.5%) reflect growing confidence in robotics for complex, high-risk procedures. These trends underscore Taiwan’s expanding multidisciplinary integration of robotic surgery.

CONCLUSIONS: This analysis highlights the evolution of robotic surgery in Taiwan, exemplifying broader innovation within East Asia. Robotic surgery remains promising across specialties, and ongoing technological integration and structured training are needed to sustain and expand its clinical impact.

PMID:41243064 | DOI:10.1007/s11701-025-02987-x

Ann Biomed Eng. 2025 Nov 16. doi: 10.1007/s10439-025-03898-6. Online ahead of print.

ABSTRACT

PURPOSE: This paper investigates the well-known Empirical Wavelet Transform (EWT) and the recently introduced Empirical Fourier Decomposition (EFD) for the early diagnosis of Alzheimer’s disease (AD). Both synthetic signals and real EEG data are decomposed and reconstructed, particularly under noisy conditions.

METHODS: EWT and EFD were applied to decompose non-stationary EEG signals into five sub-bands (Delta, Theta, Alpha, Beta, and Gamma). From each sub-band, eight features were extracted and used to classify subjects into AD and Mild Cognitive Impairment (MCI) groups. Among the five classifiers tested, Random Forest (RF) yielded the best performance for both EWT and EFD. In addition to conventional evaluation metrics, Dynamic Time Warping (DTW) and the Kolmogorov-Smirnov (KS) statistic were used for algorithm assessment.

RESULTS: The results show that EFD outperforms EWT and achieves competitive performance compared to state-of-the-art approaches.

CONCLUSION: EFD is a novel decomposition method that demonstrates robust performance on both synthetic and real EEG signals, supporting its potential use in the early diagnosis of Alzheimer’s disease.

PMID:41243056 | DOI:10.1007/s10439-025-03898-6

J Robot Surg. 2025 Nov 17;20(1):20. doi: 10.1007/s11701-025-02974-2.

ABSTRACT

Open retroperitoneal lymph node dissection (O-RPLND) has historically been the established standard surgical procedure for managing retroperitoneal lymph node disease in testicular cancer. In recent years, however, the adoption of robotic surgical systems has led to a gradual shift in urological practice, with numerous procedures traditionally performed via open surgery being increasingly accomplished using robotic techniques. This study aims to systematically compare the perioperative safety and clinical efficacy of robotic-assisted retroperitoneal lymph node dissection (RA-RPLND) versus O-RPLND in the treatment of testicular cancer. Following the AMSTAR quality rating criteria and PRISMA principles, a thorough literature search was carried out. With no start date restrictions, databases such as Web of Science, Embase, PubMed, and the Cochrane Library were searched for pertinent papers until September 2025. The study was prospectively registered in PROSPERO with the registration number CRD420251147469. Statistical analyses were carried out with Review Manager version 5.4. WMD and OR were used as effect measures for continuous and dichotomous variables, respectively, with 95% CIs. This meta-analysis incorporated 10 comparative studies comprising 6,802 patients, including 587 who underwent RA-RPLND and 6,215 treated with O-RPLND. The analysis revealed that RA-RPLND was associated with significantly prolonged operative duration (WMD = 47.71 min; 95% CI: -0.62 to 96.04; P = 0.05), yet demonstrated advantages in reduced hospitalization period (WMD = -3.89 days; 95% CI: -4.89 to -2.88; P < 0.00001). The robotic approach also showed superior outcomes in terms of diminished intraoperative blood loss (WMD = -135.11 ml; 95% CI: -162.50 to -107.71; P < 0.00001) and lower transfusion requirements (OR = 0.11; 95% CI: 0.06 to 0.21; P < 0.00001). No statistically significant differences were observed between the surgical approaches regarding overall complications, major complications (Clavien-Dindo grade ≥ III), lymph node yield, nodal positivity rates, recurrence during surveillance, or postoperative ejaculatory function. ​​Conclusion:​​ Both RA-RPLND and O-RPLND demonstrate acceptable safety and efficacy profiles for patients with testicular cancer. While the robotic technique needs longer operational durations, it has some advantages, including less blood loss, fewer transfusions, shorter hospital stays, and faster recovery. RA-RPLND therefore offers a feasible alternative to traditional open surgery. However, more studies with longer follow-up periods are needed to establish its long-term oncological results and safety profile.

PMID:41243044 | DOI:10.1007/s11701-025-02974-2

J Robot Surg. 2025 Nov 17;20(1):21. doi: 10.1007/s11701-025-02964-4.

ABSTRACT

Robotic surgical platforms facilitate accurate dissection with the help of high-definition 3D camera and greater freedom of manoeuvrability of robotic instruments. Aim was to evaluate short-term results (mucosal integrity and hospital stay) and long-term outcomes [symptom improvement and Quality of life (QoL)] of patients undergoing Robotic Heller’s Cardiomyotomy (RHC). A retrospective analysis of data collected prospectively of achalasia patients undergoing primary RHC between July 2009 and June 2025 was performed. Information collected were demography, Eckardt symptom score (ESS), QoL scores with SF-36, type and stage of achalasia, peri and post-operative data. Sixty-eight patients underwent RHC (33-males). Median age was 46 years (18-82). Median length of myotomy was 8 cm (7-11). Median length of hospital stay was 2 days (1-28). One patient had aspiration pneumonia and DVT, and another had a postoperative leak needing emergency surgery. There was no mortality. Median follow-up was 102 months (3- 192). Twenty-one (31%) needed further intervention during follow-up. There was a significant improvement in ESS and in all components of QoL (p < 0.05). RHC can be performed accurately with a very low leak rate. RHC improves symptoms and quality of life and is an alternative to Laparoscopic Heller’s Cardiomyotomy or per-oral endoscopic myotomy (POEM) in the Modern Era.

PMID:41243042 | DOI:10.1007/s11701-025-02964-4

Egypt Heart J. 2025 Nov 16;77(1):107. doi: 10.1186/s43044-025-00705-4.

ABSTRACT

BACKGROUND: Ischaemic heart disease (IHD) is a leading cause of mortality and morbidity globally. Coronary angioplasty has a vital role in treating coronary artery disease. However, this is associated with a small risk of serious side effects, including contrast-induced nephropathy, vascular complications and arrhythmia. Contrast-induced nephropathy (CIN) is a serious and common complication of coronary angioplasty that can lead to renal failure and major adverse cardiac and renal outcomes.

METHODS: We conducted a systematic review and meta-analysis by searching multiple databases, including PubMed, Scopus, Embase, Google Scholar, and ScienceDirect, as well as other sources. The inclusion and exclusion criteria are described in detail later in this article. Two independent reviewers performed the literature search in September 2024 and identified 282 articles. The study was conducted following the population, intervention, comparator, and outcome (PICO) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 17 studies were included in the final analysis after applying the inclusion and exclusion criteria. The exclusion criteria were guidelines, case reports, qualitative research, and letters to the editor, commentaries, conference proceedings, gray literature, opinions, policy papers, and case series. Articles published after 2010 were included in this meta-analysis, and data analysis was performed using Rayyan statistical software.

RESULTS: This study demonstrated that nicorandil was associated with protective effects against CIN. The total number of patients in the Nicorandil and placebo groups were 3836 and 3858 respectively. The occurrence of CIN was 5.14% in the nicorandil group, compared with 13.15% in the control group. This study also confirmed the dose-dependent effect of nicorandil on CIN. Among 662 patients enrolled in three studies, 3,9% in the double dose (DD) group presented with CIN, compared with 8,4% in the standard dose (SD) group. The occurrence of MACE was 5.7% in the Nicorandil group and 8.2% in the control group. However, there was no statistically significant protective effect against major adverse cardiovascular events (MACE) or major adverse kidney events (MAKE). Only a few studies measured the impact on MAKE, and the findings may not be truly representative of its effects.

CONCLUSION: This study demonstrated the renoprotective effects of nicorandil in preventing CIN in patients undergoing coronary angioplasty, and this relationship was also evident from the double-dose response. Further larger size randomised controlled trials are recommended to assess the efficacy of nicorandil in preventing CIN in patients undergoing coronary angioplasty.

PMID:41243041 | DOI:10.1186/s43044-025-00705-4

J Robot Surg. 2025 Nov 17;20(1):16. doi: 10.1007/s11701-025-02975-1.

ABSTRACT

The present research provides a comprehensive systematic review of the safety and effectiveness of robotic-assisted artificial urinary sphincter (AUS) implantation in treating urodynamic stress incontinence. In line with the PRISMA framework and a protocol registered in PROSPERO, we conducted a comprehensive search of PubMed, Web of Science, and the Cochrane Library for relevant studies published from inception to August 2025. Key perioperative parameters-operative time, estimated blood loss, hospital stay, continence rate, and complication rate-were extracted. Data analysis was carried out using STATA software, with heterogeneity assessed by the I² statistic and sensitivity by leave-one-out analysis. Eight studies involving 328 patients were included. Among three comparative cohorts (n = 224), operative time did not differ between robotic and open AUS (WMD = 7.62, 95% CI [-57.94, 73.17], I²=97.4).The robotic group showed significantly more blood loss (WMD = 293.5, 95% CI [81.4, 505.75], I²=95.2), more perioperative complications (OR = 3.9, 95% CI [1.75, 8.66], I²=35.5), and more hospital stay (WMD = 4.71, 95% CI [2.26, 7.16], I²=87.5). Pooled analysis of robotic cases indicated a mean operative time of 197.06 min(95% CI [177.82, 216.29], I²=86.9), mean blood loss of 19.8 mL (95% CI [14.05, 25.55], I²=0.3), hospital stay of 4.85(95% CI [4.12, 5.57], I²=88) days, and an overall complication rate of 37%(95% CI [0.27, 0.5], I²=16.6). Robot-assisted AUS implantation is a safe and effective option for treating urodynamic stress incontinence, with benefits such as reduced blood loss and faster recovery. However, the moderate risk of bias and high heterogeneity among studies limit the reliability of the findings. Larger, high-quality trials are needed to confirm its long-term efficacy.

PMID:41243039 | DOI:10.1007/s11701-025-02975-1

J Expo Sci Environ Epidemiol. 2025 Nov 16. doi: 10.1038/s41370-025-00807-w. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence of nontuberculous mycobacterial (NTM) pulmonary infection (NTM PI) varies geographically in the United States (US). Previous studies indicate that trace metals in environmental source water increase NTM PI risk.

OBJECTIVE: To examine the effect of trace metals, chromium (Cr), cobalt (Co), molybdenum (Mo), strontium (Sr), and vanadium (V) in public distribution system water on NTM PI risk among susceptible persons in the US.

METHODS: We studied NTM PI risk as a function of trace metal exposure from public distribution system water in two US patient populations: (1) The Cystic Fibrosis Foundation Patient Registry. (2) The Centers for Medicare and Medicaid Services. Patient data were extracted for the period 2010-2019. We obtained data on trace metal concentrations from the US Environmental Protection Agency, Third Unregulated Contaminant Monitoring Rule dataset. We used logistic and negative binomial generalized linear models to estimate NTM PI risk as a function of trace metal exposure in treated drinking water at the county level. Our models were adjusted for patient demographics, source water type, climate variables, and the type of disinfectant used.

RESULTS: Our cystic fibrosis (CF) population comprised 14,251 persons with CF, including 4020 NTM cases and 10,231 controls. Our Medicare population comprised 27,146,753 beneficiaries, including 84,075 NTM cases. In the Medicare analysis, V was associated with increased NTM PI risk in the Midwest, South, and West, while Mo increased NTM PI risk in the West. In the CF analysis, V increased NTM PI risk in the South, while Mo was associated with increased NTM PI risk in the West. In both the CF and Medicare populations, using chloramine as a disinfectant significantly increased NTM PI risk.

SIGNIFICANCE: Mo and V in treated water was associated with increased risk among persons susceptible to NTM PI. The effect of trace metals varies by geographic region IMPACT: The incidence and prevalence of NTM, a waterborne pulmonary infection, have been increasing in the US and have been shown to vary geographically. Our study has shown that trace metals, specifically molybdenum and vanadium, in treated drinking water significantly increase the risk of NTM pulmonary infection across the US. Our study also shows that the effect of trace metals varies by geographic region. Our research may lead to the monitoring of trace metals in drinking water as well as in susceptible populations, and ultimately, may be incorporated into a framework for NTM prevention efforts.

PMID:41243028 | DOI:10.1038/s41370-025-00807-w

Eur Arch Otorhinolaryngol. 2025 Nov 16. doi: 10.1007/s00405-025-09816-9. Online ahead of print.

ABSTRACT

BACKGROUND: Cochlear implantation (CI) is a proven treatment for severe-to-profound hearing loss, yet outcomes vary widely due to individual, device, and surgical factors. Intracochlear changes, such as fibrosis and neo-ossification, influence electrode impedance and device performance, potentially affecting speech perception.

PURPOSE: This study investigates the effects of early activation (EA) versus standard activation on intracochlear impedance telemetry across different electrode types (lateral vs. perimodiolar). It aims to assess whether EA reduces the impedance and improves CI outcomes.

METHODS: This study involved 38 participants (54 CI ears) with Cochlear slim-straight or slim perimodiolar electrodes. Impedance telemetry was measured at four key time points, ranging from intra-operative to 12 months post-activation. Mixed-effects regression models evaluated the influence of activation timing and electrode type on impedance levels, with statistical significance determined using Bonferroni-corrected thresholds.

RESULTS: Perimodiolar electrodes demonstrated significantly lower impedances compared to lateral electrodes, particularly in EA cases. EA consistently resulted in reduced impedances across all cochlear regions, with the greatest reductions observed in the apical and middle regions at 3-6 months (p < 0.0001). By ≥ 1 year, impedance differences between activation modes diminished but remained significant in select regions (p = 0.012).

CONCLUSION: EA, particularly with perimodiolar electrodes, optimizes the electrode-tissue interface, reducing impedance and potentially improving CI performance. These findings highlight the clinical benefits of EA in enhancing CI outcomes and support its consideration in routine CI protocols.

PMID:41243018 | DOI:10.1007/s00405-025-09816-9