Tag: nevin manimala

Arch Orthop Trauma Surg. 2026 Jul 9;146(1):251. doi: 10.1007/s00402-026-06411-3.

ABSTRACT

INTRODUCTION: Periprosthetic joint infections (PJIs) complicate 1-2% of primary and up to 4% of revision arthroplasties, and their diagnosis remains challenging due to the lack of a diagnostic gold standard. Differentiating PJI from aseptic failure is particularly difficult in low-grade or biofilm-related infections. Routine intraoperative microbiological screening is not recommended in presumed aseptic revisions. This study aimed to evaluate the association between routine intraoperative microbiological screening and implant survival in presumed aseptic revision arthroplasty. A secondary objective was to identify preoperative predictors of unexpected PJIs.

METHODS: Retrospectively collected data of patients undergoing presumed aseptic THA and TKA revisions between 2013 and 2019 were included. Two matched cohorts were compared: a screened group (2016-2019) undergoing routine intraoperative microbiological sampling, and an unscreened one (2013-2015) without systematic screening. Kaplan-Meier survival analysis with log-rank testing assessed overall and infection-free survival. Univariate conditional logistic regression and receiver operating characteristic (ROC) analyses evaluated potential associations between preoperative serum markers and unexpected PJI.

RESULTS: A total of 559 patients were included, of whom 295 underwent screening and 264 did not. Unexpected infections occurred in 20.3% (n = 60) of screened patients. No significant differences in implant survival were observed between groups. Although overall and infection-free survival were numerically higher in the screened cohort, these differences were not statistically significant (p = 0.168 and p = 0.118, respectively). Stratified analyses by joint and failure mechanism showed comparable findings. C-reactive protein and erythrocyte sedimentation rate were associated with unexpected PJI (p = 0.004 and p = 0.046), but ROC analysis suggested limited discrimination of individual markers, whereas a combined serum model improved diagnostic performance (AUC = 0.833).

CONCLUSIONS: Routine intraoperative microbiological screening in presumed aseptic revision arthroplasty was not associated with a significant improvement in implant survival. Future studies should investigate whether selective screening improves outcomes. Level III retrospective cohort study.

PMID:42426411 | DOI:10.1007/s00402-026-06411-3

Surg Endosc. 2026 Jul 9. doi: 10.1007/s00464-026-13107-7. Online ahead of print.

ABSTRACT

BACKGROUND: The Area Deprivation Index (ADI) is an important measure of neighborhood-level socioeconomic status (SES). Our study evaluates the correlation of ADI scores to post-operative clinic follow up compliance and completion of pre-operative high-resolution manometry (HRM) in patients with Achalasia undergoing Peroral Endoscopic Myotomy (POEM).

METHODS: We conducted a retrospective cohort study of adult patients undergoing POEM at a single tertiary care center between March 2017 and December 2024 (N = 193). ADI was assigned using 2023 national rankings based on patient residential addresses. Analyses were restricted to patients with available ADI data (n = 181). Multivariable logistic regression was performed adjusting for age, travel distance, sex, body mass index (BMI), and smoking status.

RESULTS: Patients who did not complete pre-operative HRM had higher ADI scores (89 [IQR 21]) compared to those who did (85 [IQR 29]), (p = 0.015). Patients who did not attend initial or overall post-operative follow-up also had higher ADI scores compared to those who completed follow-up. Median ADI was higher among patients with incomplete initial follow-up (90 [IQR 17] vs 85 [IQR 28]; p = 0.068) and overall follow-up (91 [IQR 18] vs 85 [IQR 27]; p = 0.064); however, these differences did not reach statistical significance on non-parametric testing. Mean values demonstrated similar patterns but were statistically significant on parametric analysis (p = 0.010 and p = 0.013, respectively). In multivariable logistic regression analysis, higher ADI rank was independently associated with increased odds of failing to complete pre-operative HRM (OR 1.04, 95% CI 1.01-1.07, p = 0.005). Age, travel distance, sex, BMI, and smoking status were not significantly associated with HRM completion (all p > 0.05).

CONCLUSION: Patients with higher ADI scores were less likely to complete HRM pre-operative testing. ADI scores can be used as a measure to risk stratify Achalasia patients undergoing POEM.

PMID:42426394 | DOI:10.1007/s00464-026-13107-7

Surg Endosc. 2026 Jul 9. doi: 10.1007/s00464-026-13090-z. Online ahead of print.

ABSTRACT

BACKGROUND: Oligometastatic prostate cancer (omPC) represents a specific state with improved outcomes following cytoreductive radical prostatectomy (cRP). Prognostic factors that guide disease progression are yet to be fully elucidated, and the role of pelvic lymph node dissection (LND) in this setting is controversial. This study aimed to evaluate the impact of LND on biochemical progression and castration-resistant prostate cancer (CRPC) in patients with omPC.

METHODS: A total of 169 omPC patients who underwent cRP with (n = 123) or without LND (n = 46) between January 2015 and February 2024 at multiple centers were retrospectively analyzed. Biochemical progression-free survival (bPFS) and time to CRPC were analyzed using Kaplan-Meier curves and Cox proportional hazards models. Subgroup analysis stratified by nodal status was performed to explore differential treatment effects.

RESULTS: In the overall cohort, multivariable analysis identified initial PSA > 30 ng/mL as an independent predictor of biochemical progression (HR = 2.53, 95% CI: 1.40-4.58, p = 0.002). For CRPC progression, no variable reached conventional statistical significance in the multivariable model. Stratified analysis revealed that among patients with node-positive disease (N1, n = 40), LND was associated with significantly prolonged bPFS (p = 0.018) and delayed progression to CRPC (p = 0.014). Notably, within the LND cohort (n = 123), N1 patients had significantly higher Gleason scores and T stages, and experienced worse CRPC than N0 patients (p = 0.02).

CONCLUSION: In omPC patients undergoing cRP, high baseline PSA independently predicted biochemical recurrence. Nodal involvement was associated with more aggressive disease features and worse outcomes within the population. An exploratory subgroup analysis suggested that node-positive patients may be associated with improved outcomes after LND; however, this finding was limited by a very small sample size and requires prospective validation.

PMID:42426390 | DOI:10.1007/s00464-026-13090-z

Surg Endosc. 2026 Jul 9. doi: 10.1007/s00464-026-13121-9. Online ahead of print.

ABSTRACT

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) slow gastric emptying and may therefore increase the risk of retained gastric contents (RGC). The optimal duration of discontinuation before esophagogastroduodenoscopy (EGD) under sedation or general anesthesia remains controversial.

METHODS: We conducted a single-center, retrospective, observational study of patients who underwent elective EGD between August 2023 and May 2025. According to GLP-1RA exposure, patients were classified as (i) no GLP-1RA use, (ii) GLP-1RA continued use, or (iii) GLP-1RA two-week hold. The primary outcome was the presence of RGC, defined as any solid residue or > 100 mL of fluid visualized during EGD. Multivariate logistic regression was used to explore the relationship between GLP-1RA use and RGC.

RESULTS: RGC occurred in 0.4% (63/15902) of patients with no GLP-1RA use, 5.83% (6/103) of patients with GLP-1RA continued use, and 1.61% (1/62) of patients with GLP-1RA two-week hold. GLP-1RA continued use was associated with a tenfold higher RGC risk versus no GLP-1RA use (odds ratio [OR] 10.68, 95% CI 3.74-30.55; p < 0.001), whereas a two-week hold reduced risk to a level statistically comparable with no GLP-1RA use (OR 2.99, 95% CI 0.37-23.89, p = 0.302). Obesity (BMI ≥ 28 kg/m²) independently increased RGC risk and, even after a two-week hold, yielded a tenfold higher risk of RGC versus no GLP-1RA use. Additionally, concurrent colonoscopy exerted a strong protective effect of RGC, and no RGC events occurred in patients with GLP-1RA two-week hold and concurrent colonoscopy.

CONCLUSIONS: A two-week hold of GLP-1RA lowered RGC incidence to a low level comparable with no GLP-1RA use, especially in normal-weight or overweight patients and in those undergoing concurrent colonoscopy, but may be insufficient for obesity.

PMID:42426387 | DOI:10.1007/s00464-026-13121-9

J Racial Ethn Health Disparities. 2026 Jul 9. doi: 10.1007/s40615-026-03092-x. Online ahead of print.

ABSTRACT

BACKGROUND: Awareness of cancer risk factors and perceptions about cancer is necessary to identify appropriate targets for cancer prevention interventions. To date, studies examining these factors among Black individuals- a population that experiences disparities in cancer-related incidence, outcomes, and survivorship – have not explored differences within ethnic subgroups. This study examined the awareness of cancer risk factors and cancer perceptions among African Americans and Sub-Saharan African immigrant adults and their associations with sociodemographics.

METHODS: This was a cross-sectional study that sampled African Americans and Sub-Saharan African immigrant adults aged 18-75 years between November 2020 and April 2022. Participants were recruited from the community using approved flyers and snowballing. We analyzed a self-administered survey that included measures of awareness of cancer risk factors, cancer perceptions, and sociodemographics. Descriptive statistics and logistic regression evaluated associations of sociodemographics with awareness of cancer risk factors and cancer risk perceptions variables.

RESULTS: A total of 197 adults completed the surveys, including 109 African Americans and 88 Sub-Saharan African Immigrants (mean age = 41.5; SD = 12.9) and 59.4% female. The mean score of participants’ awareness of cancer risk factors was 6.5 (SD = 3.3) on a scale range 0 to 13 and the cancer perceptions mean score was 13.8 (SD = 2.8) on a scale range 5 to 25. Educational attainment was associated with higher cancer risk factors awareness among African Americans but had no association among Sub-Saharan African immigrants. Every one-level increase in educational attainment among African Americans was associated with a 1.0-point increase in cancer risk awareness (b = 1.048, SE = 0.320, p = .001). The reported association is from a covariate adjusted model.

CONCLUSION: Interventions should target individuals at higher risk of limited awareness of cancer risk factors and cancer misconceptions by implementing culturally tailored, community-based educational programs that leverage trusted community settings and provide accessible, relevant cancer prevention information.

PMID:42426352 | DOI:10.1007/s40615-026-03092-x

Sci Rep. 2026 Jul 9;16(1):21398. doi: 10.1038/s41598-026-61611-6.

ABSTRACT

Previous work showed that physical fitness (PF) is more strongly related to body composition (BC) than self-reported physical activity (PA) in adults. In this study, we provide post-COVID BC statistics and evaluate the reproducibility of previously observed associations between PA, PF, and BC. We analyzed cross-sectional data from 320 adults aged 34-82 years collected in 2025 and compared them with data from 2021. PA was assessed using a validated questionnaire. PF was measured through a standardized performance test battery and BC was obtained via bioelectrical impedance analysis. Associations between PA, PF, and BC were analyzed using sex-specific linear regression models. No significant differences in BC were found between 2021 and 2025. Participants had higher PA and muscular strength but lower coordination in 2025 compared to 2021. PF showed stronger associations with BC than PA. Muscular strength remained the most important predictor of BC and showed the strongest association with phase angle (males: β = 0.40, p < .001; females: β = 0.31, p = .002). The consistency of these associations across two independent samples from 2021 to 2025 indicates a robust pattern under different societal conditions and highlights the importance of PF for supporting healthy aging with regard to BC.

PMID:42426330 | DOI:10.1038/s41598-026-61611-6

J Cancer Educ. 2026 Jul 10. doi: 10.1007/s13187-026-02938-6. Online ahead of print.

ABSTRACT

Community-engaged research (CEnR), a collaboration between academics and community partners, is an effective approach in addressing the social drivers of health (SDOH) and health disparities in local communities. Yet, CEnR training is often not a standard component of training programs in research or clinical programs. To meet the need for CEnR training, we developed and implemented a workshop to increase CEnR knowledge and skills among clinician-scientists and early-stage investigators (ESIs), and create opportunities for ongoing mentorship and professional development. In this manuscript, we discuss the organization of this workshop, learning objectives, supporting activities, and follow-up methods to facilitate a successful and engaging training experience. The workshop was developed through collaborative efforts with experts in CEnR, Community-Based Participatory Research (CBPR), cancer disparities, and SDOH. The workshop focused on (1) an introduction to CEnR and the opportunity for attendees to develop their own CEnR research ideas; (2) varied presentations, interactive activities, experiential learning, and discussion topics to fulfill the workshop’s learning objectives; (3) year-long opportunities for professional development and continued mentorship; and (4) evaluations of the workshop. Twenty-four ESIs and 11 clinician-scientists participated in the workshop. Using survey methods and descriptive statistics, the workshop was evaluated positively by participants. This manuscript provides guidance for both in-person and virtual workshop formats, from inception to implementation, and recommendations for other workshop facilitators. The impact of these workshops has the potential to have positive downstream implications for community-engaged research.

PMID:42426323 | DOI:10.1007/s13187-026-02938-6

J Math Biol. 2026 Jul 9;93(2):16. doi: 10.1007/s00285-026-02434-x.

ABSTRACT

Strain evolution poses a global threat, yet medical resources often fall short of meeting the demands of such public health emergencies. To examine how constrained medical resources and random factors influence disease transmission dynamics, this study incorporates the limited number of hospital beds into a stochastic infectious disease model that accounts for strain evolution and transmission rate affected by the logarithmic Ornstein-Uhlenbeck process. The primary contributions include deriving sufficient conditions that guarantee the existence, uniqueness and boundedness of the positive global solution for the stochastic model, identifying thresholds governing disease extinction and persistence and establishing sufficient conditions for the existence of a stationary distribution, based on which we compute the probability density function of the model to quantify the final size of the disease from a statistical perspective. Numerical simulations indicate that: (i) when strain 1 exhibits dominant transmissibility, it secures a dominant competitive position via its transmission advantage, while strain 2 sustains endemic transmission by exploiting recovered individuals, enabling the long-term coexistence of both strains. By contrast, when the two strains have comparable transmissibility, strain 1, which depends exclusively on susceptible individuals for transmission and survival, is eliminated via competitive exclusion by strain 2 (which can infect individuals recovered from strain 1), and is ultimately driven to extinction; (ii) for epidemic prevention and control, we should not only constrain the mean transmission rate of the disease below the epidemic threshold, but also reserve an adequate control safety margin against stochastic fluctuations in transmission rate; (iii) in the early stage of an epidemic when medical resources are scarce, it is necessary to rapidly expand hospital bed capacity. Once resource supply matches the epidemic demand, the focus of prevention and control should be shifted to optimizing the efficiency of resource scheduling. These results have certain significance for preventing and controlling diseases with such transmission patterns.

PMID:42426308 | DOI:10.1007/s00285-026-02434-x

Eye (Lond). 2026 Jul 9. doi: 10.1038/s41433-026-04713-9. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: To compare the subjective treatment burden of intravitreal anti-VEGF therapy (IVT) among patients with neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DME), and macular oedema secondary to retinal vein occlusion (CME).

SUBJECTS/METHODS: This single-centre, cross-sectional study surveyed 393 patients at the Department of Ophthalmology, Hietzing Hospital, Vienna. All participants had received at least five anti-VEGF intravitreal injections and had been in treatment for at least six months. Data were collected via a structured questionnaire, assessing perceived treatment burden, sociodemographics, and treatment-related experiences. Statistical analysis was performed using SPSS, with nonparametric tests applied due to ordinal data.

RESULTS: Of the 393 participants (nAMD: 305; CME: 55; DME: 33), 64% reported no or only slight burden from treatment frequency or injections. There was no statistically significant difference in overall treatment burden between disease groups (p > 0.4). However, the nature of the burden differed: nAMD patients most often cited fear of progressive vision loss, while CME and DME patients more frequently named the injection itself as the greatest burden. Better patient education significantly correlated with a lower perceived burden (p < 0.001). Nearly half of the patients required assistance with clinic visits.

CONCLUSIONS: Although the overall perceived burden of anti-VEGF treatment was similar across retinal diseases, patients’ specific concerns varied. Addressing these differences through personalised education and communication may help alleviate treatment-related anxiety and improve adherence. These findings highlight the importance of tailoring support strategies to individual patient experiences within long-term intravitreal treatment regimens.

PMID:42426273 | DOI:10.1038/s41433-026-04713-9

Eur Radiol. 2026 Jul 9. doi: 10.1007/s00330-026-12729-8. Online ahead of print.

NO ABSTRACT

PMID:42426246 | DOI:10.1007/s00330-026-12729-8