Tag: nevin manimala

J Robot Surg. 2025 Sep 5;19(1):558. doi: 10.1007/s11701-025-02657-y.

ABSTRACT

This comprehensive systematic review assesses the clinical outcomes of robotic-assisted procedures for acute abdominal emergencies, analyzing data from 27 studies comprising 1142 cases. The investigation specifically examines five critical emergency conditions: complicated appendicitis (representing 32.5% of cases), acute cholecystitis (28.7%), small bowel obstruction (15.2%), perforated peptic ulcers (9.8%), and acute diverticulitis (7.4%). Analysis reveals robotic procedures averaged 152 min (± 38) in duration, with an overall conversion rate of 9.1%. Complication rates showed no significant difference from laparoscopic methods (13.2% versus 14.7%, p = 0.21). The data highlight two significant robotic advantages: improved intraoperative hemostasis (85 mL versus 120 mL average blood loss, p = 0.03) and lower conversion rates among obese patients (11.3% versus 18.6%, p = 0.04). These findings indicate that robotic systems may provide distinct technical benefits for specific emergency scenarios while delivering safety outcomes equivalent to traditional minimally invasive surgery.

PMID:40908371 | DOI:10.1007/s11701-025-02657-y

Bull Environ Contam Toxicol. 2025 Sep 4;115(3):37. doi: 10.1007/s00128-025-04101-1.

ABSTRACT

This study aimed to assess the environmental and health risks of heavy metal contamination from e-waste recycling in Lahore, Pakistan. Surface soil (0-15 cm) samples were collected from recycling facilities, and heavy metal concentrations were measured using atomic absorption spectrophotometry. The mean concentrations (mg/kg) of Cadmium (Cd) (5.38), Copper (Cu) (835.53), Lead (Pb) (468.90), Mercury (Hg) (1.61), and Zinc (Zn) (416.39) exceeded European Union (EU) guidelines, while Manganese (Mn) (372.29), Iron (Fe) (750.05), Arsenic (As) (6.96) and Chromium (Cr) (64.80) were within limits. Soil contamination indices indicated soil quality deterioration. The highest ecological risks (Er) were from Cd (1646.232) and Hg (322.15). Children faced higher non-carcinogenic risk (2.93) and carcinogenic risk (1.76 × 10⁻³), particularly from Pb (1.74) and Cu (1.56 × 10⁻³), respectively, while adults faced no significant risks. These findings highlight the need for sustainable e-waste management practices in Pakistan.

PMID:40908348 | DOI:10.1007/s00128-025-04101-1

Eur J Orthop Surg Traumatol. 2025 Sep 4;35(1):380. doi: 10.1007/s00590-025-04504-0.

ABSTRACT

PURPOSE: To evaluate the effect of intraoperative tranexamic acid (TXA) on perioperative blood loss, transfusion requirements, and clinical outcomes in patients undergoing proximal femoral nailing (PFN) for intertrochanteric fractures.

METHODS: A retrospective cohort study of 1,728 patients who underwent PFN fixation for intertrochanteric fractures between 2017 and 2024. Perioperative hemoglobin (Hb) dynamics, transfusion requirements, and clinical outcomes were compared between patients receiving 1-1.5 g intravenous TXA (n = 1,446) and controls (n = 282).

RESULTS: The TXA group demonstrated reduced perioperative Hb decline (2.15 ± 1.40 vs 2.76 ± 1.57 g/dL, p < 0.001) and lower rates of Hb drop > 2 g/dL (47.9% vs 63.5%, OR 0.53, p < 0.001). TXA administration was associated with decreased transfusion requirements (7.1% vs 11.0%, p = 0.021). Multivariate analysis confirmed TXA as an independent protective factor against blood loss. Mortality rates showed no significant difference between groups.

CONCLUSION: Intraoperative TXA during PFN fixation was associated with reduced perioperative blood loss and transfusion requirements. These findings support TXA as an effective blood conservation strategy in elderly patients with intertrochanteric fractures.

PMID:40908344 | DOI:10.1007/s00590-025-04504-0

J Thromb Thrombolysis. 2025 Sep 4. doi: 10.1007/s11239-025-03178-z. Online ahead of print.

ABSTRACT

Optimal systolic blood pressure (SBP) targets after endovascular therapy (EVT) for stroke in older adults (≥ 65 years) remain undefined. This study assessed age-stratified associations between early post-EVT SBP (first 6 h) and outcomes. Post hoc analysis of two trials. Patients were stratified by age (18-64 vs. ≥ 65 years) and SBP (≤ 120, 120-140, > 140 mmHg). Primary outcome was 90-day functional status (modified Rankin Scale, mRS). Inverse probability treatment weighting (IPTW) and multivariable regression adjusted for confounders. Post-EVT SBP data were available for 267 young and 395 old patients. IPTW analysis revealed that sustained SBP below 120 mmHg during the first 6 h post-EVT significantly enhanced functional independence in elderly patients (common OR: 2.00; 95% CI: 1.18-3.39). Among young cohorts, maintenance of SBP ≤ 120 mmHg (cOR, 2.89; 95% CI, 1.45-5.82) and 120-140 mmHg (cOR, 3.18; 95% CI, 1.58-6.47) were associated with a better outcome. sICH incidence demonstrated no statistically significant association with systolic blood pressure (SBP) levels (P = 0.21; 95% CI: 0.93-1.35). During the initial 6-h window post-EVT, younger patients with SBP ≤ 140 mmHg and elderly patients with SBP ≤ 120 mmHg were associated with favorable outcome. These results suggest that stricter blood pressure control may be particularly beneficial for older adults in the early post-EVT phase.Trial Registration: The DEVT registration: URL: http://www.chictr.org.cn ; Chinese Clinical Trial Registry: ChiCTR-IOR-17013568, and the RESCUE BT registration: URL: http://www.chictr.org.cn ; ChiCTR-INR-17014167.

PMID:40908335 | DOI:10.1007/s11239-025-03178-z

Surg Endosc. 2025 Sep 4. doi: 10.1007/s00464-025-12162-w. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of laparoscopy combined with intraoperative choledochoscopy in treating choledochal cysts and preventing postoperative complications.

PATIENTS AND METHODS: This single-center retrospective study included 208 patients with Todani type I choledochal cysts treated laparoscopically from January 2016 to January 2023. Patients undergoing open surgery were excluded. Of these, 138 cases were treated with 6 Fr catheter irrigation (Group A), while 70 cases underwent intraoperative choledochoscopy for thorough irrigation and stone extraction (Group B). All patients were followed up for at least 18 months. Data collected included age at operation, gender, cyst diameter, preoperative manifestations, and postoperative outcomes. Statistical analysis was performed using Student’s t-test for continuous data and Fisher’s exact test for categorical data, with P < 0.05 indicating significance.

RESULTS: Clinical data of 187 cases were analyzed after excluding 21 lost to follow-up. No significant differences were found between Group A (n = 124) and Group B (n = 63) in age at operation (35.4 ± 17.2 months vs. 38.9 ± 19.6 months, P = 0.875), gender distribution (male:female ratio 34:90 vs. 13:50, P = 0.891), cyst diameter (25.6 ± 17.8 mm vs. 23.1 ± 17.5 mm, P = 0.758), or preoperative stone presence (54/124 vs. 25/63, P = 0.918). However, Group B had significantly lower incidence of residual/recurrent stones (1/63 vs. 14/124, P = 0.021) and postoperative pancreatitis (1/63 vs. 7/124, P = 0.044). At 6-month follow-up, intrahepatic bile duct dilation was significantly lower in Group B (0/63 vs. 6/124, P = 0.038), and hospital stay was shorter (9.1 ± 2.2 days vs. 10.7 ± 2.1 days, P = 0.003) without significant increase in total medical expenses (39059.6 ± 4115.3 RMB vs. 38422.8 ± 3341.6 RMB, P = 0.291).

CONCLUSIONS: Laparoscopy combined with intraoperative choledochoscopy is feasible and effective in clearing biliary stones, preventing postoperative complications such as pancreatitis and bile duct dilation, and identifying hepatic duct stenosis in choledochal cyst treatment.

PMID:40908333 | DOI:10.1007/s00464-025-12162-w

Behav Res Methods. 2025 Sep 4;57(10):275. doi: 10.3758/s13428-025-02772-6.

ABSTRACT

Computational models of early language development involve implementing theories of learning as functional learning algorithms, exposing these models to realistic language input, and comparing learning outcomes to those in infants. While recent research has made major strides in developing more powerful learning models and evaluation protocols grounded in infant data, models are still predominantly trained with non-naturalistic input data, such as crowd-sourced read speech or text transcripts. This is due to the lack of suitable child-directed speech (CDS) corpora in terms of scale and quality. In parallel, the question of how properties and individual variability in language input affect learning outcomes is an active area of empirical research, underlining the need for realistic yet controllable data for modeling such phenomena. This paper presents a solution to the training data problem through stochastic generation of naturalistic CDS data using statistical models, thereby enabling controlled computational simulations with naturalistic input. We provide a proof-of-concept demonstration of the approach by showing how naturalistic CDS transcripts can be generated with a language model conditioned on recipient information (here, infant age), and how text-to-speech systems can be used to convert the transcripts to high-quality speech with a controllable speaking style. We also conduct modeling experiments with generated speech corpora by varying different aspects of the data, showing how this maps into different learning outcomes, thereby demonstrating the feasibility of the approach for controlled language learning simulations. Finally, we discuss the limitations of using synthetic data in general, and of the present proof-of-concept pipeline in particular.

PMID:40908330 | DOI:10.3758/s13428-025-02772-6

J Cancer Res Clin Oncol. 2025 Sep 5;151(9):242. doi: 10.1007/s00432-025-06281-z.

ABSTRACT

AIM: Early cervical cancer diagnosis is a global challenge that needs to be addressed by the discovery of less invasive diagnostic and prognostic approaches. Circulating miRNAs are stable in plasma and their diagnostic potentials have been elucidated in some cancers. Therefore, in this cross-sectional study, we determined the patterns of expression of 7 selected circulating microRNAs that differ between patients with cervical cancer receiving therapy, patients with cervical not on therapy and healthy females. The goal was to investigate the diagnostic and prognostic potential of these selected miRNAs.

METHODS: Total RNA was extracted from plasma samples collected from 53 participants recruited from Komfo Anokye Teaching Hospital and the Cape Coast Teaching Hospital, Ghana. Complementary DNA (cDNA) synthesis was performed, followed by quantitative polymerase chain reaction (qPCR) to amplify and quantify the expression levels of the target microRNAs. Expression levels of seven microRNAs-hsa-miR-146a, hsa-miR-29a, hsa-miR-29b, hsa-miR-34a, hsa-miR-233, hsa-miR-155, and hsa-miR-27a were compared among three groups: healthy controls (n = 27), patients with cervical cancer on therapy (n = 13), and those not on therapy (n = 13).

RESULTS: miR-155 and miR-27a showed statistically significant differential expression between cancer patients and healthy controls. In addition, miR-29b expression levels differed significantly between stage 4b and stage 4a of patient with cervical cancer undergoing treatment.

CONCLUSION: These findings suggest that circulating plasma miRNAs may serve as non-invasive biomarkers for the early detection of cervical cancer, monitoring disease progression, and evaluating treatment response.

PMID:40908329 | DOI:10.1007/s00432-025-06281-z

Aesthetic Plast Surg. 2025 Sep 4. doi: 10.1007/s00266-025-05191-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to compare the radiological measurements of patients who underwent rhinoplasty using a piezo device with those of patients who underwent rhinoplasty using a classical osteotome.

METHODS: A total of 60 patients were included in the study: 30 rhinoplasty patients who underwent piezosurgical osteotomy and 30 who underwent classical osteotomy. Preoperative and postoperative functional and aesthetic outcomes were compared using NOSE and ROE scores. Four anthropometric parameters were measured radiologically before and after surgery: nasofrontal angle (NFA), nasal bone length (NL), pyramidal angle (PA) and the closest distance between the nasolacrimal canal and the rhinoplasty fracture line (N-R). The pyramidal angle (PA) was measured separately at two levels: at the nasal root (PA-R) and at the tip of the nasal bone (PA-T).

RESULTS: The two groups were similar in terms of age, gender, and follow-up period (p > 0.05). The operative time was significantly longer in the Piezo group (p < 0.001). Preoperative and postoperative ROE values, as well as preoperative NOSE values, were comparable between the two groups (p > 0.05). However, postoperative NOSE values were statistically significantly lower in the Piezo group compared to the Osteotome group (p = 0.004). Surgery significantly affected both NOSE and ROE values in each group (p < 0.001). No statistically significant differences were found between the groups in terms of preoperative and postoperative NFA, PA-R, and PA-T values (p > 0.05). Preoperative NL values were also similar between the groups; however, postoperative NL values were significantly shorter in the Piezo group (p < 0.001). A statistically significant difference was observed in both right and left side N-R values between the groups (right: p = 0.025; left: p = 0.010), with the N-R distance being shorter in the Piezo group.

CONCLUSION: The long-term aesthetic outcomes of the piezosurgery and conventional osteotomy groups were similar; however, the piezosurgery group demonstrated better functional results. The safe margin for the nasolacrimal canal was narrower when osteotomy was performed using piezosurgery. This finding warrants caution regarding potential complications in the lacrimal system.

LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:40908317 | DOI:10.1007/s00266-025-05191-2

Sci Rep. 2025 Sep 2;15(1):32321. doi: 10.1038/s41598-025-11152-1.

ABSTRACT

Effective sample design has a major role in the quality of parameter estimation in statistical parameter estimation issues. The ranking set sampling (RSS) strategy is effective and a less costly option than simple random sampling (SRS). A novel mixture continuous lifetime distribution that has been proposed recently is the power Chris-Jerry distribution (PC-JD). It is useful for modeling a number of real data sets. This paper investigates the RSS approach for estimating the PC-JD’s parameters. There are roughly sixteen different techniques of estimation that are used, such as the maximum likelihood method, the percentiles method, some methods based on minimum distance, the Kolmogorov method, and some methods based on minimum and maximum spacing distances. In comparison to a SRS, the simulation research assesses the performance of the suggested RSS-based estimates in terms of some measures of accuracy. To identify the optimal estimating strategy, the partial and overall ranks of many estimates are shown. According to numerical results, the maximum likelihood approach seems to be quite beneficial in evaluating the estimated quality of RSS and SRS. RSS is a more effective sampling approach than SRS owing to its better efficiency. Additionally, the different estimation techniques with survival data for both sampling techniques are examined.

PMID:40908291 | DOI:10.1038/s41598-025-11152-1

Orthop Surg. 2025 Sep 4. doi: 10.1111/os.70166. Online ahead of print.

ABSTRACT

BACKGROUND: Lumbar spondylolisthesis (LS) is a spinal disorder that often necessitates surgical intervention. However, evidence on the comparative clinical value of robot-assisted full-endoscopic transforaminal lumbar interbody fusion (RA FE-TLIF) versus conventional FE-TLIF in early-grade (Grades I and II) LS remains limited, leaving uncertainty about its true clinical value in this patient population. This study aims to compare the clinical efficacy and safety of FE-TLIF with RA FE-TLIF in patients with Grade I and II LS.

METHODS: A retrospective analysis was conducted on 47 patients who underwent surgical treatment for LS between April 2022 and April 2023 at our hospital. Patients were divided into two groups: 22 underwent RA FE-TLIF, and 25 underwent FE-TLIF. Key outcomes measured included operative time, intraoperative blood loss, postoperative recovery time, fusion rate, screw placement accuracy, Visual Analogue Scale (VAS), the Japanese Orthopaedic Association (JOA) scores, and the incidence of postoperative complications. Statistical analyses were performed using the independent-sample t test for continuous variables and the chi-square test for categorical variables, with a significance threshold of p < 0.05.

RESULTS: The RA FE-TLIF group exhibited significantly shorter operative times and lower intraoperative blood loss compared to the FE-TLIF group (p < 0.05). Postoperative recovery, as measured by hospital stay, was also shorter in the RA FE-TLIF group (p = 0.001). VAS and JOA scores indicated greater pain relief and functional improvement in the RA FE-TLIF group, with statistically significant differences observed at both 1 month and final follow-up (p < 0.05). The incidence of postoperative complications was lower in the RA FE-TLIF group, though this difference was not statistically significant (p = 0.144). Complete fusion rates were 95.45% in the RA FE-TLIF group and 88.00% in the FE-TLIF group, with no significant difference (p > 0.05). Screw placement accuracy was higher in the RA FE-TLIF group (97.73%) than in the FE-TLIF group (89.00%), with a significant difference (p < 0.05).

CONCLUSION: RA FE-TLIF demonstrates superior clinical outcomes compared to FE-TLIF in the treatment of LS. These findings support the broader adoption of RA FE-TLIF as a preferred surgical technique for this condition.

PMID:40908279 | DOI:10.1111/os.70166