Tag: nevin manimala

J Neurooncol. 2025 Dec 16;176(2):125. doi: 10.1007/s11060-025-05312-6.

ABSTRACT

PURPOSE: Meningiomas are common, mostly benign, and often asymptomatic. Minimizing surgical adverse events (AE) is essential to maintain a favorable risk-benefit balance. Traditional AE grading systems often failed to account for disabling complications like neurologic deficits, which led to the development of the multidimensional therapy-disability-neurology grade (TDN). This study evaluates risk factors and consequences of AE in meningioma patients using TDN.

METHODS: Pre- and perioperative factors associated with the occurrence and severity of AE at discharge and follow-up were retrospectively identified in a monocentric cohort of consecutive patients undergoing surgery between 2013 and 2022. Significant variables of the univariable analysis were consequently tested in a multivariable analysis. Statistical analysis to detect the relationship between TDN and clinical outcomes was performed.

RESULTS: 367 patients were included with a mean age at surgery of 60.8 years. A total of 95 AE at discharge and 144 AE at follow-up were recorded. Generalized linear models showed a relationship between the modified Rankin Scale on admission, tumor complexity as measured by the Milan Complexity Scale, and preoperative embolization with the frequency of AE at discharge and follow-up. A correlation between TDN, Karnofsky Performance Scale at discharge, and length of hospital stay was observed.

CONCLUSION: The severity of AE as classified according to TDN correlated with the length of hospital stay and functional outcome following meningioma resection in our cohort and may be predicted by specific pre- and perioperative factors.

PMID:41400878 | DOI:10.1007/s11060-025-05312-6

J Robot Surg. 2025 Dec 16;20(1):90. doi: 10.1007/s11701-025-03071-0.

ABSTRACT

Robotic surgery has become an integral part of minimally invasive surgical practice across a variety of disciplines. However, training structures, access, and perceptions of its clinical value vary significantly among surgeons worldwide. To assess global trends in robotic and laparoscopic/thoracoscopic surgery training, practice patterns, and surgeon-perceived clinical outcomes across a range of procedures. A cross-sectional, web-based survey will be conducted among surgical professionals worldwide. The survey includes structured quantitative items using Likert scales and multiple-choice formats comparing the conventional laparoscopic/thoracoscopic approaches. Data will be analyzed using descriptive statistics, subgroup comparisons, and regression models where appropriate. The study aims to identify variability in training pathways, perceived clinical benefits, and barriers to robotic surgery adoption, possibly informing curriculum development and policy changes to enhance equitable access and training.

PMID:41400869 | DOI:10.1007/s11701-025-03071-0

Environ Monit Assess. 2025 Dec 16;198(1):46. doi: 10.1007/s10661-025-14783-z.

ABSTRACT

Chlorination of drinking water is the most widely utilized disinfection technique; however, its reaction with naturally occurring organic matter causes the production of disinfection byproducts (DBPs), such as haloacetic acids (HAAs), which are the second most common DBP after trihalomethanes. This study investigates the occurrence and spatial variation of five HAA species (monochloroacetic acid (MCAA), dichloroacetic acid (DCAA), trichloroacetic acid (TCAA), monobromoacetic acid (MBAA), and dibromoacetic acid (DBAA)) in drinking water samples collected from eight locations in Jamia Nagar, New Delhi, during March-April 2023. Among these, only two species, i.e., DCAA and TCAA, were quantified, with mean concentrations of 13.97 ± 2.87 µg/L and 13.22 ± 3.47 µg/L, respectively, and total HAAs ranging from 20.81 to 34.95 µg/L. These concentrations were well below the maximum contamination limit of 60 µg/L given by USEPA, whereas no corresponding standards exist in India. Statistical analysis revealed strong positive correlations of HAA formation with residual chlorine, total organic carbon, and pH, while temperature exhibited a weak negative influence. Principal component analysis confirmed that residual chlorine, total organic carbon, and pH were the dominant contributors to HAA variability. Spatial mapping using kriging interpolation demonstrated higher HAA concentrations at sampling locations farther from the water treatment plant, indicating the effect of longer contact time between chlorine and organic precursors. The results highlight the need to consider HAAs in Indian drinking water standards and suggest that spatial monitoring can guide treatment upgrades and evidence-based policy making to ensure safe drinking water.

PMID:41400868 | DOI:10.1007/s10661-025-14783-z

Sci Prog. 2025 Oct-Dec;108(4):368504251406564. doi: 10.1177/00368504251406564. Epub 2025 Dec 16.

ABSTRACT

ObjectiveTo evaluate the role of rivaroxaban in preventing arteriovenous graft (AVG) thrombosis following endovascular intervention, assess the risk of recurrent thrombosis, and develop a clinically applicable predictive model.MethodsA retrospective analysis was performed on 108 patients with AVG thrombosis who underwent endovascular treatment at our center between October 2020 and October 2024. Patients were stratified into a rivaroxaban group (n = 71) and a control group (n = 37). Fifteen variables from the two groups were analyzed and summarized. Four machine learning algorithms (random forest, Support Vector Machine – Recursive Feature Elimination, Least Absolute Shrinkage and Selection Operator, and XGboost) were applied to identify risk factors for recurrent thrombosis. A predictive model was constructed using logistic regression and validated with an internal dataset.ResultsAmong the 108 patients, 69 were male and 39 were female, with ages ranging from 21 to 89 years. Fibrinogen levels were significantly lower in the rivaroxaban group (4.02 ± 0.87 vs. 4.59 ± 1.03, p < 0.01), More notably, the 12-month postprocedural patency rate was significantly higher in the rivaroxaban group (75%) than in the nonrivaroxaban group (17%), with a statistically significant difference (p < 0.01). No statistically significant differences were observed between the two groups in other aspects (p > 0.05). The model exhibited a C-index of 0.87 (95% CI: 0.78-0.95). The receiver operating characteristic and decision curve analysis curves demonstrated that the multifactor model had superior discriminative ability and net clinical benefit for identifying recurrent AVG thrombosis compared to single factors (AUC_{linear predictor} = 0.87, AUC_{rivaroxaban use} = 0.78, AUC_D-dimer = 0.60). Validation in the internal validation set and the entire cohort confirmed good calibration and efficacy (validation set: AUC = 0.86, entire cohort: AUC = 0.85).ConclusionRivaroxaban may exert a positive effect on maintaining the patency of AVG fistulas after endovascular treatment for thrombosis. The constructed nomogram prediction model can be used to predict the risk of recurrent thrombosis following endovascular treatment of AVG fistula thrombosis.

PMID:41400855 | DOI:10.1177/00368504251406564

Infection. 2025 Dec 16. doi: 10.1007/s15010-025-02712-8. Online ahead of print.

ABSTRACT

PURPOSE: We compared nationwide data on the clinical characteristics of deceased and non-deceased patients with Respiratory Syncytial Virus (RSV)-coded hospitalization to evaluate potential risk factors for in-hospital fatality by age group.

METHODS: Data from International Statistical Classification of Diseases (10th Revision)-based German Hospital Statistics for patients from 2010-2019 with a primary discharge diagnosis code for RSV-related pneumonia (J12.1), bronchitis (J20.5) or bronchiolitis (J21.0) were assessed by remote data retrieval. Selected underlying conditions and complications were reported stratified by age group and outcome.

RESULTS: Overall, 612 (0.3% of 205,352) RSV-coded patients died in hospital (103 children < 18 years, 51 adults 18-59 years, 458 seniors > 59 years). Children and adults with underlying chronic cardiovascular, neurological, immunological, or lower respiratory diseases had a higher risk of dying than those without (Odds Ratio 109, 58, 28, 6 in children, and 3, 3, 3, 2 in adults). In seniors, the risk was increased for patients with chronic neurological conditions (OR 1.3) but not for other underlying conditions. Acute respiratory distress syndrome, sepsis and pneumonia increased the risk of a fatal outcome in all age groups.

CONCLUSION: In-hospital fatality of RSV-coded patients varied considerably with age, chronic conditions and complications. Seniors were the most affected age group and may therefore benefit from the RSV vaccination recommended in Germany since 2024 for all over 75 years and seniors with pre-existing conditions.

PMID:41400853 | DOI:10.1007/s15010-025-02712-8

J Mol Model. 2025 Dec 16;32(1):18. doi: 10.1007/s00894-025-06591-6.

ABSTRACT

CONTEXT: In order to increase the efficiency of dye-sensitized solar cells (DSSC), we propose to study the influence of maximizing the push-pull effect by quantifying the donor force (Ds) and the acceptor capacity (Ap) calculated as functions of the Electrophilicity, Orbital Hardness, and Polarizability. The sum of the donor force and the acceptor capacity is the inductive force, which allows the push-pull effect to be maximized. With this approach, we applied the Barrera-Crivelli-Loeb (BCL) model to a series of eleven Zinc Porphyrins to correlate the Global Efficiency Index (GEI) with the experimental measurement of Photo Conversion Efficiency (PCE). The use of this strategy together with the use of siloles and siloxanes allows the design of two new dyes, BCL 516 and BCL 520, with theoretically calculated efficiencies of 10.64% and 10.61%.

METHODS: In this work, all calculations were performed with the Amsterdam Density Functional 2023 package. For geometry optimization (ground state and first singlet), the optimized Perdew-Becke-Ernzerhof exchange correlation functional was employed with a DZP basis set for H, C, N, O, S, and a Zeroth Order Regular Approximation (ZORA) – TZP basis set for Ti and Zn. Time-Dependent Density Functional Theory (TDDFT) calculations were achieved with the Statistical Average Orbital model exchange correlation potential (SAOP), including solvent effects with the Conductor-like Screening Model (COSMO). Calculations of molecular properties like electrophilicity, orbital hardness, and polarizability were carried out in the gas phase with the SAOP potential model after optimization of the target molecule with the OPBE exchange correlation functional. To determine the orbital hardness of the HOMO and LUMO, the occupation number of the frontier orbital was modified by 0.3 units.

PMID:41400849 | DOI:10.1007/s00894-025-06591-6

Int Ophthalmol. 2025 Dec 16;46(1):28. doi: 10.1007/s10792-025-03883-x.

ABSTRACT

PURPOSE: To evaluate the clinical and aesthetic efficacy of postoperative topical treatments compared to conservative management following standard upper eyelid blepharoplasty.

METHODS: This prospective, randomized controlled trial included 69 patients undergoing isolated upper eyelid blepharoplasty. Participants were randomized into three groups: (1) antibiotic-steroid ointment (Maxitrol), (2) antibiotic-only ointment (chloramphenicol), and (3) no topical treatment (control). Primary outcomes included patient satisfaction, pain, perceived swelling, and aesthetic results using the Stony Brook Scar Evaluation Scale (SBSES), assessed at one week and four months postoperatively. Adverse events and complications were also recorded.

RESULTS: There were no statistically significant differences among the three groups in patient-reported outcomes at either time point, including pain (p = 0.05), satisfaction (p = 0.3), or eyelid swelling (p = 0.9). Aesthetic evaluation by a blinded independent senior plastic surgeon showed no significant difference in SBSES scores between groups (p = 0.7). No adverse effects or postoperative infections were reported.

CONCLUSION: Routine use of postoperative topical antibiotic or corticosteroid-containing ointments following standard upper eyelid blepharoplasty does not confer additional benefit in terms of patient satisfaction, symptom control, or aesthetic outcomes when compared with conservative care alone. Given the low infection risk, potential side effects, and concerns regarding antimicrobial resistance, a simplified postoperative regimen focusing on lubrication alone may be sufficient for uncomplicated cases. These findings support a more minimalist approach to postoperative management and emphasize the need for larger, multicenter trials to validate these results across broader surgical contexts.

PMID:41400848 | DOI:10.1007/s10792-025-03883-x

Br J Radiol. 2025 Dec 16:tqaf299. doi: 10.1093/bjr/tqaf299. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate solid volume ratio (SVR) in predicting long-term postoperative outcomes in lung adenocarcinoma patients.

METHODS: This study retrospectively analyzed the clinical, pathological, and CT data of patients with lung adenocarcinoma who underwent surgical resection and were pathologically confirmed in the Department of Thoracic Surgery of our hospital from June 2014 to June 2023. Multivariate COX analysis was also conducted to identify independent factors that affect treatment effect. P < 0.05 was considered statistically significant.

RESULTS: A total of 154 patients (82 males and 72 females) were included in this study. The average age was 62.11 ± 8.74 years. There were 60 patients (38.96%) who smoked, and 63 patients (40.90%) had positive pleural invasion. The 3-year DFS rate and OS rate after surgical resection were 87.5% and 92.0%, respectively; the 5-year DFS rate and OS rate after surgical resection were 81.6% and 89.1%, respectively. Multiple COX regression analysis showed that gender (P = 0.009, OR: 4.197, 95% CI: 1.426-12.353), and the solid volume ratio (P = 0.004, OR: 1.021, 95% CI: 1.007-1.036) were identified as an independent predictor of recurrence. Multivariate COX analysis showed that SVR (P = 0.003, OR: 1.028, 95% CI: 1.009-1.046) was identified as an independent predictor of postoperative survival in patients with lung cancer.

CONCLUSION: In this study, compared with consolidation tumor rate (CTR), the SVR has certain value in evaluating the therapeutic efficacy of lung adenocarcinoma.

ADVANCES IN KNOWLEDGE: SVR is an independent predictor of postoperative recurrence and survival in lung cancer, and provides new ideas for postoperative efficacy evaluation.

PMID:41400845 | DOI:10.1093/bjr/tqaf299

Alzheimers Dement. 2025 Dec;21(12):e71034. doi: 10.1002/alz.71034.

ABSTRACT

INTRODUCTION: Research on dementia in centenarians is scarce. This study assesses the 2024 Lancet Commission risk factors for dementia in Colombian centenarians.

METHODS: The Clinical Dementia Rating-Sum of Boxes (CDR-SB), Mini-Mental State Examination, and Barthel Index were evaluated in Colombian centenarians. A preserved cognitive-functional phenotype (PCFP), defined by a CDR-SB <2 and a Barthel index ≥60, was utilized to signify the absence of dementia based on cognitive screening instruments. Associations with age-related clinical variables were assessed through multivariate analyses.

RESULTS: Among 160 centenarians, 63.7% did not meet the PCFP criteria and were classified as having dementia. Frailty, alcohol intake, and depression were linked to dementia, while physical performance, nutritional status, and quality of life were associated with PCFP. Physical activity, education, obesity, hypertension, diabetes, and smoking showed no significant associations.

DISCUSSION: Traditional dementia risk factors were not universally confirmed in centenarians, underscoring the need for prevention strategies tailored to specific settings.

HIGHLIGHTS: Dementia risk factors act differently in Colombian centenarians. Frailty and malnutrition strongly linked to dementia in centenarians. Preserved cognitive-functional phenotype identified in 36% of centenarians. Quality of life and physical performance protect against cognitive decline. Classical risk factors (education, hypertension, diabetes) showed no effect.

PMID:41400045 | DOI:10.1002/alz.71034

Clin Nurs Res. 2025 Dec 16:10547738251398357. doi: 10.1177/10547738251398357. Online ahead of print.

ABSTRACT

This study aimed to explore the effects of the incomplete prone position in non-mechanically ventilated adults with a tracheostomy, providing evidence for its clinical management. Non-mechanically ventilated adults (n = 64) with a tracheostomy who met the inclusion and exclusion criteria were included in this randomized controlled trial. They were randomly assigned to either a control group (n = 32) and or an experimental group (n = 32). Both groups received standard tracheostomy care. The experimental group was positioned in the incomplete prone position, while the control group was maintained in the lateral position. Continuous intervention lasted for 7 days. We compared the differences in respiratory oxygenation indicators, pulmonary infection rates, sputum volume, hemodynamics, and the complications between the two groups. After 7 days of intervention, the experimental group demonstrated significantly higher arterial partial pressure of oxygen and oxygenation index than the control group (p < .05). From day 2 onward, pulse oxygen saturation was consistently higher in the experimental group compared to the control group (p < .001). Furthermore, a significantly lower respiratory rate was observed in the experimental group from day 4 onward (p < .001). No statistically significant difference was found in the incidence of pulmonary infection between the two groups (p > .05). However, a significant intergroup difference was observed in the Clinical Pulmonary Infection Score (p < .05). From day 1 to 7, the experimental group exhibited significantly higher daily sputum volume than the control group (p < .001). The analysis of sputum volume revealed significant effects for both time and group (p < .001), but the group-by-time interaction effect was not statistically significant (p = .064). No significant effects for time or group were found on hemodynamic parameters, including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure (p > .05). Additionally, the group-by-time interaction effect was not statistically significant (p > .05). Importantly, no severe complications occurred in either group. The incomplete prone position significantly improved oxygenation, promoted airway secretion clearance, and reduced pulmonary infection severity in non-mechanically ventilated adults with a tracheostomy.

PMID:41400043 | DOI:10.1177/10547738251398357