Tag: pubmed

J Robot Surg. 2025 Sep 29;19(1):644. doi: 10.1007/s11701-025-02832-1.

ABSTRACT

This study evaluated short-term outcomes and learning curves following the introduction of the Intuitive© da Vinci Xi robotic platform for elective colorectal cancer resections at West Hertfordshire Teaching Hospital NHS Trust (WHTH). A smooth transition was enabled by prior experience with the CMR Surgical© Versius platform, with outcomes benchmarked against national data. A prospective cohort study included consecutive patients undergoing elective colorectal resections between April 2024 and March 2025. Data included demographics, diagnosis, operative details, complications, length of stay (LOS), and oncological outcomes. Results were compared with historical laparoscopic data from the National Bowel Cancer Audit (NBOCA, 2019-2022) and Model Health System (MHS, 2024). Learning curves for operative time were assessed using cumulative sum (CUSUM) analysis across three procedures: right hemicolectomy (RH), anterior resection (AR), and abdominoperineal resection (APR).A total of 102 patients were included, with a median age of 69 years (IQR = 60-75), and 54.9% (n = 56) were male. All colonic resections (n = 72) achieved a lymph node yield ≥ 12, significantly higher than the 88.1% in NBOCA (p = 0.001). Among rectal resections (n = 30), 96.7% had negative margins versus 90.1% in NBOCA (p = 0.10). Conversion to open surgery was 3% (n = 3), the anastomotic leak rate was 1% (n = 1), and 4% (n = 4) required a return to theatre. MHS data showed that 13% of all colorectal patients at WHTH had a LOS ≥ 9 days, compared to 29% nationally (p = 0.0001), decreasing to 7.1% in the robotic cohort. CUSUM analysis showed stabilisation after ~ 12 right hemicolectomies and 20 low pelvic resections, with variability among surgeons. Surgeons with prior robotic experience achieved faster proficiency and generated time savings. The successful introduction of the da Vinci Xi platform at WHTH, supported by prior Versius experience, led to excellent oncological outcomes, shorter hospital stays, and low complication rates. These findings highlight the value of structured robotic implementation in advancing colorectal cancer care within the NHS.

PMID:41021138 | DOI:10.1007/s11701-025-02832-1

World J Microbiol Biotechnol. 2025 Sep 29;41(10):350. doi: 10.1007/s11274-025-04589-z.

ABSTRACT

Environmental pollution is a biggest challenge faced by whole world at current time. The natural resources are victims of pollution and contamination of natural resources with heavy metals such as Pb. Pb is a highly toxic and frequent pollutant all around the world. In present study, Mithi River, a highly polluted urban water body was physico-chemically analyzed at four different sites along its course and their association was statistically analysed. Further, Pb bioremediating bacteria were isolated from Mithi river water and analysed for their Pb remediation potential. The findings revealed consistently low water quality across all sites, indicating high pollution levels, particularly in the lower stretch of river. Mithi River exhibited a substantial total heterotrophic bacteria (THB) (Taximan- 2.89 × 10⁹ and BKC- 2.13 × 10⁹) and a prevalence of lead-resistant bacteria (Taximan- 3.16 × 10⁸ and BKC 2.24 × 10⁷). A total 21 Pb resistant bacteria were isolated and gram negative coccobacilli were the most dominant. Notably, P. mirabilis demonstrated ability to bioremediate up to 100% of lead within 48 h. The SEM-EDX analysis illustrated biosorption of Pb on cell surface. Furthermore, P. mirabilis secretes significant amount of extracellular components in Pb concentration dependent manner. The study demonstrated that P. mirabilis exhibits tolerance to a wide range of environmental conditions, including variations in pH, temperature, salinity, and resistance to various toxic pollutants like heavy metals and organic contaminants. This broad tolerance spectrum to environmental conditions, combined with its strong bioremediation potential, highlights P. mirabilis as a promising candidate for lead bioremediation. Though, real-time application of bioremediation process is still lagging behind and needs immediate attention.

PMID:41021137 | DOI:10.1007/s11274-025-04589-z

Discov Oncol. 2025 Sep 29;16(1):1756. doi: 10.1007/s12672-025-02862-z.

ABSTRACT

BACKGROUND: A precise predictor is urgently needed for immunotherapy in cervical cancer (CC), which would be very helpful for disease monitoring. Thus, we explore the relationship between pre-treatment neutrophil-to-lymphocyte ratio (NLR) and prognosis in recurrent/metastatic CC patients who were treated with PD-1/PD-L1 inhibitors.

METHODS: A total of 282 patients with recurrent/metastatic cervical cancer were enrolled in this retrospective study from December 2018 to September 2023. The area under the receiver operating characteristic (ROC) curve was used to identify the optimal threshold for evaluating the influence of pre-treatment NLR on patients’ survival. Kaplan-Meier analysis was conducted to determine the predictive roles of pre-treatment NLR for progression-free survival of immunotherapy (PFSi) and overall survival (OS).

RESULTS: A pre-treatment NLR = 3.91 was determined to be the optimal cut-off value for predicting patient prognosis, with an AUC of 0.636 (P < 0.05). Patients with a pre-treatment NLR < 3.91 (low-NLR group) exhibited significantly extended PFSi (P < 0.001) and OS (P < 0.001) compared to those with pre-treatment NLR ≥ 3.91 (high-NLR group). Notably, lower pre-treatment NLR was associated with better objective response rate (36.8% vs. 18.3%, P < 0.001). In the stratification analysis, the predictive roles of pre-treatment NLR were mainly found in patients with positive expression of PD-L1 (P = 0.041 for PFSi; P = 0.001 for OS). Moreover, regardless of when the immunotherapy was initiated, a lower pre-treatment NLR correlated with longer survival.

CONCLUSION: The pre-treatment NLR could be a biomarker for predicting the response to anti-PD-1/PD-L1 therapy in recurrent/metastatic CC. In combination with PD-L1 status, it may improve the benefits of immunotherapy and lower the treatment costs.

PMID:41021135 | DOI:10.1007/s12672-025-02862-z

Trop Anim Health Prod. 2025 Sep 29;57(8):410. doi: 10.1007/s11250-025-04667-2.

NO ABSTRACT

PMID:41021134 | DOI:10.1007/s11250-025-04667-2

J Robot Surg. 2025 Sep 29;19(1):643. doi: 10.1007/s11701-025-02693-8.

ABSTRACT

To compare perioperative and oncologic outcomes between single-port (SP) and multi-port (MP) retroperitoneal robotic-assisted partial nephrectomy (RAPN) in obese patients with renal tumors. A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Web of Science up to July 2025. Eligible studies were those directly comparing SP-RAPN with MP-RAPN in obese patients (BMI ≥30 kg/m²). Extracted data included operative duration, intraoperative blood loss, warm ischemia time, length of hospitalization, complication rates, and oncologic outcomes, which were synthesized using RevMan 5.4. Three retrospective studies involving 694 patients (252 SP, 442 MP) were included. SP-RAPN was associated with a shorter hospital stay (WMD = -0.29 days, P = 0.02) but a longer warm ischemia time (WMD = 5.23 min, P < 0.00001). No significant differences were observed in operative time, estimated blood loss, complication rate, or positive surgical margins. The SP group had higher tumor complexity based on R.E.N.A.L. nephrometry scores. SP-RAPN demonstrates comparable safety and oncologic outcomes to MP-RAPN in obese patients, with the added benefit of reduced hospital stay. However, increased ischemia time should be considered when selecting the surgical approach. High-quality prospective trials are needed to confirm these findings.

PMID:41021133 | DOI:10.1007/s11701-025-02693-8

World J Microbiol Biotechnol. 2025 Sep 29;41(10):349. doi: 10.1007/s11274-025-04573-7.

ABSTRACT

This study investigates the antifungal potential of hydrothermal liquefaction (HTL) wastewater against Verticillium dahliae and its effects on the growth of pepper plants (Capsicum annuum L.). The HTL process generates wastewater containing various antimicrobial compounds, which can offer a sustainable alternative for plant protection. In this research, the biological control agent Trichoderma virens and HTL wastewater were applied both individually and in combination to assess their impact on plant growth and pathogen suppression. The results demonstrated that specific HTL wastewater treatments significantly enhanced root and shoot growth, biomass, and chlorophyll content in pepper plants. Plant growth observed in pathogen-free conditions may be related to the stimulation of plant physiology by biologically active components contained in wastewater, indicating a biostimulatory effect. Notably, the 4th wastewater mixture (wm) exhibited the highest efficacy, promoting plant development and mitigating the negative effects of V. dahliae. The combination of T. virens and wastewater also showed synergistic effects, reducing disease severity by up to 64% and improving plant biomass and structural parameters. Statistical analysis revealed significant differences among treatments, highlighting the potential of HTL wastewater as a natural and sustainable strategy for managing soil-borne pathogens. These findings suggest that integrating HTL wastewater with biocontrol agents could offer a promising approach to sustainable agriculture.

PMID:41021129 | DOI:10.1007/s11274-025-04573-7

Int Ophthalmol. 2025 Sep 29;45(1):397. doi: 10.1007/s10792-025-03748-3.

ABSTRACT

OBJECTIVE: Cataracts remain the leading cause of blindness worldwide, and phacoemulsification cataract surgery is the gold standard for cataract treatment. However, complications such as posterior capsule rupture (PCR) and posterior capsule opacification (PCO) continue to affect success of the procedure. This study investigates effect of fluid flow posterior capsule polishing in reducing the incidence of PCR and PCO during phacoemulsification cataract surgery, with the goal of improving surgical outcomes and postoperative recovery.

METHODS: A total of 290 eyes from cataract patients were randomly assigned to two groups: the fluid flow polishing group (n = 144) and the mechanical polishing group (n = 146). The incidence of posterior capsule rupture and other postoperative outcomes were compared.

RESULTS: The posterior capsule rupture rate in the fluid flow polishing group was 0%, compared to 15.38% in the mechanical polishing group (p < 0.05). The best-corrected visual acuity (BCVA) at 1 day and 1 month post-surgery was significantly higher in the fluid flow group (p < 0.05). Furthermore, the incidence of posterior capsule opacification (PCO) at 1 month was significantly lower in the fluid flow polishing group compared to the mechanical polishing group (p < 0.05). In subgroup analysis, patients older than 60 years exhibited a statistically significant difference in posterior capsule rupture rates (p < 0.05).

CONCLUSION: Fluid flow posterior capsule polishing significantly reduces the incidence of posterior capsule rupture in phacoemulsification cataract surgery, particularly in elderly patients, and contributes to better visual recovery postoperatively. This technique can be considered a safe and effective modification in cataract surgery to improve patient outcomes and reduce complications.

PMID:41021122 | DOI:10.1007/s10792-025-03748-3

Oral Maxillofac Surg. 2025 Sep 29;29(1):163. doi: 10.1007/s10006-025-01464-x.

ABSTRACT

BACKGROUND: Artificial Intelligence (AI) technologies demonstrate potential as supplementary tools in healthcare, particularly in surgery, where they assist with preoperative planning, intraoperative decisions, and postoperative monitoring. In oral and maxillofacial surgery, integrating AI poses unique opportunities and challenges due to its complex anatomical and functional demands.

OBJECTIVE: This study compares the performance of two AI language models, DeepSeek-R1 and ChatGPT-4o, in addressing technical and patient-related inquiries in oral and maxillofacial surgery.

METHODS: A dataset of 120 questions, including 60 technical and 60 patient-related queries, was developed based on prior studies. These questions covered impacted teeth, dental implants, temporomandibular joint disorders, and orthognathic surgery. Responses from DeepSeek-R1 and ChatGPT-4o were randomized and evaluated using the Modified Global Quality Scale (GQS). Statistical analysis was conducted using non-parametric tests, such as the Wilcoxon Signed-Rank Test and Kruskal-Wallis H Test, with a significance threshold of p = 0.05.

RESULTS: The mean GQS score for DeepSeek-R1 was 4.53 ± 0.95, compared to ChatGPT-4o’s mean score of 4.39 ± 1.14. DeepSeek-R1 achieved a mean GQS of 4.87 in patient-related inquiries, such as orthognathic surgery and dental implants, compared to 4.73 for ChatGPT-4o. In contrast, ChatGPT-4o received higher average scores in technical questions related to temporomandibular joint disorders. Across all 120 questions, the two models had no statistically significant difference in performance (p = 0.270). In comparisons with previous models, ScholarGPT demonstrated higher performance than the other models. While this performance difference was not statistically significant compared to DeepSeek-R1 (P = 0.121), it was statistically significantly higher compared to ChatGPT-4o and ChatGPT-3.5 (P = 0.027 and P < 0.001, respectively).

CONCLUSIONS: DeepSeek-R1 and ChatGPT-4o provide comparable performance in addressing patient and technical inquiries in oral and maxillofacial surgery, with small variations depending on the question category. Although statistical differences were not significant, incremental improvements in AI models’ response quality were observed. Future research should focus on enhancing their reliability and applicability in clinical settings.

PMID:41021121 | DOI:10.1007/s10006-025-01464-x

Clin Drug Investig. 2025 Sep 29. doi: 10.1007/s40261-025-01459-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Mitral regurgitation (MR) is the second most common valve disease in Europe with an increasing prevalence, causing a significant healthcare burden and impacting quality of life. Despite its clinical importance, real-world data on MR burden are limited.

OBJECTIVES: This study aimed to estimate MR prevalence, describe patient profiles, and assess healthcare resource utilization and related costs, stratified by degenerative (DMR) and functional (FMR) aetiologies, using real-world data from Italy.

METHODS: A retrospective study using Italy’s Hospital Discharge Records was conducted including patients discharged in 2018 with a diagnosis of MR. The cohort was stratified into degenerative (DMR) and functional MR (FMR) based on comorbidities and clinical criteria. Patients were followed for 12 months to assess interventions received, including surgical (SMVr) and transcatheter mitral valve repair (TMVr), as well as length of stay, in-hospital mortality, and associated costs.

RESULTS: In 2018, 5816 patients who met the eligibility criteria were hospitalised with MR (83.6% DMR, 16.4% FMR). Among DMR patients, 44.2% underwent isolated valve repair (89.7% SMVr, 10.3% TMVr), while 29.1% of FMR patients received repair (59.6% SMVr, 40.4% TMVr). TMVr patients were older (DMR: 41.6%, FMR: 42.9% aged ≥75 years) and had more comorbidities. Untreated patients had higher 1-year in-hospital mortality (DMR: 4.7%, FMR: 8.5%) compared to treated groups and the highest reintervention rate at 1 year (DMR: 19.9%, FMR: 13.3%). Re-intervention rates were lower in DMR (SMVr: 0.4%, TMVr: 0%) versus FMR (SMVr: 0.6%, TMVr: 0.9%). The cost differences between interventions were negligible, primarily reflecting the different DRG tariffs applied for each intervention type.

CONCLUSIONS: Untreated MR is associated with worse clinical outcomes and higher long-term resource use. These findings support early intervention strategies and highlight the need to improve access to care, especially for high-risk populations. Further studies are warranted to explore outpatient care and address treatment disparities.

PMID:41021118 | DOI:10.1007/s40261-025-01459-2

Hernia. 2025 Sep 29;29(1):283. doi: 10.1007/s10029-025-03476-8.

ABSTRACT

INTRODUCTION: While off-midline hernias represent only a small percentage of abdominal wall defects, symptoms can be debilitating for the affected patients, and repair portends substantial operative challenges for the surgeon. There are no large-scale case series that describe outcomes with extraperitoneal repair using the robotic approach. The objective of this study was to describe our experience of patients undergoing robotic repair of off-midline hernias at a tertiary care medical center.

METHODS: This study was a retrospective review of patients who underwent elective robotic repair of off-midline hernias from June 2019 to October 2024. All adults (≥ 18 years old) diagnosed with a primary (no prior repair) or recurrent off-midline hernia were included. Patient demographics, preoperative clinical variables (smoking status, BMI, ASA score, co-morbidities, presence of pain, hernia type, history of prior hernia repair, type of prior flank operation, and dimensions of the hernia on CT scan), operative variables (perioperative regional pain blocks, operative approach, type and dimensions of mesh used), and postoperative outcomes (hospital length of stay (LOS), follow-up duration, hernia recurrences, and complications including wound occurrences and chronic pain defined as pain > 3 months postop) were abstracted from a prospectively maintained hernia database. Univariate analyses were used to measure and describe all covariates and outcomes.

RESULTS: There were 43 patients included in the study. Patients had an average age of 57.5 years and an average BMI of 32.8 kg/m2. 81% of the cohort identified as White race and 65% were female. 26% of the cohort had diabetes mellitus (average HbA1c 5.8), 7% had a smoking history, and 9% had COPD. Most hernias were incisional (51%) or traumatic (47%). Average hernia length and width were 8.0 ± 4.5 and 6.7 ± 2.7 cm. 98% had a clean wound classification. Fascial closure was performed in 86% of the cases and a mesh was placed in 98% of the cases. Average mesh length and width were 21.2 ± 5.9 and 21.1 ± 5.1 cm. There were 6 (14%) hybrid procedures, where the hernia was repaired via a combination of a robotic and open approach. Average hospital length of stay was 1.9 days and average follow up was 4.4 months. There were two (5%) recurrences. There were 15 (35%) postoperative complications. The most common complications were seroma (14%), hematoma (7%) and persistent pain > 3 months (5%). One patient (2%) developed an abscess, two patients (5%) had a nerve injury, and one patient (2%) had a postoperative small bowel obstruction.

CONCLUSION: Robotic off-midline hernia repair can be performed with minimal morbidity. Most common complication was postoperative seroma. Surgical outcomes were similar to existing literature on outcomes following open repair. Surgeons performing this repair should appropriately counsel their patients on the risks of pain and recurrence postoperatively.

PMID:41021101 | DOI:10.1007/s10029-025-03476-8