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BACKGROUND: The gut visceral musculature plays essential roles in not only moving substances through the lumen but also maintaining the function and physiology of the gut. Although the development of the visceral musculature has been studied in multiple model organisms, how it degenerates is poorly understood. RESULTS: Here, we employ the Drosophila midgut as a model to demonstrate that the visceral musculature is disrupted by intrinsic and extrinsic factors, such as aging, feeding, chemical-induced tissue damage, and oncogenic transformation in the epithelium. Notably, we define four prominent visceral musculature disruption phenotypes, which we refer as sprout, discontinuity, furcation, and crossover of the longitudinal muscle. Given that the occurrence of these phenotypes is increased during aging and under various stresses, we propose that these phenotypes can be used as quantitative readouts of deterioration of the visceral musculature. Intriguingly, administration of a tissue-damaging chemical dextran sulfate sodium (DSS) induced similar visceral musculature disruption phenotypes in zebrafish larvae, indicating that ingestion of a tissue-damaging chemical can disrupt the visceral musculature in a vertebrate as well. CONCLUSIONS: Our study provides insights into the deterioration of the gut visceral musculature and lays a groundwork for investigating the underlying mechanisms in Drosophila as well as other animals.

The study of prehabilitation and rehabilitation ([p]rehabilitation) to alleviate the sequelae of bladder cancer and its treatment has generated numerous opportunities to improve the quality of life of bladder cancer survivors. The authors conducted a scoping review of randomized clinical trials (RCTs) to identify knowledge gaps in and research directions for (p)rehabilitative support for those affected by bladder cancer. The authors systematically searched six databases and synthesized key findings from RCTs conducted from January 1, 2004, through March 15, 2022, that enrolled participants with bladder cancer, survivors, or caregivers in outpatient (p)rehabilitative programs (e.g., exercise, nutrition, or psychological support). Outcomes were characterized according to eight prespecified, clinically relevant categories. The search retrieved 10,968 records, 27 of which met the inclusion criteria, and 24 described unique RCTs with 2471 enrolled participants. Of 24 interventions, 17 (71%) yielded statistically significant results for the outcome of interest. Only one RCT included a cost‐effectiveness analysis, and only two characterized the efficacy of interventions for caregivers. Of 11 RCTs involving psychological support, eight yielded statistically significant results, as did nine of 11 RCTs with physical exercise interventions, three of four RCTs with educational interventions, three of four RCTs with nutritional support interventions, one of two RCTs with pharmacologic medications, and zero of one RCT with physical therapy. The most promising interventions for inclusion in multimodal, personalized (p)rehabilitation programs included exercise, stress management training, cognitive training, smoking and alcohol cessation counseling, immunonutrition, stoma education, and penile rehabilitation. Further studies of the cost effectiveness and efficacy for caregivers of such interventions are needed. Plain Language Summary: In a scoping review of all randomized clinical trials involving prehabilitative or rehabilitative diet, exercise, and psychological support interventions for patients with bladder cancer, survivors, and their caregivers, 17 of 24 (71%) interventions yielded statistically significant improvements in the outcome of interest.Clinicians should consider implementing such interventions for those affected by bladder cancer. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to evaluate differences in carpal tunnel release volume, reimbursement, practice styles, and patient populations between male and female surgeons from 2013 to 2021. Materials and Methods: The Medicare Physician & Other Practitioners database was queried from 2013 to 2021. Procedure volume, reimbursement, surgeon information, and patient demographic characteristics were collected for any surgeon who performed at least 10 open carpal tunnel release (OCTR) or endoscopic carpal tunnel release (ECTR) procedures that year. The Welch t test, the Kruskal-Wallis test, and multivariable linear regressions were conducted to compare male and female surgeons and analyze geographic and annual differences. Results: From 2013 to 2021, the proportion of carpal tunnel releases performed by female surgeons increased for OCTR by 4.5% (7.1% to 11.6%) and for ECTR by 3.3% (4.8% to 8.1%). Female OCTR surgeons on average had fewer beneficiaries per surgeon (443.37 vs 354.20, P<.001), performed fewer billable services per beneficiary (6.37 vs 5.35, P=.03), and performed fewer unique billable services (91.13 vs 77.79, P<.001) compared with male surgeons. Female OCTR surgeons also saw a lower percentage of White patients (88.14 vs 86.48, P=.003) and a higher percentage of female patients (60.06 vs 61.70, P<.001) and dual-enrolled Medicare-Medicaid patients (10.54 vs 11.22, P=.046). Conclusion: Female representation among OCTR and ECTR surgeons increased across the country. Male OCTR surgeons billed for more services and performed more services per beneficiary and also treated a higher proportion of White patients and dual Medicare-Medicaid enrollees compared with female surgeons. Future studies are required to identify reasons for and ways to address these disparities. [Orthopedics. 2025;48(1):57–63.] [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate changes in open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR) utilization, reimbursement, and patient demographics in the Medicare population from 2013 to 2021 at national and regional levels. Materials and Methods: The Medicare Physician & Other Practitioners database from 2013 to 2021 was queried to extract all instances of OCTR and ECTR. Utilization per 10,000 beneficiaries, inflation-adjusted reimbursement, and patient characteristics were extracted for OCTR and ECTR each year. Data were stratified by region based on US Census guidelines. Kruskal-Wallis tests and multivariable linear regressions were performed. Results: From 2013 to 2021, national utilization per 10,000 beneficiaries increased by 6% for OCTR and by 50% for ECTR. In 2021, the Midwest had the greatest utilization of OCTR (29 of 10,000) and the lowest utilization of ECTR (7 of 10,000). Inflation-adjusted reimbursement declined for both OCTR and ECTR during the study period (10.3% and 11.8%, respectively), with the South having the lowest reimbursement for both procedures. The severity of patient comorbidity profiles and dual Medicare-Medicaid enrollees decreased for both procedures as well. Conclusion: Both OCTR and ECTR utilization have increased, while inflation-adjusted reimbursement has decreased. Patient populations encompassed fewer dual Medicare-Medicaid enrollees, indicating surgeons may be more selective in operative indications. These findings should be addressed to ensure the economic sustainability of carpal tunnel release procedures and equitable access to quality hand care for all patients with Medicare. [Orthopedics. 2025;48(1):e45–e51.] [ABSTRACT FROM AUTHOR]

Background Balloon-assisted enteroscopy (BAE) (both single- and double-balloon enteroscopy) has garnered attention in the treatment of small intestine strictures in patients with Crohn's disease (CD). This study aimed to evaluate the pooled clinical outcomes of BAE-mediated endoscopic dilation of small intestine strictures in patients with CD. Methods We searched multiple databases for articles reporting outcomes following BAE for small intestinal strictures in patients with CD. Outcomes studied were pooled technical success, clinical success and adverse events. Standard meta-analysis methods were employed using the randomeffects model, and heterogeneity was studied using I² statistics. Results We analyzed 26 studies, 9 prospective and 17 retrospective, involving 1570 patients. The pooled technical success rate of double-balloon enteroscopy was 87.6% (95% confidence interval [CI] 82.1-91.5; I²=53%) and the pooled therapeutic success rate was 69.7% (95%CI 61.6-76.7; I²=71%). The pooled major complications per procedure were 5.5% (95%CI 3.5-8.4; I²=57%); the risk of bleeding was 2.5% (95%CI 1.4-4.2; I²=28%), and the risk of perforation was 2.7% (95%CI 1.6-4.5; I²=3%). The pooled rate of recurrence after the first dilation was 42.3% (95%CI 16.9-72.5; I²=59%), and the rate of repeat endoscopic balloon dilation was 23.9% (95%CI 14.1%-37.5%; I²=85%), while the pooled rate of repeat surgery was 25.3% (95%CI 11.8%-46.0%; I²=44%]. Conclusion BAE is a good first line approach for patients with CD-induced strictures in an attempt to treat symptoms and potentially avoid surgery. [ABSTRACT FROM AUTHOR]

Background: Carpal Tunnel Syndrome (CTS) is associated with a significant personal and societal burden. Evaluating access to care can identify barriers, limitations, and disparities in the delivery of healthcare services in this population. The purpose of this study was to evaluate access to overall healthcare and healthcare utilization among patients with CTS. Methods: This is a retrospective cohort study conducted with the All of Us database. Patients diagnosed with CTS that completed the access to care survey were included and matched to a control group. The primary outcomes were access to care across 4 domains: (1) delayed care, (2) could not afford care, (3) skipped medications, and (4) over 1 year since seeing provider. Secondary analysis was then performed to identify patient-specific factors associated with reduced access to care. Results: In total, 7649 patients with CTS were included and control matched to 7649 patients without CTS. In the CTS group, 33.7% (n = 2577) had delayed care, 30.4% (n = 2323) could not afford care, 15.4% (n = 1180) skipped medications, and 1.6% (n = 123) had not seen a provider in more than 1 year. Within the CTS cohort, low-income, worse physical health, and worse mental health were associated with poor access to care. Conclusion: Patients experience notable challenges with delayed care, affordability of care, and medication adherence regardless of having a diagnosis of CTS. Targeted interventions on modifiable risk factors such as low income, poor mental health, and poor physical health are important opportunities to improve access to care in this population. [ABSTRACT FROM AUTHOR]

Omicron, a new variant of Covid-19 has hit the India in the third wave during 2022. The outbreak of this new variant has increased globally. At this time, there is an urgent need of fast, reliable and effective detection method. The real time RT-PCR is the most used technique for the detection of viral DNA. In the present study 'OmiSure' kit developed by Mumbai-based Tata Medical and Diagnostics Ltd (TATA MD) in partnership with The Indian Council of Medical Research (ICMR) was used for direct detection of Omicron variant in the SARS-CoV-2 positive samples via multiplex real time RT-PCR as a diagnostic tool. The reaction was tested targeting viral RNA and human target mRNA sequence using S gene target failure and S- gene mutation amplification strategy. In the present study 532 samples were tested for the presence of Omicronin the SARS-CoV-2 positive samples. The study found that a total of 501 individuals were positive for Omicron variant while 31 individuals were detected to be of other variants. Further these 31 SARS-CoV-2 positive samples were processed by nanopore whole genome sequencing and identified as Delta and its sub variants of SARS-CoV-2. These sequences were submitted in Indian SARS-CoV-2 Genomic Consortium (INSACOG) and Global Initiative on Sharing Avian Influenza Data (GISAID). The study showed that OmiSure kit is an accurate, fast and easy to use rRT-PCR Omicron diagnostic assay. [ABSTRACT FROM AUTHOR]