Pharyngo-oesophageal spasm is a common reason behind the failure of tracheo-oesophageal voice production. This study aims to describe the feasibility of high-resolution ultrasound for localisation of the spasmodic segment for botulinum toxin injection.

The pharyngo-oesophageal segment was localised using a 6–13 Hz linear probe. It was visualised as a concentric muscular area between the great vessels of the neck. The spasmodic segment was identified as the narrowest region when the patient was asked to attempt phonation and swallow.

This technique was utilised in one patient who had pharyngo-oesophageal spasm following total laryngectomy. Following botulinum toxin injection, the patient was able to attempt phonation after one week.

High-resolution ultrasound is an effective modality to guide botulinum toxin injection into the spasmodic pharyngo-oesophageal segment. It allows intervention to be performed at the bedside or outpatient setting without associated radiation exposure.

To assess anthropometric failure prevalence using a composite index of anthropometric failure and evaluate the concordance of mid-upper arm circumference (MUAC) with weight for length z score (WLZ) in identifying acute malnutrition in children.

We used data from a pre-proof-of-concept (pre-POC) study conducted in 2022–2023.

The study was conducted in the Vellore district in Tamil Nadu, South India.

We included all children aged 5–19 months who were pre-screened for the pre-POC study and had available data on weight, length, MUAC, date of birth and child sex.

A total of 663 children were available for analysis, with a mean age of 11·4 months. The prevalence of underweight, stunting and wasting was 23·8 %, 24·3 % and 16·6 %, respectively. 36·7 % of the children had at least one form of anthropometric deficit, and 8·2 % showed severe deficits. We found a fair agreement between MUAC and WLZ values (kappa = 0·32) and a poor agreement of kappa = 0·19 and 0·10 with weight for age z score (WAZ) and length for age z score (LAZ), respectively.

The prevalence of malnutrition remains a significant public health concern in South India, with rates consistent with previous literature. MUAC and WLZ cutoffs by the WHO identify different groups with acute malnutrition. Community-based studies using WLZ criteria can adopt screening with higher MUAC cutoffs, followed by WLZ or, alternatively, WAZ alone, as low WAZ covers most participants with low MUAC and WLZ, providing better feasibility. However, the optimal measurement for risk identification requires further exploration.

Difficulty visualising the round window is occasionally encountered during cochlear implant surgery. This paper presents a novel method for predicting difficult round window accessibility using pre-operative computed tomography (CT) imaging.

This is a retrospective multicentre study of all cochlear implantation surgical procedures conducted in two Singaporean tertiary hospitals between 2018 and 2021. Pre-operative CT temporal bone scans were reviewed and two lines were drawn on a single axial cut. Where both lines intersect medially, difficult round window visualisation is predicted. Computed tomography predictions were compared with intra-operative findings, and statistical analysis was performed.

In 9 of 89 cases (10.1 per cent) difficult round window access was noted intra-operatively and 8 cases (88.9 per cent) were correctly predicted by the novel method (p < 0.001; sensitivity, 89 per cent; specificity, 100 per cent).

This study describes a simple, effective method to predict difficult round window access on axial CT temporal bone images, without reconstructed images or complex calculations.

To evaluate clinical characteristics, complications and survival outcomes in patients undergoing lateral temporal bone resection for malignancy at a tertiary skull base centre.

This retrospective cohort study analysed patients treated between 2004 and 2023 at a UK tertiary referral centre. Data collected included demographics, histological diagnosis, stage, surgical approach, reconstruction and adjuvant therapy. Complications and survival were examined using descriptive statistics, Kaplan–Meier survival curves and Cox proportional hazards modelling.

Eighty-nine patients were included (mean age, 67.2 years; 69.7 per cent male). Squamous cell carcinoma (SCC) was the most frequent diagnosis (58.4 per cent) and lateral temporal bone resection was the predominant procedure (73.0 per cent). Post-operative complications occurred in 25.8 per cent of patients, with haematoma the most common complication. Median follow up was 19 months. The 5-year overall survival rate was 50 per cent, with significant differences by cancer stage and patient age.

Surgical management of lateral temporal bone malignancies, predominantly SCC, carries significant morbidity, while survival and complication rates mirror published literature, with outcomes chiefly influenced by age and cancer stage rather than nodal status.

To assess the relationship between vitamin D and post-operative hypocalcaemia in patients undergoing total thyroidectomy in our population.

A prospective cohort of 210 patients meeting inclusion criteria from March 2020 to September 2023 at Sultan Qaboos University Hospital was analysed. Pre-operative serum 25-hydroxy vitamin D was measured, with calcium and parathyroid hormone assessed post-operatively, and symptoms recorded.

Univariate and logistic regression analyses showed no significant association between pre-operative vitamin D levels and post-operative hypocalcaemia (p = 0.254 and 0.52, respectively). Receiver operating characteristic analysis showed an area under the curve of 0.6 (p = 0.012), indicating limited predictive ability.

In our population, pre-operative vitamin D level was not a reliable predictor of post-thyroidectomy hypocalcaemia. Because of population-based differences in vitamin D metabolism and assay variability, universal cut-off values remain impractical. These findings highlight the need for further research to establish population-specific thresholds for vitamin D in predicting hypocalcaemia risk.

To map the scope, methods and focus areas of qualitative research in paediatric otolaryngology.

A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic mapping review searched MEDLINE, Embase, CENTRAL and PsycInfo (August 2025) for qualitative or mixed-methods studies with a qualitative component related to paediatric otolaryngology. Two reviewers independently applied the inclusion criteria. Key study characteristics were extracted; no formal risk-of-bias assessment was performed, in line with the aims of a mapping review.

Eighty-nine studies were included. Publications rose sharply after 2015, with nearly three-quarters from the USA, Canada and the UK. Otology (49 per cent) and laryngology (40 per cent) predominated; common topics were hearing loss, tonsillectomy and tracheostomy. Interviews, mainly semi-structured (73 per cent), were the dominant method, and caregivers were the most frequent participants (62 per cent).

Qualitative research in paediatric otolaryngology is growing but remains geographically and methodologically narrow. Broader stakeholder inclusion and methodological diversity are needed to deepen understanding and support patient-centred care.

Despite growing front-of-pack labelling (FOPL) policy implementation in low-and middle-income countries (LMIC), research approaches for evaluating these policies remain poorly characterized, hindering evidence-based policy development and methodological gaps. This study explored research approaches, frameworks, and methods used in assessing FOPL policy implementation and response in LMIC.

Systematic search of five databases, including Medline, Web of Science, Scopus, Global Health, and CINAHL, for peer-reviewed articles published between 2014–2025. Studies on FOPL policy implementation or response in LMIC were included. Data on study characteristics, methods, and findings were extracted and synthesized.

LMIC.

All populations.

Thirty-one studies revealed significant research imbalances. Implementation studies (n 3) used qualitative approaches with policy theories, while response studies (n 28) predominantly employed quantitative methods including surveys, experiments, and modeling. Pronounced geographical bias emerged, with 24 studies conducted in Latin America while other LMIC regions remained underrepresented. Common limitations included non-representative sampling, self-reported data, and short timeframes. Mandatory FOPL policies achieved higher compliance than voluntary schemes, though implementation faced challenges including inadequate monitoring, limited resources, and industry resistance. Consumer awareness was generally high but varied significantly across population groups, revealing substantial equity gaps.

This review reveals critical gaps in FOPL implementation research in LMIC, with evidence heavily skewed toward consumer responses and geographically concentrated in Latin America. Future research should prioritize implementation science approaches, geographical diversity, and understanding policy processes in resource-constrained settings to develop effective, context-appropriate FOPL policies.

Timely dissemination of clinical trial results is essential to advance knowledge, guide practice, and improve outcomes, yet many trials remain unpublished, limiting impact. We examine what drives publication and timelines across three major clinical domains.

We analyzed study design and factors associated with dissemination of interventional trials, focusing on cardiovascular disease (CVD), cancer, and COVID-19. A total of 10,785 trials (CVD: 5929; cancer: 4210; COVID-19: 646) were linked to PubMed publications using National Clinical Trial identifiers. Study design, operational, and transparency-related features were assessed as predictors of time to publication, defined as the interval from study completion to first publication, using Cox proportional hazards model.

COVID-19 trials had the highest publication rate (49.6%), followed by CVD (42.3%) and cancer (32.9%), likely reflecting pandemic-related prioritization. Faster publication was associated with larger enrollment, more sites, result posting, randomization, DMC presence, and higher blinding levels (all p < 0.05). Slower publication was linked to supportive care or diagnostic trials (CVD), basic science (cancer), and later COVID-19 trial completion. In subgroups, U.S. facility presence (CVD) and phase 3 design (cancer) predicted faster publication, while healthy volunteer inclusion (CVD) predicted slower publication. Among DMC trials, more secondary outcomes were linked to faster publication across all disease areas.

Key study design and operational factors consistently predict whether and when trials are published. Strengthening methodological rigor, result reporting, and multi-site collaboration may accelerate timely dissemination into peer-reviewed literature.

This study aimed to assess the prevalence of non-sugar sweeteners (NSS) in Brazilian food products before the implementation of new nutritional labeling legislation. Specifically, we aimed to determine the eligibility of these products to contain NSS according to RDC no. 18/2008, which governed the use of NSS in Brazil during the study period.

Data were collected from 3335 packaged foods and beverages available in one of Brazil’s top 10 supermarket chains, six months following the publication of front-of-package nutrition labeling (FoPNL) and 19 months before the legislation came into force.

The study was conducted in Brazil.

Our analysis revealed that NSS were present in 12.5% of the sampled products. Notably, high frequencies of NSS were observed in powder dessert mixes and soy drinks (100%), gelatin preparations (88.1%), chewing gum (87.1%), tea (84.6%), and carbonated beverages (71.4%). Furthermore, we found that 82% of products containing NSS made claims regarding sugar and calorie reduction, with 16.6% of these claims being inconspicuous. Additionally, 14% of products targeted controlled sugar intake diets, 0.5% aimed at sugar-restricted diets, and 4% were ineligible for NSS use. Importantly, the declared NSS content adhered to Brazilian regulatory limits.

While most products complied with regulatory standards, our findings highlight the presence of ineligible products and less prominent claims, which may complicate NSS identification for consumers. Continuous monitoring of NSS prevalence, especially following the implementation of FoPNL, is essential for ensuring compliance with regulations and promoting informed consumer choices in Brazil.

Levodopa-induced dyskinesia (LID) is a disabling symptom of Parkinson’s disease (PD). There have been prior attempts to find risk factors contributing to this symptom, but risk factors for the severity of LID have not been comprehensively studied. We aimed to evaluate factors that correlate with LID severity in patients with PD based on the Unified Dyskinesia Rating Scale (UDysRS).

A cross-sectional study was designed on 52 idiopathic PD patients who were referred for LID between 2023 and 2024. Their demographic and clinical records were studied. Furthermore, cognitive decline (MoCA), PD severity (Hoehn and Yahr) and the severity of dyskinesia (UDysRS) were examined. The association between factors and LID severity was evaluated by carrying out univariate regression and multivariate regression backward elimination analysis.

The mean age of patients with LID was 59.9 ± 11.4 years. Results of univariate regression analysis indicated that male sex (β = −0.24, P = 0.04), BMI (β = −0.3, P = 0.005), H&Y (β = 0.4, P = 0.002), diabetes mellitus (β = 0.3, P = 0.018) and levodopa dosage per kilogram (β = 0.37, P = 0.01) were significant factors involved in the severity of dyskinesia. The univariate regression model results showed that lack of constipation (P = 0.04), hyperlipidemia (P = 0.04) and total daily levodopa dosage per kilogram (P = 0.01) were associated with the severity of end-dose dystonia.

This study revealed that female sex, more advanced PD, diabetes mellitus, daily levodopa dosage per kilogram body weight and BMI are associated with the severity of LID. Also, it suggests that hyperlipidemia and lack of constipation are associated with the severity of end-dose dystonia.

Evaluate and improve the accuracy of disaster triage decisions for pediatric patients among clinicians of various training levels using the Sort, Assess, Life-Saving Intervention, Treatment/Transport (SALT) triage system.

We used an online pediatric disaster triage module to evaluate and improve accuracy of triage decisions. During a pre- and post-test activity, participants triaged 20 fictional patients. Between activities, participants completed a didactic covering concepts of disaster triage, SALT triage, and pediatric limitations of triage systems. We assessed accuracy and improvement with non-parametric tests.

There were 48 participants: 27 pediatric emergency medicine attendings (56%), 9 pediatric emergency medicine fellows (19%), 12 pediatric residents (25%). The median (interquartile range [IQR]) pre-test percent accuracy across all participants was 75 (IQR 65-85). Attendings scored higher than residents 80 (IQR 73-88) compared to 60 (IQR 55-65, P < 0.01) but not significantly higher than fellows 75 (IQR 70-85, P = 0.6). For the 44 participants who completed both the pre- and post-test, median score significantly improved from 75 (65-85) to 80 (75-90), P < 0.01.

The accuracy of triage decisions varies at different training levels. An online module can deliver just-in-time triage training and improve accuracy of triage decisions for pediatric patients, especially among pediatric residents.