Nevin Manimala

BMC Oral Health. 2026 Jan 29. doi: 10.1186/s12903-025-07599-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To comparatively evaluate the effects of mineral trioxide aggregate (MTA) mixed with distilled water (DW), phosphate-buffered saline (PBS), and disodium hydrogen phosphate (DSHP) on the root dentine of teeth affected by diabetes mellitus (DM).

MATERIALS AND METHODS: Five samples of MTA were mixed with either distilled water (DW), phosphate-buffered saline (PBS), or disodium hydrogen phosphate (DSHP). Then, they were assessed for surface characteristics using high-resolution scanning electron microscopy-energy-dispersive X-ray spectroscopy (HRSEM-EDX), surface microhardness via Vickers indentation, and in vitro bioactivity after 21 days of immersion in simulated body fluid. For the other in vitro tests, 82 single-root human permanent premolars (nondiabetic = 41; diabetic = 41) were decoronated to a standardized length of 12 ± 1 mm. Following tubular density evaluation (n = 5) using HRSEM, push-out bond strength (n = 18) and fracture resistance (n = 9) were assessed using a universal testing machine, whereas the cement-dentine interface (n = 9) was analyzed using HRSEM-EDX. The root specimens were then randomly subdivided into subgroups based on the different ionic MTA formulations as follows: subgroup I: MTA + DW, subgroup II: MTA + PBS, and subgroup III: MTA + DSHP. Statistical analysis was conducted using GraphPad Prism 10.4.1, using independent t-tests and two-way analysis of variance with Bonferroni correction for comparisons (P < 0.05).

RESULTS: MTA + PBS exhibited a uniform matrix with distinct crystalline structures and the highest microhardness (69.2 ± 3.97 VHN), followed by MTA + DSHP and MTA + DW test materials. All formulations promoted apatite formation, with MTA + PBS showing dense, homogenous platelet-like crystals. Tubular density was reported to be higher in diabetic dentine (P < 0.05). MTA + PBS demonstrated superior cement-dentine interface, push-out bond strength, and fracture resistance, followed by MTA + DSHP and MTA + DW in both DM and non-DM root dentine specimens (P < 0.05).

CONCLUSION: DM significantly affects the physicochemical and biological properties of root dentine. Among the various test ionic formulations, MTA + PBS exhibited superior surface characteristics, physicochemical, and biological characteristics compared to MTA + DSHP and MTA + DW. Hence, MTA mixed with phosphate ionic vehicles, is clinically recommended for effective endodontic management of diabetic dentine.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41606578 | DOI:10.1186/s12903-025-07599-3

BMC Public Health. 2026 Jan 28. doi: 10.1186/s12889-026-26391-8. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatitis B virus is a blood borne disease that poses a significant public health problem and is classified as an occupational hazard for healthcare workers, including nursing students. Healthcare workers are four times more likely to contract HBV than the general population. Therefore, a thorough understanding of HBV is crucial for nursing students. This study aimed to assess the level of knowledge about HBV infection among nursing students at Jiblah University of Medical and Health Sciences.

METHODS: A descriptive cross-sectional study was conducted. This study included all 94 students enrolled in the Faculty of Nursing. A standardized, pre-tested questionnaire consisting of three sections was used: students’ sociodemographic data, their knowledge of hepatitis B virus infection, and their knowledge of hepatitis B treatment and prevention. The collected data were analyzed using SPSS version 26. The chi-squared test value was set at 0.05. A p-value less than 0.05 is considered statistically significant.

RESULTS: The results showed that the mean age of the participants was 22.15 ± 2.32 years, and that 57.47% were female. Overall, 73% of students had a good knowledge of hepatitis B virus. Forty-six students (48.9%) in the study group were vaccinated against HBV. A lack of knowledge was found regarding HBV transmission methods. Students’ knowledge of HBV infection was associated with gender and year of study.

CONCLUSIONS: The study indicated that students had a good knowledge of hepatitis B virus infection. There were statistically significant correlations between students’ knowledge of hepatitis B virus infection and their gender and year of study.

PMID:41606557 | DOI:10.1186/s12889-026-26391-8

BMC Pulm Med. 2026 Jan 28. doi: 10.1186/s12890-026-04144-y. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory condition with high morbidity and mortality. This study aimed to investigate the relationship between interleukin-33 (IL-33), thymic stromal lymphopoietin (TSLP), and eosinophilic granulocyte (EOS) levels and the treatment effect and exacerbation risk of COPD.

METHODS: A total of 225 COPD patients who were diagnosed and treated in our hospital from October 2021 to September 2024 were selected as the research objects for retrospective analysis and study, and were recorded as the COPD group. 200 subjects who underwent physical examination in our hospital at the same period were selected as the control group. The serum levels of IL-33, TSLP and EOS were compared between the two groups. The patients were divided into the effective group (102 cases) and the ineffective group (123 cases) according to the reduction of chronic obstructive pulmonary disease assessment test (CAT) score not less than 2 points or lung function grade not less than 1 grade after 1 week of treatment (considered effective). After a 12-month follow-up, patients were further divided into acute exacerbation (n = 104) and non-acute exacerbation (n = 121) groups according to the occurrence of acute exacerbation (patients’ clinical symptoms deteriorated beyond the daily range in a short period of time and needed to change treatment). The changes of serum IL-33, TSLP and EOS levels in patients with different treatment effects and exacerbation risks were detected. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum IL-33, TSLP and EOS alone and in combination for the treatment effect and malignant risk of COPD. Multivariate Logistic regression was used to analyze the influencing factors of ineffective treatment and exacerbation in COPD patients.

RESULTS: Patients with COPD showed higher serum IL-33 and EOS levels and lower TSLP compared to the control group (P < 0.05). Compared with the effective group, patients in the ineffective group showed significantly higher serum levels of IL-33 and EOS and a significantly lower level of TSLP (P < 0.05). Patients in the acute exacerbation group showed higher serum levels of IL-33 and EOS and a lower level of TSLP than the non-acute exacerbation group (P < 0.05). The area under the curve (AUC) of serum IL-33, TSLP, and EOS in detecting the treatment effect of COPD was 0.803, 0.778, and 0.870, respectively. The AUC of combined detection was 0.938, suggesting that the combined detection had a higher predictive value. The AUC for IL-33, TSLP, and EOS were 0.679, 0.716, and 0.891, respectively, with a combined detection AUC of 0.931. For the assessment of COPD exacerbation risk, the combined detection of three indicators had higher clinical value. Multivariate Logistic regression analysis showed that after adjusting for confounding factors such as age, sex, smoking status, and basic pulmonary function, elevated serum IL-33 and EOS levels were still independent risk factors for treatment failure (P < 0.05), while elevated TSLP level was a protective factor (P < 0.05). In terms of predicting the risk of acute exacerbation, the elevated EOS level was an independent risk factor (P < 0.001), and the independent predictive value of IL-33 and TSLP did not reach statistical significance (P > 0.05).

CONCLUSION: The levels of IL-33 and EOS were significantly increased, and the level of TSLP was significantly decreased in patients with effective treatment and acute exacerbation of COPD. The above indicators could be used as important indicators to predict the treatment effect and malignant risk of COPD, and the combined detection had high sensitivity and specificity.

PMID:41606552 | DOI:10.1186/s12890-026-04144-y

BMC Psychiatry. 2026 Jan 28. doi: 10.1186/s12888-026-07804-9. Online ahead of print.

ABSTRACT

OBJECTIVE: Tuberous sclerosis complex (TSC) is a rare disease, and children with TSC are at certain risk for autism spectrum disorder (ASD). This study aims to recognize risk factors for TSC children with ASD by analyzing the clinical characteristics.

METHODS: 171 TSC patients were retrospectively recruited, including 62 patients with ASD, and 109 without. All patients met the diagnostic criteria of TSC recommended in the International TSC Consortium in 2018. The diagnosis of ASD was based on the Diagnostic and Statistical Manual 5th Edition (DSM-5) and the Autism Diagnostic Scale (ADOS).

RESULTS: There was no difference in age at diagnosis, number of unpigmented macules, seizure-free rate, effective rate of drug treatment, concordance of cranial MRI lesion and localization of electroencephalography (EEG) epileptiform discharges between TSC children with ASD and without ASD (p > 0.05). The region of the cranial MRI lesion and cardiac hamartoma might be risk factors of ASD in TSC patients(p = 0.04,p = 0. 013).

CONCLUSIONS: Children with TSC exhibiting frontal lobe lesions or cardiac hamartomas are at a higher risk of developing ASD.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41606547 | DOI:10.1186/s12888-026-07804-9

BMC Med Imaging. 2026 Jan 28. doi: 10.1186/s12880-026-02181-x. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to evaluate the predictive value of preoperative Node-RADS determination at imaging for axillary lymph node (ALN) involvement in cases of breast cancer.

MATERIALS AND METHODS: Node-RADS was determined in all cases using preoperative breast magnetic resonance imaging (MRI) by two radiologists blinded to pathologic results. The ROC curves and AUCs depicted the overall diagnostic performance of the Node-RADS score for lymph node involvement. In addition, the presence of a flare-like perinodal signal was also evaluated as an imaging feature suggestive of extranodal extension. Size and morphological parameters were assessed separately for their association with metastatic involvement.

RESULTS: Both readers demonstrated high diagnostic accuracy in predicting ALN metastasis using the Node-RADS system, with the best diagnostic performance observed at a cutoff value above Node-RADS 2. In logistic regression analysis, heterogeneous internal texture of the lymph node and flare sign were also found to be statistically significantly associated with invasion (p < 0.05). The presence of a fatty hilum was a statistically significant predictor (p < 0.001) associated with a markedly lower likelihood of lymph node metastasis (OR = 0.019, 95% CI = 0.002-0.153).

CONCLUSION: The Node-RADS scoring system demonstrates high diagnostic reliability and reproducibility in the evaluation of axillary lymph nodes in breast cancer. However, the size criterion for ALN assessment may need to be re-evaluated, and the inclusion of size or extranodal extension parameters in the scoring system should be reconsidered.

PMID:41606527 | DOI:10.1186/s12880-026-02181-x

BMC Cancer. 2026 Jan 28. doi: 10.1186/s12885-026-15547-9. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer worldwide. Advanced CRC has a grim prognosis, so there is a high demand for an early non-invasive diagnostic biomarker.

METHODS: We present a colorectal tissue-serum proteomics approach combined with external database analysis to identify early diagnostic biomarkers specific to CRC. Subsequently, RT-qPCR, PRM, and ELISA experiments were employed to validate the biomarkers in an independent CRC case-control group. Furthermore, in vitro experiments were conducted to investigate the implications of a biomarker on CRC cell phenotyping.

RESULTS: Nine proteins (CA1, HBD, SMPDL3A, HBB, ALAD, S100A4, RAB27B, HBA2, CAT) were identified as potential diagnostic biomarkers. Among them, CA1 and SMPDL3A exhibited CRC specificity. The combination of CA1 and SMPDL3A demonstrated superior diagnostic efficacy in CRC (AUC = 0.917; 95% CI = 0.877-0.957). The overexpression of SMPDL3A inhibits the migration and invasion of CRC cells.

CONCLUSIONS: CA1 and SMPDL3A proteins are promising novel specific biomarkers for the early diagnosis of CRC. However, larger prospective trials are necessary to validate their clinical utility.

PMID:41606526 | DOI:10.1186/s12885-026-15547-9

BMC Geriatr. 2026 Jan 28. doi: 10.1186/s12877-026-06985-y. Online ahead of print.

ABSTRACT

BACKGROUND: Persons with dementia (PwD) experience difficulties in daily time management (DTM), which restricts their participation in valued activities. Time management products (TMPs) are assistive devices that support DTM and functional independence. Most previous research on TMP has been based on developed regions of the world. Given the limited research in low- and middle-income countries, the present study aimed to explore the use of TMP by PwD and caregivers in India.

METHODS: We conducted a mixed-methods, explanatory sequential study. We first undertook a single-group, prospective, prepost, interventional study involving 38 dyads of persons with mild to moderate dementia and their caregivers. We assessed the self-reported and caregiver-reported DTM, performance and satisfaction in valued daily activities, time processing abilities, and well-being of the PwD and the caregivers’ well-being and ability to cope. The participants were then encouraged to use the TMP provided as an intervention. We reassessed the participants after three months and conducted semistructured interviews with three PwD and 12 caregivers to understand their experience of using the TMP.

RESULTS: Within-group analysis revealed minimal but statistically insignificant changes in the scores of the PwD and caregiver on all the assessments. These findings suggest that TMP may help maintain the ability of PwD, especially those with mild dementia, and support caregivers to some extent. Thematic analysis revealed benefits to PwD, including reduced annoyance with caregivers’ prompts, improved confidence in knowing the time and doing valued activities more independently, increased caregiver involvement in supporting device use, complex operation of some products, and suggestions to make the products more suitable for use in India. The study also identified salient factors that may influence the use of TMPs, including PwD and caregivers’ need and priority for DTM; personal characteristics; and contextual factors, especially living arrangements and prevalent sociocultural attitudes towards time, devices, and elders. An increased demand for such products in the future is also anticipated.

CONCLUSION: This study provides encouraging evidence on the usefulness and acceptance of TMP by PwD and caregivers in India, although DTM may not be a priority for most individuals. The adoption of such products would entail a person-centred, context-specific approach to the development and provision of assistive technology.

TRIAL REGISTRATION: The trial was registered with the Clinical Trail Registry – India (CTRI/2017/06/008916) on 27 June 2017.

PMID:41606478 | DOI:10.1186/s12877-026-06985-y

J Orthop Res. 2026 Feb;44(2):e70134. doi: 10.1002/jor.70134.

ABSTRACT

Post-traumatic osteoarthritis (PTOA) develops following severe knee trauma like anterior cruciate ligament (ACL) injury. PTOA can be identified by measuring morphology (thickness) and matrix composition of articular cartilage. Morphological MRI has been used to measure cartilage thickness, while quantitative magnetic resonance imaging (qMRI) has been used to measure cartilage matrix composition. In hopes of utilizing a single MRI technique to obtain both measurements simultaneously, this study explored whether cartilage thickness measurements from qMRI sequences were comparable to those from a morphological MRI sequence. Healthy participants with atraumatic, normal knees underwent three MRI acquisitions on their left knee: a three-dimensional (3D) morphological MRI sequence (T1-weighted Fast Field Echo [T1FFE]) and two 3D quantitative MRI sequences (T1ρ, T2*). The images were manually segmented to characterize the articular cartilage surface and subchondral bone-cartilage interface. 3D articular cartilage thickness maps were developed for each acquisition for the lateral and medial compartments of the tibia and femur. The qMRI thickness maps were compared to the morphological MRI thickness maps within subjects at fixed anatomical points. T1ρ cartilage thickness maps showed strong agreement with T1FFE maps as evidenced by ICCs exceeding 0.8 for 11 of 12 regions of interest (ROIs). In addition, mean thickness differences smaller than the in-plane pixel size of the reconstructed images, indicated minimal bias. There was inferior agreement between the T2* and T1FFE maps, and statistically significant bias observed for 8 of 12 ROIs. T1ρ qMRI sequences can simultaneously provide quantitative and comparable morphological measurements of knee articular cartilage thickness.

PMID:41606439 | DOI:10.1002/jor.70134

Community Dent Oral Epidemiol. 2026 Jan 28. doi: 10.1111/cdoe.70055. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: The Health (Fluoridation of Water Supplies) Act of 1960 in Ireland mandates monthly fluoride sampling in Public Water Supplies (PWS). In 2007, authorities adjusted the mandated fluoride concentration from 0.8-1.0 to 0.6-0.8 mg/L. Approximately 71% of the Irish population has access to fluoridated drinking water. This study aimed to analyse fluoride measurements in Irish water supplies for five decades (1964-2016) to assess compliance and effectiveness of the fluoridation programme.

METHODS: Data were sourced from government records and Environmental Protection Agency (EPA) reports. Analysis focused on fluoride concentration measurements, compliance rates, and data completeness across public, private, and group water supplies. Descriptive statistics were used to evaluate trends and patterns in fluoride levels over time.

RESULTS: By 2000, over 90% (n = 307) of PWS, each serving more than 1000 persons, were fluoridated. In the early monitoring period (1964-69), missing data were substantial at 66%, with satisfactory fluoride results (0.8-1.00 mg/L) at only 17% and marginal results (0.70-0.80 and > 1.00-1.10 mg/L) at 15%. Compliance improved steadily, reaching peak performance in 1994-99 with 57% satisfactory results. Following the 2007 adjustment in target concentrations, missing data decreased significantly to 18%, with satisfactory results (0.60-0.80 mg/L) increasing from 40% to 49% and marginal results (0.50-0.60 mg/L and > 0.80-0.90 mg/L) stabilising at 7%-13%. Analysis of private and group supplies revealed evolving trends: from 2000 to 2006, 21% of fluoride testing results were satisfactory and 75% marginal, while the 2007-2016 period showed 39% satisfactory and 48% unsatisfactory results, though only 1% exceeded 0.9 mg/L.

CONCLUSION: The fluoride control in PWS has been largely effective, with consistent improvements in monitoring practices and compliance with target levels over the study period.

PMID:41606420 | DOI:10.1111/cdoe.70055

Clin Pharmacokinet. 2026 Jan 29. doi: 10.1007/s40262-026-01618-4. Online ahead of print.

ABSTRACT

BACKGROUND: High-dose methotrexate (HDMTX) is a key treatment for lymphoma with central nervous system involvement. Whether incorporating cystatin C into glomerular filtration rate estimation improves methotrexate (MTX) clearance prediction remains unclear.

OBJECTIVES: We aimed to evaluate whether cystatin C-inclusive glomerular filtration rate equations improve MTX clearance prediction and to explore the relationship between MTX exposure and acute kidney injury (AKI) in adult patients with lymphoma receiving HDMTX.

METHODS: This was a prospective single-center study performed on 80 adult patients with lymphoma receiving HDMTX (1.5-8 g/m²) over a 4-h infusion. A population pharmacokinetic model was constructed using data from 80 administrations of HDMTX and 427 serum MTX concentrations. The population pharmacokinetic model estimated MTX concentrations were included in a logistic regression to assess the relationship between MTX exposure and AKI.

RESULTS: A two-compartment model best described the pharmacokinetic data, with baseline albumin and CKD-EPI creatinine-cystatin C (eGFRCr-CysC) as significant covariates on clearance. Seventeen patients (21%) developed any-stage AKI. Among those receiving ≤ 3.5 g/m², model-estimated 4-h MTX concentrations were associated with AKI (odds ratio: 1.02 per µmol/L; p = 0.0038), with an optimal threshold of 160 µmol/L (area under the concentration-time curve: 0.818). Patients above this threshold were 22 times more likely to experience AKI (p = 0.0005). This association was not observed in patients treated with 8 g/m². Despite a lower dose and exposure, patients receiving ≤ 3.5 g/m² demonstrated a stronger concentration-toxicity relationship.

CONCLUSIONS: Our results support the use of cystatin C-inclusive glomerular filtration rate estimates in MTX pharmacokinetic modeling and suggest early MTX concentration sampling may identify AKI risk, enabling proactive, AKI-mitigating clinical interventions during HDMTX therapy.

PMID:41606413 | DOI:10.1007/s40262-026-01618-4