Category: Nevin Manimala

J Funct Biomater. 2025 Mar 13;16(3):99. doi: 10.3390/jfb16030099.

ABSTRACT

The periodontal ligament (PDL) is a fibrous connective tissue that anchors the tooth-root surface to the alveolar bone with specific orientations. It plays a crucial role in functional restoration, optimal position stabilities, biomechanical stress transmission, and appropriate tissue remodeling in response to masticatory loading conditions. This pilot study explored spatial microarchitectures to promote PDL orientations while limiting mineralized tissue formation. A computer-designed perio-complex scaffold was developed with two parts: (1) PDL-guiding architectures with defined surface topography and (2) a bone region with open structures. After SEM analysis of micropatterned topographies on PDL-guiding architectures, perio-complex scaffolds were transplanted into two-wall periodontal defects in the canine mandible. Despite the limited bone formation at the 4-week timepoint, bone parameters in micro-CT quantifications showed statistically significant differences between the no-scaffold and perio-complex scaffold transplantation groups. Histological analyses demonstrated that the PDL-guiding architecture regulated fiber orientations and facilitated the functional restoration of PDL bundles in immunohistochemistry with periostin and decorin (DCN). The perio-complex scaffold exhibited predictable and controlled fibrous tissue alignment with specific angulations, ensuring spatial compartmentalization for PDL tissues and bone regenerations. These findings highlighted that the perio-complex scaffold could serve as an advanced therapeutic approach to contribute periodontal tissue regeneration and functional restoration in tooth-supporting structures.

PMID:40137378 | DOI:10.3390/jfb16030099

J Funct Biomater. 2025 Mar 10;16(3):96. doi: 10.3390/jfb16030096.

ABSTRACT

This study assessed the changes in the mechanical and surface properties of the transition zone in multilayered translucent monolithic zirconia subjected to long-term hydrothermal aging. A total of 360 disk-shaped specimens (diameter: 15.0 mm; thickness: 1.2 mm) were prepared using conventional (3Y-TZP in LT; ZL, 4Y-TZP in MT; ZM) and multilayered translucent zirconia (5Y-TZP in MT Multi; ZT, 3Y/5Y-TZP in Prime; ZP) among IPS e.max ZirCAD blocks. Specimens were divided into three groups (n = 30) and aged in the autoclave at 134 °C under 0.2 MPa for 0 h (control group), 5 h (first aged group), and 10 h (second aged group). The mechanical and surface properties of the transition zone in the multilayered translucent zirconia were investigated, followed by statistical analysis (α = 0.05). Before and after aging, ZL (1102.64 ± 41.37 MPa) and ZP (1014.71 ± 139.86 MPa) showed the highest biaxial flexural strength (BFS); ZL showed the highest Weibull modulus (31.46) and characteristic strength (1121.63 MPa); and ZT exhibited the highest nanoindentation hardness (20.40 ± 1.80 GPa) and Young’s modulus (284.90 ± 20.07 GPa). After aging, ZL (116.75 ± 9.80 nm) exhibited the highest surface roughness (Ra); the monoclinic phase contents in ZL and ZP increased; and surface uplifts, microcracks, and irregular defects caused by phase transformation appeared on ZL and ZP surfaces. The 3Y/5Y-TZP transition zone exhibited flexural strength, Vickers hardness, phase distribution changes, and surface microstructure changes similar to those of 3Y-TZP before and after aging; however, the surface roughness was lower than that of 3Y-TZP and higher than those of 4Y-TZP and 5Y-TZP after aging. The mechanical and surface characteristics, excluding BFS and Vickers hardness, were influenced by the yttrium oxide content in each zone and the aging process.

PMID:40137375 | DOI:10.3390/jfb16030096

J Funct Biomater. 2025 Mar 10;16(3):95. doi: 10.3390/jfb16030095.

ABSTRACT

The aim of this study was to compare the efficacy of the guided tissue regeneration (GTR) of periodontal infrabony defects using the frozen radiation-sterilized allogenic bone graft (FRSABG) versus deproteinized bovine bone mineral (DBBM) 5 years after treatment. The association between patients’ compliance and periodontitis recurrence with 5-year outcomes was also evaluated. Thirty infrabony defects in 15 stage III/IV periodontitis patients were randomly allocated to the FRSBAG group (tests) or the DBBM group (controls). Between 1 and 5 years, one patient was lost to follow-up and one tooth was extracted due to root fracture. No tooth was extracted for periodontal reasons. Consequently, 13 teeth in test sites and 14 teeth in control sites were available for the 5-year analysis. The clinical attachment level gain (CAL-G, primary outcome), probing pocket depth (PPD), radiographic defect depth (DD), and linear defect fill (LDF) were examined at baseline and 5 years post-surgically. Both groups showed statistically significant improvements in all evaluated clinical and radiographic parameters at 5 years, with insignificant intergroup differences. CAL-Gs were 4.46 ± 2.07 mm in the FRSBAG group, and 3.86 ± 1.88 mm in the DBBM group (p = 0.5442). In six (43%) patients, we observed periodontitis recurrence, among whom two (33.33%) participated regularly in supportive periodontal care (SPC) and the other four (66.7%) did not take part in SPC. A regression analysis revealed that periodontitis recurrence was a significant predictor of CAL loss and DD increase. FRSBAG and DBBM were both equally effective 5 years after the GTR of infrabony defects. Within the limitations of the present study, its outcomes advocate that both grafts may be considered as a viable option based on patient preferences and clinical considerations.

PMID:40137374 | DOI:10.3390/jfb16030095

J Funct Biomater. 2025 Mar 4;16(3):87. doi: 10.3390/jfb16030087.

ABSTRACT

There is continuing interest in using biologics in root coverage procedures. The aim of the present study was to explore the 2-year outcomes following multiple gingival recessions (GRs) coverage using the application of cross-linked hyaluronic acid (HA) in combination with modified coronally advanced tunnel (MCAT) together with subepithelial connective tissue graft (SCTG). Adopting a split-mouth design, 266 GRs were randomly allocated to either a test (MCAT + SCTG + HA) or control group (MCAT + SCTG). The main outcome variable was the stability of the obtained mean root coverage from 6 months to 24 months. Twenty-four patients were evaluated at the 2-year follow-up. Comparisons between test and control sides at the same time points were evaluated using the t-test for independent variables. The changes in time were compared by one-way analysis of variance with the Tukey post hoc test separately for the test and control groups. The study protocol was registered at ClinicalTrials.gov (NCT05045586). At 2 years, around ninety percent of recessions showed complete root coverage (87.02% of the test group and 91.90% of the control group). Mean root coverage did not differ between the two sides, with 81.37 ± 37.17% (test) and 84.63 ± 35.33% (control), respectively. Significant improvements in the reduction of gingival recession height, clinical attachment level gain, gingival thickness increase, and the root esthetic score were found in both groups after 2 years, but no statistically significant difference was observed between the groups. The adjunctive application of HA significantly improved soft tissue texture (STT, 0.94 ± 0.23 for the test group vs. 0.71 ± 0.46 for the control group). Treatment of multiple gingival recessions with MCAT + SCTG with or without HA yielded marked and comparable 2-year clinical outcomes, which could be maintained over a period of 24 months. The clinical relevance of the demonstrated significant difference in STT between groups may be minimal.

PMID:40137366 | DOI:10.3390/jfb16030087

Can J Physiol Pharmacol. 2025 Mar 25. doi: 10.1139/cjpp-2024-0221. Online ahead of print.

ABSTRACT

The lack of polygenic scores (PGSs) developed for body-mass index (BMI) in children may be problematic because the genetic architecture characterizing BMI changes throughout life. This study aims to describe the genetic susceptibility to obesity in children and to compare two PGSs based on data from adults and children and their association with BMI and discrimination of obesity. The study sample comprises 717 participants aged 4 to 13. Adult- and child-based PGS were evaluated by examining 1) mean BMI across polygenic score risk categories, 2) the capacity to identify obesity with logistic regression and 3) the linear association with BMI z-scores using linear regression. Increases in one standardized unit of adult-based PGS were related to a stronger increase in BMI z-score (β=0.24-0.39) than PGS derived in children (β=0.21-0.30). The association between obesity and the child score was higher (OR = 1.75-2.33) than for the adult score (OR = 1.74-2.06) for the age group 4-7 years. The inverse was observed for the age group 8-13 years (ORchild 1.56-1.79 vs. ORadult 1.78-2.54). Both adult- and child-based PGS show strong associations with BMI and risk of obesity, with the adult-based score standing out from 8 years old.

PMID:40132211 | DOI:10.1139/cjpp-2024-0221

J Med Internet Res. 2025 Mar 25;27:e70508. doi: 10.2196/70508.

ABSTRACT

BACKGROUND: Adolescent cyberbullying has been a persistent issue, exacerbated by the shift to remote learning and increased screen time during the COVID-19 pandemic. These changes have sparked concerns about potential increases in cyberbullying and its associated risks.

OBJECTIVE: This study aims to explore how factors such as age, exposure to violent media, parental communication quality, internet access, sex, and sibling relationships influence cyberbullying behavior at school. Additionally, we examine how the COVID-19 pandemic may have altered these dynamics.

METHODS: Leveraging a panel dataset, we examine the same group of adolescents both before and during the pandemic. The analysis focused on identifying relationships between the selected factors and cyberbullying perpetration and victimization, with an emphasis on the dynamics introduced by the COVID-19 pandemic.

RESULTS: Perceived quality of parental communication was found to reduce the risk of both cyberbullying perpetration and victimization, with the former effect becoming more pronounced during the COVID-19 pandemic. Exposure to violent media increased both cyberbullying perpetration and victimization, but the effect on perpetration decreased during the COVID-19 pandemic. The well-established correlation between internet access and both cyberbullying perpetration and victimization remained unaffected by COVID-19. Surprisingly, adolescents with siblings were less likely to become victims or perpetrators of school-related cyberbullying, irrespective of the pandemic.

CONCLUSIONS: In hindsight, COVID-19, functioning as a kind of natural experiment, has provided us with a unique opportunity to examine the effects of a global event, forcing major behavioral changes on the persistent challenge of cyberbullying in middle schools.

PMID:40132197 | DOI:10.2196/70508

JMIR Res Protoc. 2025 Mar 25;14:e67128. doi: 10.2196/67128.

ABSTRACT

BACKGROUND: Climate change is affecting public health and well-being. In 2016, Swiss emergency departments (EDs) treated 1,722,000 cases, with 4718 daily admissions. In 2023, the ED of Sion Regional Hospital recorded 75,000 consultations. The links between climate change and health are complex, necessitating urgent research on its impact on cardiopulmonary health in Valais, Switzerland. Raising awareness among frontline professionals is crucial for developing health promotion and disease prevention strategies.

OBJECTIVE: This study explores the preliminary effects of climate change on cardiopulmonary health in Valais and assesses adult patients’ knowledge of its health consequences. Findings will inform adaptations in patient care, health promotion, and disease prevention at Sion Hospital’s ED. The feasibility of patient selection and data collection will also be evaluated.

METHODS: Using a convergent, parallel, mixed methods design, data will be collected from September 21, 2024, to September 20, 2025, with a target sample of 60 patients. The quantitative phase will examine patient recruitment feasibility, consultation reasons, and triage levels, correlating them with climate variables (temperature, nitrogen dioxide, particulate matter, sulfur dioxide, and ozone). It will also analyze sociodemographic profiles. The qualitative phase will explore patients’ knowledge of climate change and its potential links to their ED visits. The feasibility and acceptability of the study process will be assessed. The protocol follows the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Extension for Pilot and Feasibility Trials.

RESULTS: Data collection started on September 21, 2024, following the approval by the ethical commission. Data collection will take place over 1 year, until September 20, 2025.

CONCLUSIONS: This study will test the feasibility of a larger investigation and examine potential associations between Valais’ changing microclimate and population health. Findings will establish patient profiles and explore their perceptions and knowledge of climate change, informing future health interventions.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67128.

PMID:40132196 | DOI:10.2196/67128

J Med Internet Res. 2025 Mar 25;27:e66393. doi: 10.2196/66393.

ABSTRACT

BACKGROUND: Digital cognitive training (DCT) has been found to be more effective than traditional paper-and-pencil training in enhancing overall cognitive function. However, a significant barrier to its long-term implementation is that older adults with mild cognitive impairment (MCI) do not continue to use it or even show a dropoff in usage after the initial engagement. Such short-term engagement may limit the potential benefits of DCT, as sustained use is required to achieve more pronounced cognitive improvements. Exploring the reasons for the shift in discontinuous usage behavior is crucial for promoting successful DCT implementation and maximizing its positive effects.

OBJECTIVE: This study aimed to explore the intrinsic reasons for the transition from initial acceptance to discontinuous usage behavior among older adults with MCI throughout the DCT process, by employing the extended model of IT continuance (ECM-ITC).

METHODS: We employed a qualitative research methodology and conducted 38 semistructured interviews before and after the use of DCT (3 times per week over 1 month, with each session lasting 30 minutes) with 19 older adults with MCI (aged 60 years or older) and 4 family members between January and March 2024. Thematic analysis and deductive framework analysis were used to identify the reasons for the discontinuous usage of DCT, with mapping to the ECM-ITC.

RESULTS: Most participants failed to complete the standard dosage of DCT. Data analysis revealed the reasons for the shift to discontinuous usage. Despite their need to improve cognitive function, participants found the cognitive training confusing and discovered that DCT did not align with their preferred method of training upon actual use. The disparity between their vague expectations and reality, combined with the contradiction between the “delayed gratification” of DCT and their desire for “immediate gratification,” made it difficult for them to discern the usefulness of DCT. Participants also viewed DCT as an additional financial burden and tended to avoid training under family pressure. They relied on motivational measures, which further weakened their intention to continue DCT, ultimately leading to the inability to develop continuous usage behavior.

CONCLUSIONS: Continuous usage behavior differs from initial acceptance as it evolves dynamically with user experience over time. To encourage older adults with MCI to persistently engage with DCT, it is essential to not only thoroughly consider their genuine preferences and the potential disruptions DCT may bring to their lives but also bridge the gap between expectations and actual experiences. While ensuring that older adults receive appropriate external incentives and encouragement, it is equally important to foster their intrinsic motivation, thereby gradually cultivating the habit of sustained DCT usage.

PMID:40132189 | DOI:10.2196/66393

JMIR AI. 2025 Mar 25;4:e59094. doi: 10.2196/59094.

ABSTRACT

BACKGROUND: The application of machine learning methods to data generated by ubiquitous devices like smartphones presents an opportunity to enhance the quality of health care and diagnostics. Smartphones are ideal for gathering data easily, providing quick feedback on diagnoses, and proposing interventions for health improvement.

OBJECTIVE: We reviewed the existing literature to gather studies that have used machine learning models with smartphone-derived data for the prediction and diagnosis of health anomalies. We divided the studies into those that used machine learning models by conducting experiments to retrieve data and predict diseases, and those that used machine learning models on publicly available databases. The details of databases, experiments, and machine learning models are intended to help researchers working in the fields of machine learning and artificial intelligence in the health care domain. Researchers can use the information to design their experiments or determine the databases they could analyze.

METHODS: A comprehensive search of the PubMed and IEEE Xplore databases was conducted, and an in-house keyword screening method was used to filter the articles based on the content of their titles and abstracts. Subsequently, studies related to the 3 areas of voice, skin, and eye were selected and analyzed based on how data for machine learning models were extracted (ie, the use of publicly available databases or through experiments). The machine learning methods used in each study were also noted.

RESULTS: A total of 49 studies were identified as being relevant to the topic of interest, and among these studies, there were 31 different databases and 24 different machine learning methods.

CONCLUSIONS: The results provide a better understanding of how smartphone data are collected for predicting different diseases and what kinds of machine learning methods are used on these data. Similarly, publicly available databases having smartphone-based data that can be used for the diagnosis of various diseases have been presented. Our screening method could be used or improved in future studies, and our findings could be used as a reference to conduct similar studies, experiments, or statistical analyses.

PMID:40132187 | DOI:10.2196/59094

Interact J Med Res. 2025 Mar 25;14:e54651. doi: 10.2196/54651.

ABSTRACT

BACKGROUND: Taiwan’s categorization of hospital emergency capability (CHEC) policy is designed to regionalize and dispatch critical patients. The policy was designed in 2009 to improve the quality of emergency care for critical time-sensitive diseases (CTSDs). The CHEC policy primarily uses time-based quality surveillance indicators.

OBJECTIVE: We aimed to investigate the impact of Taiwan’s CHEC policy on CTSDs.

METHODS: Using Taiwan’s 2005 Longitudinal Health Insurance Database, this nationwide retrospective cohort study examined the CHEC policy’s impact from 2005 to 2011. Propensity score matching and difference-in-differences analysis within a generalized estimating equation framework were used to compare pre- and postimplementation periods. The study focused on acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), septic shock, and major trauma. AIS and STEMI cases, monitored with time-based indicators, were evaluated for adherence to diagnostic and treatment guidelines as process quality measures. Mortality and medical use served as outcome indicators. Major trauma, with evolving guidelines and no time-based monitoring, acted as a control to test for policy spotlight effects.

RESULTS: In our cohort of 9923 patients, refined through 1:1 propensity score matching, 5566 (56.09%) were male and were mostly older adults. Our analysis revealed that the CHEC policy effectively improved system efficiency and patient outcomes, resulting in significant reductions in medical orders (-7.29 items, 95% CI -10.09 to -4.48; P<.001), short-term mortality rates (-0.09%, 95% CI -0.17% to -0.02%; P=.01) and long-term mortality rates (-0.09%, 95% CI -0.15% to -0.04%; P=.001), and total medical expenses (-5328.35 points per case, 95% CI -10,387.10 to -269.60; P=.04), despite a modest increase in diagnostic fees (376.37 points, 95% CI 92.42-660.33; P=.01). The CHEC policy led to notable increases in diagnostic fees, major treatments, and medical orders for AIS and STEMI cases. For AIS cases, significant increases were observed in major treatments (β=0.77; 95% CI 0.21-1.33; P=.007) and medical orders (β=15.20; 95% CI 5.28-25.11; P=.003) compared to major trauma. In STEMI cases, diagnostic fees significantly increased (β=1983.75; 95% CI 84.28-3883.21; P=.04), while upward transfer rates significantly decreased (β=-0.59; 95% CI -1.18 to -0.001; P=.049). There were also trends toward increased major treatments (β=0.30; 95% CI -0.03 to 0.62, P=.07), medical orders (β=11.92; 95% CI -0.90 to 24.73; P=.07), and medical expenses (β=24,275.54; 95% CI -640.71 to 4,991,991.78; P=.06), although these were not statistically significant. In contrast, no significant changes were identified in process or outcome quality indicators for septic shock. These findings suggest policy spotlight effects, reflecting a greater emphasis on diseases directly prioritized under the CHEC policy.

CONCLUSIONS: The CHEC policy demonstrated the dual benefits of reducing costs and improving patient outcomes. We observed unintended consequences of policy spotlight effects, which led to a disproportionate improvement in guideline adherence and process quality for CTSDs with time-based surveillance indicators.

PMID:40132185 | DOI:10.2196/54651