Category: Nevin Manimala

Lasers Med Sci. 2025 Aug 15;40(1):336. doi: 10.1007/s10103-025-04583-9.

ABSTRACT

This study aimed to investigate the synergistic effects of Er, Cr: YSGG laser and fluoride varnish (Duraphat) on the remineralization of demineralized enamel in vitro. The study further compared the combined treatment with the individual effects of the laser and Duraphat, providing a theoretical foundation and technical insights for early caries management. A randomized controlled study was conducted, involving 50 extracted teeth assigned to four groups: control, laser only, Duraphat only, and a combination of laser and Duraphat. Following standardized demineralization protocols, samples underwent respective remineralization treatments. The mineralization level was quantified using a DIAGNOdent pen, and enamel surface microstructural changes were assessed via scanning electron microscopy (SEM). Data were analyzed using one-way ANOVA and paired-sample t-tests, with statistical significance set at P < 0.05. The laser and Duraphat combination group exhibited the most pronounced remineralization effects, as indicated by a significant reduction in DIAGNOdent values (P < 0.05), outperforming both the laser-only and Duraphat-only groups. SEM analysis demonstrated uniform and dense crystal deposition on the enamel surface, nearly sealing demineralized pores. In contrast, the Duraphat group showed surface-concentrated crystal deposition with limited depth, while the laser group primarily improved enamel surface microstructure without significantly increasing mineralization depth. No notable changes were observed in the control group.The combination of Er, Cr: YSGG laser and Duraphat significantly enhances remineralization by optimizing enamel microstructure and improving fluoride penetration depth and mineralization efficiency, surpassing the efficacy of individual treatments.

PMID:40815334 | DOI:10.1007/s10103-025-04583-9

Environ Geochem Health. 2025 Aug 15;47(9):389. doi: 10.1007/s10653-025-02686-4.

ABSTRACT

The increasing adoption of photovoltaic farms is driven by the growing demand for clean, renewable energy. As advancements in solar technology continue and costs decrease, large-scale solar farms are becoming essential for reducing carbon emissions and enhancing energy security. While PV farms offer a sustainable energy solution, they also pose environmental risks. During their operational lifetime, PV panels can be damaged, potentially releasing hazardous materials into the environment. Additionally, stormwater runoff from solar installations may carry pollutants into soil and water sources. Mitigating these risks is crucial to ensuring that solar energy remains both sustainable and environmentally responsible. This work aims to evaluate PV panels’ environmental impact, especially on the soil in one of the oldest PV installations in Poland, comparing it with other sources of pollution in the region, such as mining. Therefore, soil and water samples underwent chemical analysis, statistical analysis, pollution indices assessment, and geospatial analysis to determine potential pollution sources for the observed elemental chemical matrix. Also, the chemical composition of PV material was analyzed. The results indicate that In and Sb are emerging pollutants at moderate levels, potentially originating from long-term use of PV installations. In contrast, elements such as Cd, Cr, Pb, and Zn, which come from mining and smelting activities, present significantly higher environmental risks. This study suggests conducting further similar research across various geological backgrounds to draw broader conclusions. Besides, it is vital to develop experiments that assess the impact of PV panels as hazardous waste materials on soil and water.

PMID:40815333 | DOI:10.1007/s10653-025-02686-4

Discov Ment Health. 2025 Aug 15;5(1):122. doi: 10.1007/s44192-025-00244-z.

ABSTRACT

BACKGROUND: Recognizing the importance of spiritual health in professional practice is crucial for providing effective patient care. This study examines the relationship between spiritual health and professionalism among Iranian operating room interns in 2024.

METHODS: A cross-sectional study investigated the relationship between spiritual health and professionalism among Iranian operating room interns in 2024. A random sample of 151 students completed a three-part questionnaire assessing demographics, the Spiritual Well-Being Scale (SWBS) developed by Ellison (1983), and the Penn State Professionalism Questionnaire (PSPQ) developed by Black et al. (2007). Data analysis, using SPSS version 26.0, included descriptive statistics and correlation analyses.

RESULTS: Participants had a mean (standard deviation) age of 23.24 (6.23) years, predominantly female (67.5%), mostly in their eighth semester (64.2%), with 70.2% achieving an average grade below 18 (out of 20 points). Mean (SD) scores indicated spiritual well-being at 89.23 (18.93) and professionalism at 137.75 (15.08), with religious well-being 47.66 (10.47) exceeding existential well-being 41.57 (9.66). Among professionalism dimensions, respect (25.36 ± 3.33) and honor and integrity (23.89 ± 3.39) ranked highest, while altruism (20.97 ± 3.05) and duty (21.79 ± 3.36) were lower. A significant relationship was found between religious well-being and all professionalism dimensions, while existential well-being correlated with accountability, duty, and excellence.

CONCLUSION: The findings suggest that enhancing spiritual well-being, particularly religious aspects, may foster professionalism in medical practice, ultimately contributing to improved patient care and intern development in the healthcare setting.

PMID:40815331 | DOI:10.1007/s44192-025-00244-z

Eur Radiol. 2025 Aug 15. doi: 10.1007/s00330-025-11929-y. Online ahead of print.

ABSTRACT

OBJECTIVES: This study evaluates the efficiency, accuracy, and cost-effectiveness of radiology reporting using audio multimodal large language models (LLMs) compared to conventional reporting with speech recognition software. We hypothesized that providing minimal audio input would enable a multimodal LLM to generate complete radiological reports.

MATERIALS AND METHODS: 480 reports from 80 retrospective multimodal imaging studies were reported by two board-certified radiologists using three workflows: conventional workflow (C-WF) with speech recognition software to generate findings and impressions separately and LLM-based workflow (LLM-WF) using the state-of-the-art LLMs GPT-4o and Claude Sonnet 3.5. Outcome measures included reporting time, corrections and personnel cost per report. Two radiologists assessed formal structure and report quality. Statistical analysis used ANOVA and Tukey’s post hoc tests (p < 0.05).

RESULTS: LLM-WF significantly reduced reporting time (GPT-4o/Sonnet 3.5: 38.9 s ± 22.7 s vs. C-WF: 88.0 s ± 60.9 s, p < 0.01), required fewer corrections (GPT-4o: 1.0 ± 1.1, Sonnet 3.5: 0.9 ± 1.0 vs. C-WF: 2.4 ± 2.5, p < 0.01), and lowered costs (GPT-4o: $2.3 ± $1.4, Sonnet 3.5: $2.4 ± $1.4 vs. C-WF: $3.0 ± $2.1, p < 0.01). Reports generated with Sonnet 3.5 were rated highest in quality, while GPT-4o and conventional reports showed no difference.

CONCLUSION: Multimodal LLMs can generate high-quality radiology reports based solely on minimal audio input, with greater speed, fewer corrections, and reduced costs compared to conventional speech-based workflows. However, future implementation may involve licensing costs, and generalizability to broader clinical contexts warrants further evaluation.

KEY POINTS: Question Comparing time, accuracy, cost, and report quality of reporting using audio input functionality of GPT-4o and Claude Sonnet 3.5 to conventional reporting with speech recognition. Findings Large language models enable radiological reporting via minimal audio input, reducing turnaround time and costs without quality loss compared to conventional reporting with speech recognition. Clinical relevance Large language model-based reporting from minimal audio input has the potential to improve efficiency and report quality, supporting more streamlined workflows in clinical radiology.

PMID:40815310 | DOI:10.1007/s00330-025-11929-y

Eur Radiol. 2025 Aug 15. doi: 10.1007/s00330-025-11927-0. Online ahead of print.

ABSTRACT

OBJECTIVES: To explore the different criteria of integrating diffusion-weighted imaging (DWI) for predicting pathologic complete response (pCR) of rectal cancer on post-chemoradiotherapy (CRT) MRI.

MATERIALS AND METHODS: In this multi-center retrospective study, five radiologists reviewed pre- and post-CRT MRIs of patients with rectal cancer diagnosed in 2017-2021. In addition to mrTRG, three criteria were assessed: “AND” criterion (mrTRG 1-2 and absence of DWI restriction considered as CR), “OR” criterion (mrTRG 1-2 or absence of restriction), and a modified MR tumor regression grade (modMR-TRG). A crossed random effects model was used to pool sensitivity and specificity across five radiologists. F1 score and positive predictive value (PPV) were analyzed across varying pCR rates.

RESULTS: In 146 patients (median age [IQR], 63 [57-70] years; 87 men), the AND criterion yielded higher specificity (77.4% [63.3-80.0%] vs 75.3% [60.5-79.0%], p = 0.001) without significant difference in sensitivity (63.9% [42.8-75.3%] vs 67.5% [45.3-76.0%], p = 0.063) compared with mrTRG. OR criterion yielded higher sensitivity (86.1% [65.3-89.3%]; p < 0.001) but lower specificity (49.5% [36.2-62.6%]; p < 0.001). The modMR-TRG demonstrated similar effects to the OR criterion. Assuming a 20% pCR rate, PPV and F1 score of the AND criterion (point estimate of 41.4% and 50.3%, respectively) were higher than those of the OR criterion (PPV, 29.9%; F1 score, 44.4%), although the difference diminished with increasing pCR rate.

CONCLUSION: The AND criterion-which utilizes DWI complementarily to further exclude patients with residual tumors after initial screening on T2WI-should be preferred over other criteria giving greater emphasis on DWI.

KEY POINTS: Question How should diffusion-weighted images be combined with T2-weighted images in predicting complete tumor response of rectal cancer on MRI following CRT? Findings Compared to mrTRG, the AND criterion yielded higher specificity without a significant difference in sensitivity, while the OR and modMR-TRG criteria yielded higher sensitivity but lower specificity. Clinical relevance Our study explores practical strategies for integrating DWI with T2WI that can be applied in daily practice. The AND criterion by using DWI conservatively is preferred over OR criteria, which results in a disproportionately higher number of additional false-positives than additional true-positives.

PMID:40815309 | DOI:10.1007/s00330-025-11927-0

Glob Health Sci Pract. 2025 Aug 14;13(1):e2400177. doi: 10.9745/GHSP-D-24-00177. Print 2025 Aug 14.

ABSTRACT

INTRODUCTION: Gender-based violence (GBV) not only poses significant public health and human rights challenges but is also closely associated with HIV. GBV acts as a barrier to HIV prevention, testing, and treatment adherence, and fear of GBV inhibits disclosure of HIV status to sexual partners. In Malawi, where both GBV and HIV prevalence is high, integrating GBV services into HIV care is crucial. We describe the integration of GBV services into Lighthouse Trust’s HIV testing and treatment clinics in Malawi, including screening, documentation, intervention implementation, outcomes, and lessons learned.

METHODS: We conducted a retrospective analysis from January 2020 to June 2024. Data on cases identified, post-GBV services, and perpetrator demographics were collected from the GBV register. We used descriptive statistics to describe the intervention outcomes.

RESULTS: We documented 9,045 reported GBV cases among males and females from January 2020 to June 2024. Adolescent girls aged 10-19 years constituted a significant proportion of survivors. Psychosocial services were the most common type of service that was offered to GBV survivors (25%), followed by HIV testing (19%) and sexually transmitted infection screening (18%). Perpetrators were mostly known to survivors.

CONCLUSION: We successfully integrated GBV services into the Lighthouse Trust HIV clinics in close collaboration with the one-stop centers in Malawi. Training health care providers enhanced support for GBV survivors, with a focus on increasing awareness, especially for children and adolescents. Recommended actions include improving access to GBV services, enhancing documentation, and promoting multi-sectoral collaboration to ensure comprehensive care aimed at creating a safer, more dignified health care environment for all, particularly GBV survivors.

PMID:40813243 | DOI:10.9745/GHSP-D-24-00177

J Nucl Med. 2025 Aug 14:jnumed.124.269234. doi: 10.2967/jnumed.124.269234. Online ahead of print.

ABSTRACT

Deep learning (DL) represents a promising technique for image restoration. We explored its ability to restore ultra-low-count [¹⁸F]FDG PET studies of the brain in subjects with dementia and in healthy subjects to allow for reduced scan durations or administered activities without compromising diagnostic performance. Methods: Various DL models using the content aware image restoration approach of CSBDeep toolbox (3D U-nets) were trained with subvolumes of 1,000 random subjects. On the basis of 10-min list-mode PET data after injection of 208 ± 10 MBq of [¹⁸F]FDG, we reconstructed reduced scan durations of 2 min, 1 min, 30 s, 20 s, and 10 s. The resulting models were applied to [¹⁸F]FDG PET scans of subjects with Alzheimer disease (n = 15), frontotemporal dementia (n = 14), and healthy controls (n = 13). We explored the effect of reduced scan times on individual regional measures in diagnostically relevant regions and on voxel-based group contrasts. Three independent readers rated all datasets with regard to assessability, diagnosis, and diagnostic confidence. Results: Individual mean regional [¹⁸F]FDG uptake remained largely unchanged. The SD strongly increased with shorter scan duration without application of DL (mean increase ≤ 48%), whereas it slightly decreased with DL (≥-7%). In group contrasts, the number of significant voxels strongly decreased with shorter scan time without DL (≥-41%), which was partially offset by DL (≥-27%). On visual reads, the fraction of assessable images steeply fell to only 4% (10-s scan) for scan durations below 2 min without DL, whereas every single image restored with DL was assessable. The diagnostic confidence continuously declined with shorter scan durations without DL, whereas diagnostic confidence only negligibly changed with DL (intermediate-to-high confidence ratings: 0%-54% vs. 80%-84%; 83% for the 10-min scan). The diagnostic accuracy of PET reads dropped from 90% to 4% without and remained high with DL (90%-93%; 90% for the 10-min scan). Conclusion: Our study demonstrates the compelling performance of DL to restore cerebral [¹⁸F]FDG PET datasets with ultra-low-count statistics for quantitative regional, voxel-based group, and clinical visual analyses. Consequently, DL enables a dramatic reduction of scan durations or administered activities (e.g., 10-min scan with 3.5 MBq, equivalent to ∼60 µSv) for [¹⁸F]FDG PET in patients with dementia and possibly other indications.

PMID:40813236 | DOI:10.2967/jnumed.124.269234

J Nucl Med. 2025 Aug 14:jnumed.124.268841. doi: 10.2967/jnumed.124.268841. Online ahead of print.

ABSTRACT

The improved sensitivity of total-body (TB) PET/CT offers the possibility of reducing injected activities. The aim of our study was to define a lower limit of reduced injected activities in [¹⁸F]FDG TB PET/CT for interim and end-of-treatment assessment of patients with lymphoma at 2 acquisition times. Methods: Twenty-four consecutive patients with lymphoma who were undergoing interim and end-of-treatment TB PET/CT were prospectively enrolled in this study. An [¹⁸F]FDG activity of 3.0 MBq/kg served as the reference standard (RS). Images simulating low doses of 1.0, 0.5, 0.25, and 0.125 MBq/kg were reconstructed at 1 and 2 h after injection. The coefficient of variation of the liver was assessed. Lymphoma lesions were segmented and semiquantitatively compared with the RS using the SUV. Additionally, metabolic tumor volume (MTV) for each lesion, patient-based total MTV, and total-lesion glycolysis (TLG) were analyzed. Semiquantitative parameters were normalized to the liver and blood pool by tumor-to-background ratios (TBRs) and contrast-to-noise ratios. Therapy response was assessed using Deauville criteria. Results: Overall, 191 lymphoma lesions were analyzed. SUV_max demonstrated a trend toward a statistically significant increase in scans with reduced activity at 1 h after injection (6.28 ± 5.87 for RS vs. 7.76 ± 6.69 for 0.125 MBq/kg; P = 0.07) and 2 h after injection (7.14 ± 7.16 for RS vs. 8.67 ± 7.62 for 0.125 MBq/kg; P = 0.13). SUV_peak, SUV_mean, MTV, and TLG did not significantly differ between the reduced injected activities and the RS. The coefficient of variation for the liver increased significantly with decreasing injected activities (P < 0.01). The TBR for the liver did not differ significantly, whereas the TBR for the blood pool was significantly higher only for the lowest injected activity (P < 0.01) at 2 h after injection. The contrast-to-noise ratio significantly decreased with reduced activities. Deauville scores did not differ significantly, up to a dose of 0.25 MBq/kg at 1 h after injection and a dose of 1.0 MBq/kg at 2 h after injection. Below this limit, we noted significantly lower Deauville scores for reduced injected activities (P < 0.01). Conclusion: Reduction of injected activities with [¹⁸F]FDG TB PET/CT for therapy response assessment in patients with lymphoma may be possible and does not result in significant differences in MTV, TBR, or TLG. SUV_max and Deauville scores were comparable to the RS to a lower limit of 0.25 MBq/kg at 1 h after injection and 1.0 MBq/kg at 2 h after injection.

PMID:40813234 | DOI:10.2967/jnumed.124.268841

J Craniomaxillofac Surg. 2025 Aug 13:S1010-5182(25)00247-1. doi: 10.1016/j.jcms.2025.07.024. Online ahead of print.

ABSTRACT

PURPOSE: Craniofacial microsomia (CFM), the second most common congenital craniofacial anomaly, is poorly characterized in bilateral cases because conventional cephalometry cannot accurately assess facial asymmetry. This study aims to characterize craniofacial morphology in children with bilateral CFM using three-dimensional (3D) cephalometric analysis.

MATERIALS AND METHODS: A retrospective 3D cephalometric analysis was conducted on 8 bilateral CFM patients and 10 age-/sex-matched normal patients as controls. A coordinate system was established with three reference planes: the Frankfurt Horizontal Plane (FHP), the Midsagittal Plane (MSP) and the Nasion Perpendicular Plane (CP). Fifteen linear and angular measurements assessed maxillary, mandibular, chin, and occlusal parameters. Subgroups were stratified by bilateral mandibular deficiency severity according to Pruzansky-Kaban classification (Group A: similar; Group B: different). Statistical comparisons utilized independent t-tests (CFM vs. controls) and Mann-Whitney U tests (subgroups), with Pearson’s correlation analysis exploring variable relationships.

RESULTS: Bilateral CFM patients exhibited significant reductions in ramal height (Co-Go: p < 0.001) and mandibular body length (Go-Me: p < 0.001), a posteriorly inclined occlusal plane (OP-FHP: 27.63° ± 5.50° vs. 8.13° ± 3.33°, p < 0.001), and pronounced chin retrusion (Me-NP: 46.08 ± 6.66 mm vs. 8.28 ± 7.71 mm, p < 0.001) and lateral deviation (Me-MSP: 5.84 ± 4.64 mm vs. 1.73 ± 0.93 mm, p < 0.05). Me-NP and Me-MSP differed significantly in subgroup analyses. Pearson correlation analysis revealed strong associations between Me-NP and Me-MSP and OP-MSP, posterior maxillary height (U6-FHP) and Co-Go.

CONCLUSION: Bilateral CFM is mainly characterized by posteriorly inclined occlusal plane and pronounced mandibular retrognathia. The occlusal plane and chin will consistently deviate toward the more severely affected side. When bilateral mandibular involvement is similar in extent, chin deviation tends to be mild, resulting in less severe facial asymmetry.

PMID:40813223 | DOI:10.1016/j.jcms.2025.07.024

Int J Oral Maxillofac Surg. 2025 Aug 13:S0901-5027(25)01398-0. doi: 10.1016/j.ijom.2025.07.009. Online ahead of print.

ABSTRACT

Temporomandibular joint (TMJ) closed lock, corresponding to Wilkes stage 3 internal derangement, is a common cause of restricted mouth opening and functional impairment. Early diagnosis is essential but challenging, particularly when imaging is unavailable. This study analyzed 40 consecutive patients diagnosed with TMJ closed lock. Patients were routinely evaluated using a standardized 11-test assessment format as part of regular practice, and these records were retrospectively analyzed. Statistical analysis compared findings between the affected and non-affected joints and the muscles of mastication. The most frequent clinical findings included tenderness in the affected joint on passive stretch (75%), on palpation (67.5%), on contralateral movement (57.5%), and on contralateral loading (47.5%). On average, the affected joint was tender in 4.1 of 11 tests, while the contralateral joint was positive in only 0.2 tests (P < 0.001). Passive stretch increased mouth opening from 27.1 mm to 31.7 mm, with a hard end feel observed in 85% of patients. Muscular tenderness was observed in 32.5% of patients, most commonly in the ipsilateral masseter (25%) and temporalis (12.5%). These findings support structured clinical evaluation for early recognition of TMJ closed lock, improving diagnostic accuracy and enabling timely intervention.

PMID:40813221 | DOI:10.1016/j.ijom.2025.07.009