Nevin Manimala

Epilepsia Open. 2025 May 10. doi: 10.1002/epi4.70055. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effects of personalized multichannel tDCS on seizure frequency, severity, quality of life, and psychiatric comorbidities in patients with drug-resistant focal epilepsy. Secondary goals include assessing the safety and feasibility of this approach.

METHODS: This open-label pilot study involved 16 patients with drug-resistant focal epilepsy. Patients underwent 3 cycles of personalized multichannel tDCS over 6 months, targeting the EZ defined by stereoelectroencephalography (SEEG). Each cycle consisted of five consecutive days of tDCS, with two daily sessions of 20 min each. The primary endpoint was a reduction in seizure frequency, with secondary endpoints addressing quality of life (QOLIE-31 scores), seizure severity (NHS3 scores), and psychiatric comorbidities (NDDI-E and GAD-7 scales).

RESULTS: Across all participants, a statistically significant 20% reduction in seizure frequency was observed (p = 0.044). Six patients (37%) were identified as responders (≥50% seizure reduction), with one achieving seizure freedom. The mean seizure reduction among responders was 68%. Significant improvements were noted in overall quality of life (QOLIE-31, p = 0.009), with greater benefits for patients with poorer baseline scores. No overall significant changes were observed in depression, anxiety, and seizure severity scores, though individual variability was noted. The treatment was well tolerated, with mild adverse events, primarily skin-related.

SIGNIFICANCE: Personalized multichannel tDCS shows promise as a noninvasive therapeutic option for drug-resistant focal epilepsy, with benefits in seizure reduction and quality of life. Although results were variable, the method’s safety and feasibility support further exploration through randomized controlled trials to refine protocols, better select potential responders’ patients, and validate findings.

PLAIN LANGUAGE SUMMARY: This study tested a personalized brain stimulation technique called tDCS in people with difficult-to-treat epilepsy. The treatment led to fewer seizures in some patients and improved their quality of life. The approach was safe and caused only mild side effects. These results suggest that this type of noninvasive brain stimulation may be a helpful new option for people who do not benefit from medication or surgery.

PMID:40347434 | DOI:10.1002/epi4.70055

Int J Clin Oncol. 2025 May 10. doi: 10.1007/s10147-025-02778-2. Online ahead of print.

ABSTRACT

BACKGROUND: There is no definitive consensus on the necessity and impact of lymph-node dissection during radical cystectomy for non-muscle-invasive bladder cancer (NMIBC). This study aimed to evaluate the prognostic significance of lymph-node dissection in NMIBC and identify preoperative factors influencing non-urinary tract recurrence-free survival (NUTRFS).

METHODS: We retrospectively analyzed data for 2674 cases of bladder cancer treated with radical cystectomy between January 2013 and December 2019 from a multicenter Japanese database; 410 patients were preoperatively diagnosed with NMIBC. Patients were divided into lymph-node dissection and non-lymph-node dissection groups, and NUTRFS and overall survival were compared as endpoints. Univariate and multivariate analyses were performed to determine NUTRFS prognostic factors.

RESULTS: Lymph-node dissection was performed in 374/410 patients and not in 36/410. Compared with the lymph-node dissection group, the non-lymph-node dissection group was older, and had a lower proportion of a performance status of 0 and a higher proportion of clinical stage < T1 disease. The pathological lymph-node positivity rate in the lymph-node dissection group was 6.9%. However, lymph-node dissection did not provide a statistically significant prolonged survival. Results remained consistent after propensity score matching. Multivariate analysis revealed poor performance status and bladder neck tumors as independent risk factors for NUTRFS. Lymph-node dissection was not a significant prognostic factor in preoperatively diagnosed NMIBC.

CONCLUSIONS: Routine lymph-node dissection may be unnecessary for all NMIBC cases; however, our findings suggest that this should be considered for NMIBC involving the bladder neck.

PMID:40347426 | DOI:10.1007/s10147-025-02778-2

Environ Monit Assess. 2025 May 10;197(6):646. doi: 10.1007/s10661-025-14081-8.

ABSTRACT

In the past five decades, Dhaka city, the capital of Bangladesh experienced urbanization in an unprecedented manner. The city has grown spatially in all directions to accommodate the urban population that resulted in accelerated growth of the construction and demolished floor areas in Dhaka and its surroundings, commonly known as the Greater Dhaka. As a result, the quantities of construction and demolition waste have increased significantly within this region. Through an onsite field investigation of 21 construction and 12 demolition project sites in Greater Dhaka, the study identified the waste generation rate to be approximately 463.67 kg and 90.31 kg per m² floor area of demolition and construction projects, respectively. Projection based on this waste generation rate; the annual waste amount has been calculated for the eight districts of the Greater Dhaka region. The recycling potential identified through this study also estimated the economic benefits of the studied construction and demolition waste (CDW) materials for these eight districts for years 2022 to 2030. The findings of the present study are expected to assist the relevant stakeholders and policymakers to devise business development and legislative measures for the successful implementation of the sustainable waste management plan for the construction industry.

PMID:40347400 | DOI:10.1007/s10661-025-14081-8

Clin Oral Investig. 2025 May 10;29(6):294. doi: 10.1007/s00784-025-06368-4.

ABSTRACT

OBJECTIVE: Since relapse after orthodontic treatment and stability and failure of CAD/CAM fabricated and Conventional fixed retainers are widely discussed, this study investigated and compared two-year post-treatment stability after insertion of a CAD/CAM fabricated or Conventional fixed retainer in the lower jaw.

MATERIALS AND METHODS: Digitized dental casts or intraoral scans of n = 60 patients were used for data acquisition. The patients were divided into two groups according to the retention protocol: CAD/CAM fabricated fixed retainer (n = 30, mean age 16.97 ± 5.74 years) and Conventional fixed retainer (n = 30, mean age 15.70 ± 4.19 years). The evaluation included established procedures for dental measurements of the mandible (Intercanine Distance and Little´s Irregularity Index) before orthodontic treatment, at the end of orthodontic treatment, when the fixed retainer was inserted and two years after the insertion of the fixed retainer. All retainers were inserted by the same practitioner. Complications were recorded. Statistics included Shapiro-Wilk-, T- and Friedman-Tests. The level of significance was set at p < 0.05.

RESULTS: In patients with Conventional fixed retainers the change of the Intercanine Distance between insertion of the fixed retainer and two years afterwards was significantly more pronounced than in patients with CAD/CAM fabricated fixed retainers (ICD: Δ CAD/CAM_t1-t2: -0.03 ± 0.22 mm; Δ Conventional_t1-t2: 0.12 ± 0.29 mm). Stability of Intercanine Distance was less in patients with Conventional fixed retainers. The change of Little´s Irregularity Index was not significant between the groups. In two patients with a Conventional fixed retainer a bonding surface was renewed within the first three months.

CONCLUSIONS: Within two years, CAD/CAM fabricated fixed retainers showed less relapse of Intercanine Distance and fewer complications than Conventional fixed retainers.

CLINICAL RELEVANCE: Considering the amount of relapse and the differences in complications, CAD/CAM fabricated fixed retainers and Conventional fixed retainers are useful appliances for stabilization of treatment results with favorable stability. Fabrication of CAD/CAM based fixed retainers is aside from that timesaving compared to Conventional fixed retainers.

PMID:40347399 | DOI:10.1007/s00784-025-06368-4

Int Ophthalmol. 2025 May 10;45(1):188. doi: 10.1007/s10792-025-03556-9.

ABSTRACT

PURPOSE: To assess the macular vascular effects of prolonged use of latanoprost compared to the dorzolamide-timolol fixed combination in patients with very early-stage glaucoma, where glaucoma-specific damage has been minimized.

METHODS: The retinal vascular effects of latanoprost versus the dorzolamide-timolol fixed combination were evaluated using Optical Coherence Tomography Angiography (OCT-A) in a case-control study design. A total of 71 eyes from 71 individuals were included in the study: 28 eyes receiving latanoprost (Group 1), 20 eyes receiving the dorzolamide-timolol combination (Group 2), and 23 eyes from healthy individuals (Group 3). Superficial, deep, and radial peripapillary capillary plexus vascular density (SCP-vd, DCP-vd, RPCP-vd) and foveal avascular zone (FAZ) measurements were taken with OCT-A. The comparative analysis between groups was performed with SPSS V.26.

RESULTS: Across the groups (from 1 to 3), whole image vascular density (vd) measurements were as follows: SCP-vd: 45.86 ± 3.99, 44.58 ± 4.58, 48.35 ± 4.04; DCP-vd: 44.86 ± 5.75, 44.02 ± 6.87, 49.74 ± 4.84; and RPCP-vd: 46.97 ± 3.81, 47.07 ± 5.49, 49.90 ± 2.43. All these measurements were significantly decreased in both glaucoma groups (groups 1 and 2) compared to healthy subjects (group 3). In subgroup analyses of the macular region, including the fovea, parafovea, and perifovea, vd measurements were decreased in all areas except the fovea in glaucoma patients. However, no statistically significant differences were found between the latanoprost and dorzolamide-timolol groups regarding retinal vascular structure. In FAZ measurements, no significant differences were found in any anatomical location among the three groups.

CONCLUSION: This study demonstrates that latanoprost, the first prostaglandin analog known for its edema-inducing effect on the macula, does not have a long-term impact on macular vascularity. However, this result should be supported with longer and larger studies.

PMID:40347381 | DOI:10.1007/s10792-025-03556-9

Lasers Med Sci. 2025 May 10;40(1):219. doi: 10.1007/s10103-025-04470-3.

ABSTRACT

The purpose of this research was to evaluate the impact of an 810 nm high-power diode laser on decontaminating both surface and intradentinal biofilm, as well as removing the smear layer. Forty human mandibular premolars were contaminated with a biofilm composed of Enterococcus faecalis and Streptococcus mutans. The teeth were divided into groups and treated with NaOCl 2.5% + PUI, saline solution + 810 nm laser, NaOCl 2.5% + PUI + 810 nm laser, and a control group. The samples were then evaluated using a confocal laser scanning microscope (CLSM). Another 40 teeth, prepared as dentin discs, were contaminated with the same biofilm to assess surface decontamination. Additionally, 80 bovine dentin discs with an induced smear layer, placed in the apical third of mesial root canals of 3D-printed teeth, underwent similar treatments. Pre- and post-treatment images were obtained using an environmental scanning electron microscope. Data were statistically analyzed with ANOVA test and Tukey’s test, respectively. Intradentinal disinfection rates were 67,33% for PUI, 51,50% for the 810 nm laser, and 55,32% for the PUI + 810 nm laser, with no statistically significant differences (p > 0.05). Surface decontamination rates were 39,52%, 51,27%, and 45,20% for the respective groups, also without significant differences (p > 0.05). No significant differences were found regarding smear layer removal (p > 0.05). The 810 nm diode laser with saline achieved disinfection similar to 2.5% sodium hypochlorite with ultrasound. Combining laser and PUI didn’t improve disinfection. None of the studied protocol removed the smear layer.

PMID:40347363 | DOI:10.1007/s10103-025-04470-3

Discov Oncol. 2025 May 10;16(1):717. doi: 10.1007/s12672-025-02553-9.

ABSTRACT

BACKGROUND: This retrospective study aimed to evaluate the safety and effectiveness of hepatic arterial infusion chemotherapy with raltitrexed and oxaliplatin (RALOX-HAIC) combined with radiotherapy, tyrosine kinase inhibitors, and immune checkpoint inhibitors in patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

METHODS: A propensity score-matching (PSM) cohort study was conducted. The tumor response, treatment-related adverse events, survival outcomes were compared. Univariate and multivariate analyses were conducted to explore the risk factors of overall survival (OS).

RESULTS: Twenty-one pairs of patients were evaluated after PSM. No statistical differences were found in the tumor response, objective response rate, disease control rate, PVTT response, surgical resection rate, metastasis, and mortality between the two groups before and after PSM. Compared with the FOLFOX-HAIC group, the incidences of abdominal pain and fever was lower in the RALOX-HAIC group (P = 0.028, P = 0.029). These differences still had statistical significance after PSM (P = 0.013, P = 0.014). No statistical differences were found in OS and progression-free survival (PFS) between the two groups before and after PSM (Before [OS: hazard ratio(HR) = 1.138; 95%CI 0.569-2.276, P = 0.715; PFS: HR = 0.549; 95%CI 0.195-1.548, P = 0.257; After [OS: HR = 0.998; 95%CI 0.438-2.274, P = 0.995; PFS: HR = 0.792; 95%CI 0.359-1.748, P = 0.564]). The prealbumin < 170 mg/L before therapy was an independent risk factor for OS (HR = 2.234; 95%CI 1.051-4.751; P = 0.037).

CONCLUSIONS: The RALOX-HAIC combined radiotherapy, TKI, and ICI may provide similar survival advantages with fewer treatment-related abdominal pain and fever compared to FOLFOX-HAIC for HCC patients with PVTT. The prealbumin < 170 mg/L before therapy is an independent risk factor for OS.

PMID:40347357 | DOI:10.1007/s12672-025-02553-9

J Gambl Stud. 2025 May 10. doi: 10.1007/s10899-025-10391-1. Online ahead of print.

ABSTRACT

Loss chasing is a defining clinical criterion for Gambling Disorder. Using actual player records, we investigated the potential for a multidimensional loss chasing concept (based on bet size, betting odds, and time between bets) to predict potential gambling harm among online sports bettors (N = 36,331) and daily fantasy sports (DFS) players (N = 34,596). Our main focus was whether optimized thresholds (derived from ROC analysis) for loss chasing yielded greater predictive value than both median-derived thresholds and a natural continuous form. Compared to the other tested forms of chasing, optimized thresholds of loss chasing showed the most promise (i.e., positive and statistically significant effects and improved model fit) for two out of three dimensions (i.e., bet size and odds) for one outcome (i.e., loss trajectory) among sports bettors. For these bettors and outcomes, all three loss chasing dimensions predicted the outcome in isolation; however, grouping all three expressions into a single model yielded poor model fit. Loss chasing effects were less apparent (generally non-significant or in the negative direction) for another outcome (i.e., percent change in net loss) and among DFS players. Still, this study demonstrates the promise of a multidimensional concept of loss chasing, and the potential for optimized thresholds to improve prediction of potential harm-related outcomes.

PMID:40347356 | DOI:10.1007/s10899-025-10391-1

Patient. 2025 May 10. doi: 10.1007/s40271-025-00737-7. Online ahead of print.

ABSTRACT

INTRODUCTION: Like in many countries, coverage of sexual and reproductive health (SRH) services among adolescents and young people (AYP) aged 15-24 remains low in Zambia. Increasing coverage of SRH services requires interventions that are responsive to the needs and preferences of AYP. We conducted a discrete choice experiment (DCE) to elicit AYP’s preferences for SRH service delivery in Lusaka, Zambia.

METHODS: A cross-sectional DCE was conducted with AYP aged 15-24 years. Consenting participants were presented with alternative SRH service delivery strategies represented by six attributes, namely: location, type of provider, type of services, service differentiation by sex, availability of edutainment, and opening hours. Multinomial logit and random parameters logit models were used to analyse the data. All variables were effect coded.

RESULTS: A total of 423 AYP aged 15-24 years (61% female) completed the DCE. Respondents preferred SRH services that were integrated with other healthcare services (b = 0.65, p < 0.001), delivered by medical staff and peer support workers (b = 0.44, p < 0.001), and provided at a hub within a health facility (b = 0.62, p < 0.001). AYP also preferred services to be available on weekends during the daytime (b = 0.37, p < 0.001). Participants also preferred alternatives which included edutainment (b = 0.22, p < 0.001). Service differentiation by sex had little effect on the preference for SRH service delivery (b = – 0.05, p = 0.08). The coefficient for the “neither” option was negative and statistically significant (b = – 5.31, p < 0.001), implying that AYP did not favor routine SRH service delivery in an outpatient department.

CONCLUSION: Efforts to increase SRH service utilization among AYP should focus on providing comprehensive SRH services that are integrated with other healthcare services. These services should be delivered by a combination of medical staff and peer supporter workers in youth-friendly spaces. Careful attention should be paid to opening times to ensure that these are convenient to AYP.

PMID:40347324 | DOI:10.1007/s40271-025-00737-7

Odontology. 2025 May 10. doi: 10.1007/s10266-025-01121-5. Online ahead of print.

ABSTRACT

This study aimed to investigate the prognosis of adolescent patients with anterior disk displacement without reduction (ADDwoR) who were treated with disk repositioning through suturing or arthrocentesis plus hyaluronic acid (HA) combined with stabilization splint (SS). A total of 96 ADDwoR patients aged ranging from 12 to 18 years, were divided into two groups, including 52 patients in Group A (underwent disk repositioning by suturing) and 44 patients in Group B (underwent arthrocentesis plus HA combined with SS). Condylar height, disk length, maximum mouth opening (MMO), maximal protrusive movement (PM), left/right maximal lateral movement (LLM/RLM) and visual analogue scale (VAS) pain scores were comparatively analyzed between the two groups before and after treatment. Baselined data analysis showed there was no statistical significance in condylar height, disk length, MMO, PM, LLM, RLM, and VAS values between two groups preoperatively. Postoperatively, values of condylar height and disk length in Group A were larger than those in Group B (all P < 0.001); whereas PM, LLM, and RLM values of Group B were all significantly larger than those of Group A (all P < 0.001). However, no statistical difference was obtained in MMO and VAS score between two groups after treatment (all P > 0.05). Both two surgical techniques can effectively relieve pain and improve MMO of adolescent patients with ADDwoR. The maximal protrusive and lateral movement of Group B were superior to those of Group A, while the latter can effectively enhance condylar development and prevent mandibular deformities.

PMID:40347314 | DOI:10.1007/s10266-025-01121-5