Nevin Manimala

Syst Rev. 2025 Dec 5. doi: 10.1186/s13643-025-03009-5. Online ahead of print.

ABSTRACT

BACKGROUND: Invasive intra-arterial blood pressure (IABP) monitoring using an arterial catheter carries both risks and practical limitations. Noninvasive blood pressure (NIBP) monitoring using the widely adopted oscillometric automated brachial cuff is performed in nearly all patients in acute care settings at some point, yet its reliability remains in question. Conventional statistical approaches to assessing the global trueness (bias) and precision (standard deviation, SD) of NIBP compared to IABP may not fully capture the risk of harm posed by NIBP’s measurement errors to patients, nor its ability to detect blood pressure (BP) values above or below critical thresholds. Moreover, risk factors for poor performance of NIBP warrant further investigation. We will perform a meta-analysis using individual participant data (IPD) to evaluate the clinical suitability of NIBP in acute care settings.

METHODS: We will search the Cochrane Library, MEDLINE, and Scopus^™ databases to identify relevant peer-reviewed studies published in full-text English or French from 2000 to June 20, 2024. Studies will be included if they compare brachial cuff NIBP measurements with simultaneous radial, femoral, brachial, or pedal intra-arterial IABP measurements in adult patients in acute care settings. Retrospective studies will be excluded. Authors will be contacted to request IPD. For mean and systolic BP, we will assess the risk of harm associated with measurement error (via a dedicated error grid). As secondary objectives, we will evaluate (i) the bias between NIBP and IABP measurements (pooled estimate, SD, and limits of agreement), (ii) the precision (via within-patient SD, calculated for patients who had multiple paired measurements taken closely in time during stable periods), (iii) the ability of NIBP to detect IABP above or below critical thresholds and to identify response to therapy (via the area under the receiver operating characteristic curve), and (iv) the covariates associated with each of the abovementioned outcomes and with poor performance of NIBP. One-stage generalized linear mixed-effects models will be applied for the analyses. A meta-analysis combining IPD and aggregated data will also be conducted using a two-stage approach. Risk-of-bias assessment will follow the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines. For each outcome, a subgroup of particular interest will consist of studies with a low risk of bias. No funding is required.

DISCUSSION: This meta-analysis will provide actionable insights to optimize BP monitoring strategies.

TRIAL REGISTRATION: PROSPERO CRD42021233707.

PMID:41350911 | DOI:10.1186/s13643-025-03009-5

Virol J. 2025 Dec 5. doi: 10.1186/s12985-025-03027-8. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatitis E virus (HEV) is a major cause of viral hepatitis in low- and middle-income countries, particularly in South Asia, where poor sanitation facilitates its fecal-oral transmission. Nepal, Bangladesh, and Pakistan experience a significant HEV burden, with severe outcomes in high-risk groups like pregnant women and hepatic patients, who face elevated mortality rates. This systematic review and meta-analysis aimed to estimate HEV seroprevalence in these countries, focusing on the general population, pregnant women, and hepatic patients, to inform public health strategies.

METHODS: We searched PubMed, Embase, Cochrane Library, and ProMED-mail for studies published between 2000 and 2017, following PRISMA guidelines and a registered protocol [PROSPERO: CRD42018099558]. Studies reporting HEV seroprevalence in Nepal, Bangladesh, or Pakistan using serological or molecular methods were included. The original search period was retained as data extraction was completed in 2018, and including newer studies was not feasible. A random-effects meta-analysis was conducted using the ‘metaprop’ function in R, with heterogeneity assessed via I² and τ² statistics. Publication bias was evaluated using Egger’s test and funnel plots.

RESULTS: The meta-analysis included 64 studies, totaling 25,301 participants. Pooled HEV seroprevalence was 23.8% (95% CI: 13.7%-35.5%) in the general population (n = 9,935), 41.2% (95% CI: 27.6%-55.6%) in pregnant women (n = 4,345), and 41.8% (95% CI: 30.7%-53.4%) in hepatic patients (n = 11,021). High heterogeneity was observed (I²=98.3-99.4%), with significant country-level variation in hepatic patients (p = 0.0002). Subgroup analyses revealed country-specific variations, particularly for hepatic patients where Bangladesh and Nepal showed higher prevalence than Pakistan. Publication bias was evident in pregnant women (p = 0.0002) and hepatic patients (p = 0.0066), but not in the general population (p = 0.6235).

CONCLUSIONS: These findings highlight the substantial burden of HEV in South Asia, with notable differences across population groups and countries. The high seroprevalence in hepatic patients and pregnant women underscores the need for targeted surveillance and intervention strategies like improved sanitation and vaccination. High heterogeneity and publication bias suggest cautious interpretation, and future research should focus on standardizing diagnostics and conducting longitudinal studies to assess temporal trends in HEV prevalence.

PMID:41350906 | DOI:10.1186/s12985-025-03027-8

Reprod Biol Endocrinol. 2025 Dec 5. doi: 10.1186/s12958-025-01504-x. Online ahead of print.

ABSTRACT

BACKGROUND: More than 500 patients have received cryopreserved ovarian tissue transplantation (OTT) worldwide, resulting in over 200 live births. Although guidelines recognize OTT as an effective fertility preservation method, there is no consensus on the optimal grafting site of OTT. This systematic review and meta-analysis aim to assess whether reproductive outcomes of OTT vary across different grafting sites.

METHODS: A literature search was conducted through March, 2024, in PubMed, Embase and the Cochrane library, using the following terms: ‘patient’, ‘fertility preservation’, ‘ovarian tissue transplantation’ and ‘live birth’. Studies including 5 or more subjects were included. Two reviewers independently selected the studies, collected the data and assessed the risk of bias. Heterogeneity and publication bias were evaluated using the I² statistic and Egger’s test, respectively. A fixed-effect meta-analysis was performed only if I² was 0%, otherwise a random-effect model was applied. The primary outcome was the live birth rate (LBR). The secondary outcomes included the proportion of women who became pregnant, those who had at least one live birth, and those who underwent repeat OTT.

RESULTS: Eighteen studies including 560 women were included. The estimated LBRs after transplantation to the remaining ovary and the pelvic peritoneum were 64% (20%-130%, I² = 74%) and 31% (15%-51%, I² = 21%), respectively. The LBRs after orthotopic transplantation (defined as transplantation to the remaining ovary, the pelvic peritoneum or both sites, which allowed spontaneous pregnancy), heterotopic transplantation and combined (orthotopic + heterotopic) transplantation were 44% (25%-69%, I² = 79%), 5% (0%-21%, I² = 0%) and 23% (4%-53%, I² = 19%), respectively. No publication bias was observed.

CONCLUSION: Reproductive outcomes of OTT vary across different grafting sites. The LBR of orthotopic transplantation is higher than that of heterotopic transplantation. Additionally, the LBR of OTT to the remaining ovary is higher than that to the pelvic peritoneum. The remaining ovary may therefore be a more suitable site for women undergoing OTT to preserve future fertility.

REGISTRATION NUMBER: CRD42023447618.

PMID:41350899 | DOI:10.1186/s12958-025-01504-x

BMC Oral Health. 2025 Dec 5;25(1):1879. doi: 10.1186/s12903-025-07272-9.

ABSTRACT

BACKGROUND: Ultrasonic activation may alter the bond strength and intratubular penetration ability of root canal sealers, which are important criteria for the long-term success of root canal treatment. The aim of this study was to compare the effect of mediated ultrasonic activation in the push-out bond strength and intratubular penetration values of epoxy resin- and silicate-based root canal sealers.

METHODS: One hundred and sixty human mandibular premolar teeth were used. The teeth were divided into two groups for bond strength and tubular penetration tests and further divided into four subgroups for obturation and ultrasonic activation (n = 20). Chemo-mechanical preparation of the root canals was performed with a Mtwo rotary instrument system accompanied by NaOCl irrigation up to #40/0.04 apical size. The root canals were filled with NeoMTA Plus or AH Plus sealers using the single cone technique. Gutta-percha-mediated ultrasonic activation was applied during obturation in one group of each sealer. Three horizontal sections were taken from the apical, middle and coronal regions of the roots. The sections were subjected to push-out bond strength tests and intratubular penetration analysis with a confocal laser scanning microscope. Failure modes were recorded after the bond strength test. Statistical differences between sealers were compared with the Mann-Whitney U test, and regional pairwise comparisons were made with the Friedman test. Bonferroni corrections were applied when necessary.

RESULTS: No significant difference was observed between NeoMTA Plus and AH Plus in terms of push-out bond strength, regardless of ultrasonic activation. Ultrasonically activated AH Plus showed a decreased maximum penetration depth. Ultrasonic activation did not change the distribution of failure modes in the bond strength test.

CONCLUSION: Ultrasonic activation via a gutta-percha cone resulted in a significant reduction in bond strength of AH Plus in the apical third. No significant effect was observed for NeoMTA Plus. A similar trend was noted for intratubular penetration; however, the differences were not statistically significant in all regions.

PMID:41350868 | DOI:10.1186/s12903-025-07272-9

BMC Oral Health. 2025 Dec 6. doi: 10.1186/s12903-025-07435-8. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to compare three-dimensional (3D) alveolar bone changes and root resorption in skeletal Class I malocclusion treated with fixed appliances (FAs) or clear aligners (CAs), under extraction and non-extraction protocols, using Cone-beam computed tomography (CBCT).

MATERIALS AND METHODS: This retrospective study involved 120 adult patients, divided into an equal groups of non-extraction and extraction treatment. Each group received either FAs or CAs. A total of 960 incisors from all patients, and 480 canines and second premolars from 60 patients in the extraction group, were analyzed. CBCT scans were evaluated using InVivo 6.0.3 software for 3D measurements of alveolar bone thickness (ABT), height (ABH), root length, and bone defects. All patients underwent CBCT scans immediately before- (T0) and after-treatment (T1). The reported measurements represent the changes between these two time points. Intra-group comparisons were analyzed using paired t-tests, and inter-group comparisons were examined using independent t-tests. Statistical significance was set at P < 0.05.

RESULTS: In the non-extraction group, FAs demonstrated greater increases in labial ABT at upper central incisors (U1) and lateral incisors (U2), with smaller reductions at lower central incisors (L1) compared to CAs. FAs also resulted in more pronounced decreases in lingual ABT at U1 and L1 but showed larger increases at U2 and L2. In the extraction group, FAs induced more labial thickening at L1 and L2, greater lingual thinning at U1 and L1, and higher levels of root resorption, particularly at U2 and L1. FAs also triggered larger increases in bone measurements at upper canines and second premolars (P < 0.05).

CONCLUSION: Fixed orthodontic appliances resulted in more pronounced alveolar bone remodeling and root resorption compared to clear aligners, most notably in extraction cases. While Clear aligners helped in preserving labial bone and minimizing root resorption, neither method completely averted bone loss. Therefore, treatment decisions should take into account clinical objectives, anatomical risks, and patient factors.

TRIAL REGISTRATION: Not applicable.

PMID:41350867 | DOI:10.1186/s12903-025-07435-8

BMC Oral Health. 2025 Dec 5. doi: 10.1186/s12903-025-07317-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the orthodontic outcomes of multiple impacted maxillary anterior teeth using cone-beam computed tomography (CBCT) and analyze the root and alveolar bone attachment following orthodontic traction.

METHODS: Sixteen patients with multiple impacted maxillary anterior teeth treated at the Department of Orthodontics, Affiliated Stomatological Hospital of Guangxi Medical University between 2016 and 2020 were included. A total of 14 Impacted maxillary central incisors(IMCIs), 13 Impacted maxillary lateral incisors(IMLIs), and 16 Impacted maxillary canines(IMCs) were assessed. CBCT scans and three-dimensional reconstructions were performed immediately after treatment completion. Measurements included root length(RL), intraosseous root ratio, alveolar bone loss of labial, lingual side(LaBL, LiBL), apical alveolar bone thickness(ABT) , and labial, lingual alveolar bone thickness(LaABT, LiABT) of impacted teeth compared to their contralateral counterparts. Statistical analysis was conducted to assess differences.

RESULTS: The RL and intraosseous root ratio of IMCIs and IMLIs were significantly smaller than those of the control teeth (p < 0.05). No statistically significant difference was observed in RL between IMCs and controls (p > 0.05), but the intraosseous root ratio was smaller in IMCs (p < 0.05). IMCIs exhibited greater LaBL (p < 0.05) and thinner LaABT (p < 0.05) compared to controls, while LiABT, LiBL or ABT showed no significant differences (p > 0.05). IMLIs had larger LiBL (p < 0.05), but LaBL, LiABT, LaABT or ABT did not differ significantly (p > 0.05). IMCs demonstrated greater LaBL (p < 0.05), with no significant differences in LaABT, LiABT, LiBL or ABT (p > 0.05). The success rates of orthodontic traction were 71.43% for IMCIs, 84.62% for IMLIs, and 93.75% for IMCs.

CONCLUSION: Orthodontic traction facilitates the preservation of multiple impacted maxillary anterior teeth, though post-traction alveolar bone attachment remains suboptimal. Among the impacted teeth, canines exhibit superior root development and higher traction success rates.

PMID:41350866 | DOI:10.1186/s12903-025-07317-z

J Clin Neurosci. 2025 Dec 4;144:111778. doi: 10.1016/j.jocn.2025.111778. Online ahead of print.

ABSTRACT

BACKGROUND: Neuroanatomy is a cornerstone of medical education, yet is perceived by many as daunting. Student-led events, such as the National Undergraduate Neuroanatomy Competition (NUNC), newly re-established in Scotland, provides a platform to address this challenge by fostering academic interest and enhancing learning through extracurricular achievement and specialty talks.

METHODS: This mixed-methods study analysed data from the 11th NUNC, involving 93 registered medical students. Post-event surveys collated participants’ experiences with institutional neuroanatomy education, preferred learning resources, and self-assessment of their performance in NUNC’s written and practical exams. Quantitative responses were analysed using descriptive and inferential statistics, while qualitative data provided insights into learning preferences and challenges.

RESULTS: Of 58 survey respondents, most reported dissatisfaction with the depth and accessibility of institutional neuroanatomy teaching. Online resources (74.1 %) and textbooks (53.4 %) were most frequently used for self-directed learning, in addition to resources provided by students’ institutions. Participants rated both the single-best-answer and spotter exams as difficult, and demonstrated accurate self-assessment of their performance, with modest but significant correlations between perceived and actual scores in both assessments (p = 0.0002). These findings highlight a potential dichotomy between reliance on institutional teaching and students’ preferred resources, emphasising the value of supplementary, accessible, and clinically contextualised materials in the learning of future clinicians. Accuracy in self-assessment suggests that NUNC encourages reflective learning and confidence in neuroanatomy knowledge. This has positive implications for the future clinical practice of these participants as it is increasingly common for non-specialist clinicians to be first point-of-contact for neurological presentations.

CONCLUSION: NUNC provides an impactful platform for addressing gaps in neuroanatomy/clinical neuroscience education, promoting self-directed learning, and inspiring confidence among students interested in careers in neuroanatomy-related fields such as neurosurgery, neurology and other neuroanatomy related fields. Future efforts should focus on integrating a broader range of learning modalities into medical curricula to improve the learning experience and establish reliable foundations for future clinical practice.

PMID:41349184 | DOI:10.1016/j.jocn.2025.111778

Neural Netw. 2025 Nov 25;196:108367. doi: 10.1016/j.neunet.2025.108367. Online ahead of print.

ABSTRACT

This study addresses the stabilization challenge of discrete-time Markovian jump systems (MJSs) in the presence of deception attacks by employing an event-triggered control (ETC) approach. The proposed ETC framework minimizes the frequency of data transmissions, thereby optimizing network bandwidth usage and mitigating congestion risks. Deception attacks, represented using a Bernoulli-distributed random variable, threaten system security by interfering with normal communication to extract sensitive information. To ensure mean-square stability of the considered MJS, sufficient conditions are established, and controller gain parameters are determined by solving linear matrix inequalities (LMIs). The effectiveness of the proposed method is demonstrated through two numerical examples, including an application to a DC motor system.

PMID:41349173 | DOI:10.1016/j.neunet.2025.108367

J Chromatogr B Analyt Technol Biomed Life Sci. 2025 Nov 30;1269:124870. doi: 10.1016/j.jchromb.2025.124870. Online ahead of print.

ABSTRACT

The rising global burden of obesity underscores the need to better characterize metabolic alterations associated with this condition. Choline (Cho) and its derivative phosphocholine (ChoP) are key intermediates in phospholipid metabolism, yet their relationships with obesity remain unclear. In this study, we established and validated a UPLC-MS/MS method for quantifying serum Cho and ChoP, and investigated their associations with obesity and fasting glucose in a pilot human cohort. Serum samples from 62 participants (obese vs. nonobese) were analyzed. The primary analysis compared metabolite levels between groups, and key secondary analyses included Pearson correlations with fasting glucose and receiver operating characteristic (ROC)-based discrimination; two-sample Mendelian randomization (MR) was conducted using external GWAS summary statistics. Obese individuals had lower ChoP levels and ChoP/Cho ratios. ChoP and the ChoP/Cho ratio were inversely associated, and Cho was positively associated, with fasting glucose. ChoP showed modest discriminative ability for obesity, and MR suggested that higher ChoP levels may be related to a lower risk of obesity. Overall, we validated a UPLC-MS/MS assay for serum Cho and ChoP, and our findings indicate that ChoP and the ChoP/Cho ratio are linked to obesity and glucose status.

PMID:41349158 | DOI:10.1016/j.jchromb.2025.124870

Prostaglandins Leukot Essent Fatty Acids. 2025 Oct 1;208:102710. doi: 10.1016/j.plefa.2025.102710. Online ahead of print.

ABSTRACT

Fatty acid (FA) profiles can be examined in both plasma and red blood cells (RBCs), with the latter showing the average FA concentrations over the past 3-4 months and not being susceptible to daily fluctuations dependent on diet or supplementation. This study provides data on changes in the FA profile in RBCs as a result of 12 weeks supplementation with long chain omega-3 polyunsaturated fatty acids (n-3 PUFAs; EPA and DHA) and training intervention in amateur runners. The study included 26 amateur runners, 14 of whom were assigned to the n-3 PUFA supplementation group (2234 mg of EPA and 916 mg of DHA daily) and 12 to the placebo group; both groups underwent the exercise training. After the 12-week intervention, runners taking n-3 PUFAs showed statistically significant increases in EPA, docosapentanoic acid, DHA and total PUFAs, and decreases in lignoceric, palmitoleic, vaccenic, gondoic, linoleic, eicosadienoic, dihomo-γ-linolenic, and arachidonic acids compared to placebo group. In addition, increases in omega-3 index, delta 9-desaturase index (C16), and PUFA/MUFA index, and a decrease in monounsaturated fatty acids (MUFAs) and AA/EPA ratio was observed. There were no changes in RBC FAs in the placebo group indicating that exercise training had no effect on RBC FAs. This study provides novel insights into the changes in FA profile in RBCs with n-3 PUFA supplementation, the importance of which in both sports and health scenarios requires further research.

PMID:41349157 | DOI:10.1016/j.plefa.2025.102710