Nevin Manimala

BMC Psychol. 2025 Dec 30. doi: 10.1186/s40359-025-03919-y. Online ahead of print.

ABSTRACT

BACKGROUND: Attitudes towards aging are multidimensional. It is often affected by the individual’s social and cultural background. Valid and reliable tools across diverse cultures are important to assess the attitudes towards aging among older adults.

METHODS: The Sinhala version of the Attitudes to Aging Questionnaire (AAQ) was cross-culturally validated following standard procedures. A validation study was conducted with a sample of 185 Sinhala-speaking older adults residing in residential care facility homes in the Colombo district. The Sinhala version of the AAQ was interviewer-administered along with the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Floor and ceiling effects were assessed for each AAQ subscale, considering effects present if ≥ 15% of participants achieved the lowest or highest possible score. Psychometric properties (Internal consistency reliability, convergent validity, known-group validity, and construct validity) were assessed by descriptive and inferential statistics using SPSS version 26. Statistical significance was set as 0.05.

RESULTS: The mean age of the sample was 72.3 ± 6.1 years. The majority (56.8%) of the participants were females. No significant floor or ceiling effects were observed for any subscale of AAQ. Internal consistency reliability, measured by Cronbach’s alpha for psychosocial loss, psychological growth, and physical change subscales was 0.81, 0.77, and 0.74, respectively. Significant correlations were shown in Pearson’s correlation between all the AAQ subscales and WHOQOL-BREF domains, indicating the convergent validity. Known-group validity showed that married individuals and individuals diagnosed with chronic disease scored significantly higher mean on all three subscales of AAQ. The exploratory factor analysis extracted three factors with 57.77% cumulative variance with exceptions from the original version. Twenty-two items loaded to any of the factors except items 21and 23.

CONCLUSION: The Sinhala version of the AAQ has sound psychometric characteristics and it is a culturally appropriate and reliable measure to assess attitudes towards aging among Sinhala-speaking older adults.

PMID:41469751 | DOI:10.1186/s40359-025-03919-y

Int Endod J. 2025 Dec 30. doi: 10.1111/iej.70089. Online ahead of print.

ABSTRACT

AIM: To investigate how the application of dual heat treatment during the manufacturing process influences the mechanical performance (flexibility, cyclic fatigue resistance, torsional strength, bending, buckling and cutting efficiency) of rotary nickel-titanium endodontic instruments.

METHODOLOGY: Rainbow One (n = 58) and Rainbow Ultra (n = 58) instruments (size 25/0.06, 25 mm length) were evaluated. Geometric analysis was performed using optical 3D scanning and SEM to assess cutting edges, tip design and surface features. Metallurgical characterisation included EDS for elemental composition and DSC for phase transformation temperatures, with segments obtained from the tip, middle and coronal blade regions. Mechanical testing comprised cyclic fatigue, torsional strength (torque to failure, maximum angle of rotation), bending resistance, buckling strength and cutting efficiency. Standardised testing protocols were applied, including ASTM and ISO guidelines for mechanical assessments. Statistical analyses were conducted using Shapiro-Wilk and Levene tests to assess assumptions, followed by independent Student’s t-tests, with significance set at 5%.

RESULTS: Both instruments shared equivalent geometries, with deviations below 100 μm, and similar tip designs and surface characteristics. EDS confirmed near-equiatomic NiTi composition for both systems. DSC revealed R-phase crystallographic structure at room temperature for both instruments; however, Rainbow Ultra exhibited higher phase transformation temperatures (Rs 35°C vs. 25°C; Rf 45°C vs. 31°C; As 30°C vs. 24°C; Af 50°C vs. 38°C) and a double austenitic transformation peak, compared with a single peak for Rainbow One. Mechanically, Rainbow Ultra demonstrated greater cyclic fatigue resistance (95.5° ± 7 vs. 79.1 ± 6 s), higher maximum rotation angle (485° ± 49° vs. 402° ± 50°), and improved cutting efficiency (p < 0.05). Rainbow One exhibited higher torque to failure (1.8° ± 0.2 vs. 1.4° ± 0.1 N·cm), greater bending load (369 ± 34 vs. 336 ± 14 gf), and higher buckling resistance (339 ± 32 vs. 273 ± 24 gf), indicating stiffer behaviour.

CONCLUSIONS: The application of dual heat treatment during manufacturing significantly influenced the mechanical performance of the tested rotary NiTi instruments. Rainbow Ultra, subjected to sequential heat treatments, exhibited higher flexibility, cyclic fatigue resistance and cutting efficiency, whereas Rainbow One demonstrated greater torsional strength and buckling resistance.

PMID:41469750 | DOI:10.1111/iej.70089

Syst Rev. 2025 Dec 30. doi: 10.1186/s13643-025-03042-4. Online ahead of print.

ABSTRACT

BACKGROUND: Phosphodiesterase type-5 inhibitors (PDE5is) are used for the treatment of erectile dysfunction (ED) and have potential cardioprotective effects. The impacts of PDE5is on cardiovascular parameters, which may be associated with the occurrence and progression of subclinical cardiovascular diseases, remain uncertain. In this study, we evaluated the effects of PDE5is on vascular parameters.

METHODS: Randomized controlled trials (RCTs) that compared the effects of PDE5is and placebo on vascular parameters and were published from 1998 to 2022 were identified from PubMed, Scopus and Web of Science. Mean differences (MDs) with 95% confidence intervals (CIs) were pooled. A sensitivity analysis was conducted to confirm the robustness of the pooled results. The keywords that were searched in the databases are as follows: ((systolic blood pressure) OR (SBP) OR (diastolic blood pressure) OR (DBP) OR (mean arterial pressure) OR (MAP) OR (Pulse Wave Velocity) OR (PWV) OR (intima-media thickness) OR (cIMT) OR (augmentation Index) OR (AI) OR (FMD) OR (flow-mediated dilation) OR (reactive hyperemia index) OR (RHI) OR (Endothelial microparticles) OR (EMP) OR (EPCs) OR (Endothelial Progenitor Cells) OR (PSV) OR (peak systolic velocity)) AND ((PDE5 Inhibitors) OR (PDE5i) OR (Sildenafil) OR (Vardenafil) OR (Tadalafil) OR (Lodenafil) OR (Udenafil) OR (Avanafil)).

RESULTS: Sixty-three studies involving 3242 subjects were included. Overall, PDE5is decreased systolic blood pressure (MD: -2.80 mmHg, 95% CI: -4.24, -1.37, P < 0.001), diastolic blood pressure (MD: -1.80 mmHg, 95% CI: -2.37, -1.22, P < 0.001), carotid intima‒media thickness (MD: -0.01 mm, 95% CI: -0.02, -0.01, P < 0.001), and pulse wave velocity (MD: -0.75 cm/s, 95% CI: -1.01, -0.49, P < 0.001). In addition, PDE5is increased the peak systolic velocity (MD: 3.70 cm/s, 95% CI: 3.52, 3.88, P < 0.001), flow-mediated dilation (MD: 2.47%, 95% CI: 1.24, 3.71, P < 0.001), concentration of endothelial progenitor cells (MD: 475.29 cells/mL, 95% CI: 51.38, 899.20, P = 0.03), and concentration of endothelial microparticles (MD: 4.86%, 95% CI: 0.65, 9.07, P = 0.02). However, the effects of PDE5is on the augmentation index, brachial artery diameter and reactive hyperemia index were not statistically significant.

CONCLUSION: Compared with the placebo, PDE5is improved vascular parameters, indicating the potential of PDE5is for treating subclinical cardiovascular diseases. Further research is needed to confirm the role of the improvement on vascular parameters by PDE5isin preventing and treating cardiovascular diseases.

SYSTEMATIC REVIEW REGISTRATION: The present study protocol was reviewed and approved by PROSPERO. The title is “Associations between PDE5is and vascular parameters: A systematic review and meta-analysis” (https://www.crd.york.ac.uk/PROSPERO/) (Reg. No. CRD42023387924).

PMID:41469737 | DOI:10.1186/s13643-025-03042-4

BMC Sports Sci Med Rehabil. 2025 Dec 30;17(1):387. doi: 10.1186/s13102-025-01433-7.

ABSTRACT

BACKGROUND: Physical inactivity is a key risk factor for metabolic disorders. High-intensity interval training (HIIT) has been recognized for its metabolic benefits, but its acute effects on adiponectin isoforms remain unclear. This study examines the impact of a single HIIT session on circulating adiponectin (high-molecular weight; HMW, medium-molecular-weight; MMW, and low-molecular weight; LMW) isoforms and metabolic outcomes in insufficiently active young adults.

METHODS: A quasi-experimental study was conducted with 21 physically inactive adults (11 women, 10 men, mean age 22.7 ± 1.5 years). Participants performed a HIIT session consisting of six bouts at 80% heart rate reserve (HRR). Pre- and post-exercise blood samples were ana-lyzed for adiponectin isoforms via Western blotting, and metabolic markers were assessed. Statistical analyses included Wilcoxon tests.

RESULTS: MMW adiponectin significantly increased (~ 19%; effect size [95%CI]: 0.49 [-0.02-1.00] p < 0.05), while LMW and HMW adiponectin remained unchanged. The HMW/MMW ratio decreased (-16%; effect size [95%CI]: -0.49 [-0.99-0.00] p < 0.05). Additionally, non-HDL cholesterol (effect size [95%CI]: 0.464 [-0.03-0.958]) and lactate levels (effect size [95%CI]: 1.164 [0.568-1.759]) increased post-exercise (both p < 0.05).

CONCLUSIONS: A single HIIT session acutely increases MMW adiponectin in insufficiently active young adults. Further research is needed to determine the long-term metabolic implications of repeated HIIT sessions on adiponectin isoform dynamics.

TRIAL REGISTRATION: retrospectively registered in ClinicalTrials.gov (NCT07146867) on August 21st, 2025.

PMID:41469733 | DOI:10.1186/s13102-025-01433-7

Isr J Health Policy Res. 2025 Dec 31;14(1):81. doi: 10.1186/s13584-025-00744-x.

ABSTRACT

BACKGROUND: Appropriate procurement of blood cultures (BC) is essential for diagnosis of bacteremia and susceptibility testing. This includes (1) adequate preparation of the venipuncture site to minimize contamination; (2) obtaining ≥ two sets with a time interval before starting antibiotics. Although these recommendations are standard since the 1960s, adherence is far less than expected – which may adversely impact on the management of bacteremic patients.

AIMS OF STUDY: This single-center study conducted in Shaare Zedek Medical Center aimed to decrease the proportion of contaminated BCs and to increase the percentage of obtaining two sets of BC/ blood-culture-taking episode.

METHODS: Determination of both markers at baseline, then monthly for one year, then subsequently on a quarterly basis; showing data from all departments in real-time to all department directors; and providing short educative lectures during departmental staff meetings, at baseline and after 1-2 years. These markers were adopted as one of the hospital-wide quality measures.

RESULTS: In the 20-year period 2000-2019 more than 1 million BCs were obtained, of which 70% were from patients ≤ 72 h in hospital. During the 5-year study (2020-2024), the percent of blood-culture-taking episodes from which two culture sets were obtained increased annually by ± 16% from a baseline of 27% (9010/33306) in 2020, to 46% (18462/40191) in 2024 (Incidence Rate Ratios, IRR 1.16 [95%CI 1.13-1.18], p < 0.001). This improvement was observed in almost all departments and was especially profound in the emergency department (ED), starting at a baseline of 19% (1979/10326) and increasing to 53% (5304/9915)(IRR 1.33 [95%CI 1.27-1.39], p < 0.001). During the same period, the annual proportion of false-positive BCs, from which only contaminants were isolated, decreased annually by 18% from 2.4% (1592/65230) in 2020 to 1.3% (895/68991) in 2024 (IRR 0.82 [95%CI 0.77-0.88], p < 0.001). This improvement was observed in all departments: in the emergency department, this rate decreased from 3.3% (676/20529) to 1.56% (272/17459) (IRR 0.79 [95%CI 0.75-0.83], p < 0.001).

CONCLUSION: A simple educational intervention, combined with meticulous data mining and presentation of each department’s results, with comparison of all other departments, led to significant and sustained improvement in measurable markers.

PMID:41469732 | DOI:10.1186/s13584-025-00744-x

Cancer Med. 2026 Jan;15(1):e71490. doi: 10.1002/cam4.71490.

ABSTRACT

BACKGROUND: Patient-derived organoid (PDO) models have emerged as critical tools in pancreatic ductal adenocarcinoma (PDAC) research and are used as surrogates for studying the individual’s tumor biology. Still, PDO-based concepts for direct clinical application remain challenging. In this prospective observational trial (OrgaPanCCC-01), we aim to address clinical feasibility, identify predictive factors for PDO establishment, and assess the prognostic potential of PDO establishment for patient’s survival.

METHODS: Samples for PDO generation were prospectively collected via endoscopy, surgery, and transcutaneous punch biopsy, or from ascites. Patients were followed up for a median time of 14.6 months. We evaluated the clinical feasibility by determining the PDO establishment rate and the time required for establishment. Uni- and multivariate analyses were performed to examine the effect of clinical and sample characteristics on PDO establishment. For the predictive and prognostic potential, PDO establishment was correlated to the patients’ disease-free (DFS), progression-free (PFS) and overall survival (OS).

RESULTS: Between 2021 and 2023, 75 patients were enrolled with radiologically suspected PDAC at the Charité Universitätsmedizin Berlin and at the Waldfriede Krankenhaus Berlin. PDAC was confirmed in 62 patients (83%). PDO establishment was achieved in 58% (n = 36/62) of patients within a median of 28 days, supporting the feasibility of clinical implementation. In the uni- and multivariate analysis, samples from metastatic sites (p = 0.04) and higher CA19-9 levels (p = 0.03) were found to be positively correlated with PDO growth. Patients without PDO growth tended to have longer PFS (p = 0.32), whereas no statistically significant correlation was observed between PDO growth and OS.

CONCLUSION: In this prospective observational trial, we show that PDO generation is feasible at a success rate of 58% within a clinically reasonable time frame of 6 weeks. The efficacy of PDO establishment depended on sample site, with metastatic samples showing higher establishment rates. Higher CA 19-9 levels were positively correlated with PDO growth. Successful PDO establishment did not have a prognostic value for OS. Overall, our findings underline the great potential of PDO-based precision medicine approaches, which should further be evaluated in prospective interventional translational trials.

PMID:41469727 | DOI:10.1002/cam4.71490

Obstet Gynecol Surv. 2025 Dec 1;80(12):757-759. doi: 10.1097/OGX.0000000000001475.

ABSTRACT

(Abstracted from Lancet Oncol 2025;26(10):1370-1381) Fifteen percent to 20% of endometrial cancer patients have a high-risk form of the disease; this classification indicates a higher risk of cancer recurrence and cancer-related death. The standard therapy for high-risk endometrial cancer is pelvic radiotherapy.

PMID:41468091 | DOI:10.1097/OGX.0000000000001475

Obstet Gynecol Surv. 2025 Dec 1;80(12):737-738. doi: 10.1097/01.ogx.0001176336.07664.a1.

ABSTRACT

(Abstracted from JAMA 2025;333(21):1925-1928) Restrictive abortion policies in many states may raise ethical and clinical considerations among neonatologists, who feel obligated to attempt life support to infants, regardless of the prognosis. Studies that have evaluated trends in initiating active treatment and the survival rate of infants born between 22 and 25 weeks of gestation are scarce.

PMID:41468084 | DOI:10.1097/01.ogx.0001176336.07664.a1

Breastfeed Med. 2025 Dec 22. doi: 10.1177/15568253251406258. Online ahead of print.

ABSTRACT

Background: Diaper dermatitis (DD) is a very common problem in infants between 1 and 6 months. While it rarely causes long-lasting problems, it can cause serious short-term problems for both infants and parents. Accordingly, this study compared the effect of breast milk and diaper rash cream containing Hamamelis virginiana (12 mg/100 g) on the healing process in 0-6 month-old infants with DD. Methods: This randomized, single-blinded trial was conducted with 60 infants aged 0-6 months diagnosed with DD. Participants were assigned to either the breast milk group (BG) or the comparison group (CG) receiving Hamamelis virginiana cream. Demographic characteristics and DD severity were assessed using a structured demographic questionnaire and the validated Assessment of the Severity of Uncomplicated DD in Infants Scale. Statistical analyses included Shapiro-Wilk, Mann-Whitney U, Wilcoxon signed rank, Chi-square, and Fisher’s exact tests. Significance was set at p < 0.05. Results: Before the intervention, the mean scale score was 5.17 ± 0.46 in the BG, 2.83 ± 1.37 in the CG, which was a statistically significant difference. After the intervention, there was a significant decrease in the mean scale score in the BG to 0.03 ± 0.18, whereas the mean decrease was smaller in the CG (1.53 ± 1.11). The difference in the mean scale scores between the groups was statistically significant (p < 0.001). Furthermore, the postintervention mean scale score of the BG was significantly lower than that of the CG. However, baseline severity differences limit direct comparison of treatment efficacy. Conclusions: Topically applied breast milk appears to be a safe, accessible, and cost-effective option for treating uncomplicated DD, with greater improvement than cream containing Hamamelis virginiana. However, baseline severity differences limit direct comparison. Further studies using block randomization are recommended.

PMID:41468068 | DOI:10.1177/15568253251406258

Surg Infect (Larchmt). 2025 Dec 19. doi: 10.1177/10962964251409563. Online ahead of print.

ABSTRACT

Introduction: Surgical site infections continue to pose a major challenge in healthcare, contributing to prolonged hospitalizations and increased morbidity and mortality. Despite advancements in antimicrobial agent treatments, bacterial resistance remains an important obstacle. Among various antimicrobial agents, silver compounds have been re-evaluated for their broad-spectrum efficacy. Previous studies, have demonstrated the potential of silver carboxylate embedded in a titanium dioxide/polydimethylsiloxane (TiO₂/PDMS) matrix as a material of biomedical relevance. This study aims to expand upon these findings by examining the cytotoxicity profile of silver carboxylate in four human cell lines that play a crucial role in wound healing. Hypothesis: Controlled silver elution from the TiO₂/PDMS matrix produces a cytotoxicity profile comparable with commonly used antibiotic agents at clinically relevant exposures. Methods: In this study, silver carboxylate beads were prepared using a modified method, whereby silver neodecanoate was incorporated into a TiO₂/PDMS matrix. The modification involved adjusting the concentration ratios to optimize the release profile for controlled silver elution. Primary human osteoblasts (OBs), keratinocytes (KTs), skeletal muscle cells (SkMs), and endothelial cells (ETs) were cultured under standard conditions and, after 24 h, were exposed to specific silver carboxylate concentrations (1×, 10×, and 100%) without additional washing steps before exposure. In addition, we included a comparative analysis with newly developed silver formulations (silver nanoparticles at 10 and 30 nM, and colloidal silver at 100 and 300 nM) and a panel of conventional antibiotic agents, including vancomycin (5 and 50 µg/mL), tobramycin (5 and 50 µg/mL), linezolid (2 and 20 µg/mL), and polymyxin E (2 µg/mL). Cell viability following exposure was measured using the MTT assay, and the results were analyzed statistically using analysis of variance followed by post hoc Tukey tests. Results: OBs exhibited marked cytotoxicity at higher silver carboxylate concentrations, particularly at the 10× condition, with viability comparable with that observed with higher dose antibiotic agents such as vancomycin 50 µg/mL and tobramycin 50 µg/mL. SkMs and ETs demonstrated limited sensitivity at 1× exposure but showed substantial loss of viability at 10×, consistent with dose-dependent toxicity. KTs were the most sensitive cell type, displaying decreased viability even at 1× exposure. The modified TiO₂/PDMS matrix demonstrated an enhanced controlled release mechanism, resulting in lower cytotoxicity compared with both early silver formulations and conventional antibiotic agents. Conclusion: This study builds upon previous investigations on silver carboxylate and provides new insights into its cytotoxic effects across additional human cell lines, including ETs and SkMs. The enhanced controlled release from the modified TiO₂/PDMS matrix reduces cytotoxicity compared with previous formulations and commonly used antibiotic agents. These results highlight the importance of concentration-dependent toxicity and support further evaluation of this material in future in vivo and translational studies. The cytotoxicity profile of silver carboxylate embedded in a modified TiO₂/PDMS matrix shows variability across different human cell types, but may be relevant for future evaluation in models that require a detailed assessment of biocompatibility. This study expands on previous research by introducing additional cell lines and optimizing the release mechanism of silver carboxylate to enhance its cytotoxicity profile and safety. Addressing current limitations, including lactate dehydrogenase (LDH) interference, will be essential for a comprehensive evaluation and for establishing safe concentration thresholds for future in vivo applications. Future research should focus on validating these findings in animal models and evaluating the systemic effects of prolonged silver exposure.

PMID:41468057 | DOI:10.1177/10962964251409563