Nevin Manimala

Arch Iran Med. 2025 Sep 1;28(9):506-513. doi: 10.34172/aim.34624. Epub 2025 Sep 1.

ABSTRACT

BACKGROUND: Surgical site infections (SSIs), particularly after spinal procedures, remain a major concern despite advances in infection control. This study aimed to determine the prevalence and associated risk factors of postoperative spinal infections in northwestern Iran.

METHODS: A cross-sectional study was conducted on 500 adult patients (≥18 years) who underwent spinal surgery in two referral hospitals in Tabriz (Imam Reza and Shohada) between March 2019 and February 2024. Postoperative infections were confirmed by infectious disease specialists. Data on demographics and surgical variables (including surgical site, approach, duration, blood loss, and transfusion) were collected using a standardized checklist. Statistical analyses were conducted in SPSS version 23.0 using Chi-squared and independent samples t-tests. Logistic regression was performed to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: The prevalence of postoperative spinal infections was 6%. Staphylococcus aureus was the most common pathogen (66.7%). Significant risk factors included female sex, older age, corticosteroid use, diabetes mellitus, longer surgery duration (>4 hours), blood loss (>1 liter), and blood transfusion (P<0.05). Diabetes (OR=5.90, 95% CI: 2.30-15.20) and prolonged surgery (OR=6.90, 95% CI: 2.50-19.00) showed the strongest associations. No significant associations were found for BMI, smoking, hypertension, CRP, ESR, surgical site, or technique.

CONCLUSION: A 6% infection rate was identified, with several clinical and demographic factors increasing risk. Recognizing these predictors is essential for prevention. Broader, multi-center studies are recommended to validate findings and inform national surgical infection control policies.

PMID:41159353 | DOI:10.34172/aim.34624

Arch Iran Med. 2025 Aug 1;28(8):443-451. doi: 10.34172/aim.34506. Epub 2025 Aug 1.

ABSTRACT

BACKGROUND: Chronic low-grade inflammation is implicated in diabetic microvascular complications, but the relationship between circulating high-sensitivity C-reactive protein (hs-CRP) and diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) remains incompletely defined. We evaluated whether plasma hs-CRP levels are independently associated with DR presence and severity in a cohort of T2DM patients.

METHODS: In this analytical cross-sectional study, 149 T2DM patients referring to endocrinology and ophthalmology clinics at Babol University of Medical Sciences (April 2022-June 2023) were categorized into no DR (n=50), non-proliferative DR (NPDR; n=49), and proliferative DR (PDR; n=50) groups. Comprehensive ophthalmic examination classified DR stage. We measured hs-CRP (low: 0-1 mg/L, moderate: 1-3 mg/mL, high:>3 mg/mL), HbA1c, fasting blood sugar (FBS), and total cholesterol in fasting blood samples. Statistical analysis was performed with SPSS v.22.

RESULTS: Mean hs-CRP concentrations rose progressively with DR severity: 2.71±1.14 mg/L (no DR), 4.89±5.31 mg/L (NPDR), and 10.60±9.24 mg/L (PDR; P=0.023). After adjusting for age, sex, diabetes duration, HbA1c, BMI, hypertension, smoking, cholesterol, and treatment, each 1 mg/L increase in hs-CRP was associated with 1.40-fold higher odds of DR (OR 1.40; 95% CI 1.08-1.94; P=0.011). Other independent predictors included longer diabetes duration (OR 1.19 per year; 95% CI 1.10-1.29; P<0.001), higher HbA1c (OR 1.62 per %; 95% CI 1.06-2.48; P=0.023), and female sex (OR 3.25; 95% CI 1.11-9.52; P=0.031).

CONCLUSION: High hs-CRP levels correlate with DR severity in T2DM, highlighting inflammation’s role and potential for early detection strategies.

PMID:41159344 | DOI:10.34172/aim.34506

Phys Chem Chem Phys. 2025 Oct 29. doi: 10.1039/d5cp02522b. Online ahead of print.

ABSTRACT

It has been demonstrated that quantum effects play an important role in nitrogen adatom diffusion over partially Ga-covered GaN(0001) surfaces. This is partially related to the bonding in both the initial and activated complex states. It is shown that wurtzite gallium nitride is bonded differently from standard semiconductors having two separate valence subbands: upper by gallium 4sp³ hybridized orbitals and nitrogen resonant 2p states, and lower by gallium 3d and nitrogen 2s orbitals. Second, the diffusion energy barrier may be changed owing to the quantum statistics of electrons governed by the Fermi energy, as shown in the case of nitrogen diffusion over a clean and gallium-covered Ga-terminated GaN(0001) surface. Under fractional Ga coverage of the GaN(0001) surface, the nitrogen diffusion energy barrier is at the saddle point. The barrier affects the electron redistribution between the surface quantum states at both the initial and saddle points. In the case of full GaN coverage, the diffusion path is from the top N adatom configuration to the H3 site, which corresponds to the maximal energy. Therefore the diffusion barrier is ΔE_bar = 1.18 eV for clean and ΔE_bar = 0.92 eV for (1/6) ML to finally ΔE_bar = 1.23 eV for full Ga coverage. Thus, the overall barrier was ΔE_bar = 0.92 eV. The identified stable N-on-top configuration for Ga coverage is essential for the GaN growth mechanism.

PMID:41159340 | DOI:10.1039/d5cp02522b

Hua Xi Kou Qiang Yi Xue Za Zhi. 2025 Oct 1;43(5):689-695. doi: 10.7518/hxkq.2025.2024462.

ABSTRACT

OBJECTIVES: This study aimed to investigate the influence of the dimensional stability of 3D printed resin master model on the replication accuracy of implant replicas.

METHODS: Ten digital impressions of patients undergoing continuous crowns or fixed bridge restoration supported by two implants were obtained, and resin models with implant replicas were 3D printed. Scanning rods were fixed on the replicas 3, 7, and 14 days after printing. The 3D, linear, and angular deviations of the scanning rods at different times were analyzed through Geomagic Wrap 2021 software.

RESULTS: The position of the replicas shifted mesiolingually, in the same direction as the shrinkage of the model. From day 7 onward, the 3D, distance linear, and angular deviations of the replicas (scanning rod) significantly increased compared with those on the 3rd day (P<0.05). On the 14th day, the changes were even more pronounced, with the above deviations showing statistical significance (P<0.05) compared with those for the 3-day and 7-day groups. No statistical difference in height linear deviation was observed among the groups.

CONCLUSIONS: The insufficient dimensional stability of 3D printed resin models can lead to changes in the relative position and angle of the replicas, thereby affecting the accuracy of the replicas in recreating the implant’s position. Complete manufacturing of prosthesis is recommended within 7 days after the model is printed.

PMID:41159330 | DOI:10.7518/hxkq.2025.2024462

Hua Xi Kou Qiang Yi Xue Za Zhi. 2025 Oct 1;43(5):679-688. doi: 10.7518/hxkq.2025.2024449.

ABSTRACT

OBJECTIVES: Color doppler flow imaging (CDFI) and cone-beam computed tomography (CBCT) were utilized to evaluate changes in mucosal vascular parameters and the osteogenic effects following guided bone regeneration (GBR) in the maxillary anterior region using trapezoidal or modified triangular flaps.

METHODS: Patients undergoing single maxillary anterior dental implant surgery with GBR were randomly allocated into two groups: a trapezoidal flap group and a modified triangular flap group. After GBR surgery, the mucosal vascular parameters at the surgical site were assessed at various time intervals (preoperative, 2 h, 1 and 3 days, and 1, 2, and 4 weeks postoperative) using CDFI. In addition, the effects of bone augmentation were evaluated through the analysis of CBCT images obtained preoperatively, 2 h, and 6 months postoperative.

RESULTS: The buccal mucosa in the edentulous area had a lower blood flow rate than the corresponding tooth in the same jaw, and the difference was statistically significant (P<0.001). The mucosal blood flow rate in the surgical area increased compared with that in the preoperative period. The peak flow rate was recorded at 2 weeks postoperatively and then decreased to levels comparable to those of the reference tooth. A statistically significant difference was observed between the two groups (P<0.05). The buccal alveolar ridge width of the implant platform was reduced by (1.3±0.9) mm in the trapezoidal flap group and (0.9±0.7) mm in the modified triangular flap group, respectively, at 6 months postoperatively, compared with 2 h postoperative. The buccal alveolar ridge width of the 5 mm from the implant platform was reduced by (0.9±0.6) mm and (0.3±0.6) mm, respectively. The buccal alveolar ridge width of the 10 mm from the implant platform was reduced by (0.6±0.8) mm and (0.2±0.6) mm, respectively. The height of the alveolar ridge was reduced by (1.9±1.4 ) mm and (1.4±1.3) mm. The change in graft volume was (136±78 ) mm³ and (114±85) mm³. However, the differences between the two groups were not statistically significant (P>0.05).

CONCLUSIONS: When a tooth is missing, blood flow to the buccal mucosa on the side of the missing tooth is reduced. The modified triangular flap group demonstrated superior microcirculation of blood flow in the operative area after GBR of the maxillary anterior teeth. Trapezoidal and modified triangular flaps achieved the anticipated bone augmentation during bone augmentation surgery in the maxillary anterior region, with no considerable effect on the changes in alveolar bone size parameters.

PMID:41159329 | DOI:10.7518/hxkq.2025.2024449

Hua Xi Kou Qiang Yi Xue Za Zhi. 2025 Oct 1;43(5):671-678. doi: 10.7518/hxkq.2025.2025013.

ABSTRACT

OBJECTIVES: To compare the clinical effects of concentrated growth factor (CGF) membrane and Bio-Gide ^® collagen membrane, combined with Bio-Oss ^® sticky bone respectively in alveolar ridge preservation (ARP) of maxillary anterior teeth.

METHODS: Thirty patients who needed alveolar ridge preservation after maxillary anterior tooth extraction were selected and randomly assigned to the Bio-Gide group and the CGF group. In both groups, the extraction sockets were tightly filled with the Bio-Oss^® sticky bone. In the Bio-Gide group used Bio-Gide^® collagen membrane to cover the upper edge of the Bio-Oss^® sticky bone and closed the wound. The CGF group, the CGF membrane was covered on the upper edge of the Bio-Oss^® sticky bone and the wound was closed. The soft tissue wound healing status at 10 days after ARP, the changes in alveolar ridge height and width immediately after ARP and at 6 months after ARP, and the doctor-patient satisfaction at 6 months after ARP were compared and evaluated between the two groups.

RESULTS: At 6 months after ARP, there was no statistically significant difference in the changes of alveolar bone width and height between the two groups (P>0.05). However, the CGF group showed better performance in soft tissue healing after ARP and doctor-patient satisfaction, and the differences were statistically significant (P<0.05).

CONCLUSIONS: Compared with the Bio-Gide^® collagen membrane, the combined application of CGF membrane and Bio-Oss^® sticky bone can lead to better soft tissue healing after ARP of maxillary anterior teeth and higher doctor-patient satisfaction, showing obvious advantages in ARP of maxillary anterior teeth.

PMID:41159328 | DOI:10.7518/hxkq.2025.2025013

J Cosmet Dermatol. 2025 Nov;24(11):e70491. doi: 10.1111/jocd.70491.

ABSTRACT

OBJECTIVE: To analyze and evaluate the clinical effect of cosmetic debridement and suture combined with recombinant human epidermal growth factor (rhEGF).

METHODS: A systematic review of the literature was performed by searching China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Chinese Science and Technology Journals, China Biomedicine, PubMed, Web of Science, and Cochrane Library. RevMan 5.4.1 software was used for statistical analysis. Heterogeneity among studies was assessed using the Q test (p value). Publication bias was evaluated via funnel plots, forest plots were generated, and the combined odds ratio (OR) was calculated using a fixed-effects model or random-effects model.

RESULTS: The combined therapy showed favorable clinical efficacy [OR = 6.62, 95% confidence interval (95% CI) (3.14-13.92), p < 0.00001], shorter wound healing time [mean difference (MD) = -2.69, 95% CI (-3.10 to -2.29), p < 0.00001], and improved scar outcomes (lower Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) scores) at 6 months. Serum epidermal growth factor (EGF) levels were higher, while interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were lower in the combined therapy group (all p < 0.05).

CONCLUSION: Aesthetic debridement and suture combined with rhEGF have a good clinical effect in the treatment of maxillofacial trauma.

PMID:41159304 | DOI:10.1111/jocd.70491

Biom J. 2025 Dec;67(6):e70082. doi: 10.1002/bimj.70082.

ABSTRACT

Often probabilities of nonstandard time-to-event endpoints are of interest, which are more complex than overall survival. One such probability is chronic graft-versus-host disease (GvHD-) and relapse-free survival, the probability of being alive, in remission, and not suffering from chronic GvHD after stem cell transplantation, with chronic GvHD being a recurrent event. Because the probabilities for endpoints with recurrent events may not fall monotonically, one should not use the Kaplan-Meier estimator for estimation, but the Aalen-Johansen estimator. The Aalen-Johansen is a consistent estimator even in non-Markov scenarios if state occupation probabilities are being estimated and censoring is random. In some multistate models, it is also possible to use linear combinations of Kaplan-Meier estimators, which do not depend on the Markov assumption but can estimate probabilities to be out of bounds. For these linear combinations, we propose a wild bootstrap procedure for inference and compare it with the wild bootstrap for the Aalen-Johansen estimator in non-Markov scenarios. In the proposed procedure, the limiting distribution of the Nelson-Aalen estimator is approximated using the wild bootstrap and transformed via the functional delta method. This approach is adaptable to different multistate models. Using real data, confidence bands are generated using the wild bootstrap for chronic GvHD- and relapse-free survival. Additionally, coverage probabilities of confidence intervals and confidence bands generated by Efron’s bootstrap and the wild bootstrap are examined with simulations.

PMID:41159300 | DOI:10.1002/bimj.70082

Int J Cancer. 2025 Oct 29. doi: 10.1002/ijc.70211. Online ahead of print.

ABSTRACT

The combination of two immune checkpoint inhibitors (CPI) or a CPI with a tyrosine kinase inhibitor (TKI) has expanded the therapeutic options for advanced/metastatic renal cell carcinoma (aRCC) beyond TKI monotherapy. In the absence of head-to-head randomized trials comparing these strategies, we estimate their real-world effectiveness by emulating a hypothetical randomized trial. A total of 936 patients with aRCC from the prospective, observational, multicenter clinical registry CARAT (NCT03374267) starting first-line treatment after January 15, 2019, were included. Inverse probability of treatment weighting (IPTW) was used to compare first-line CPI + TKI (n = 447), CPI + CPI (n = 257), and TKI monotherapy (n = 166). Real-world progression-free survival (rwPFS), overall survival (OS), and time-to-deterioration (TTD) of health-related quality of life (HRQoL) were analyzed, also stratified by patients’ prognostic risk according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model. IPTW-adjusted median rwPFS and OS independent of IMDC risk were 12.3 [10.4-15.6] and 29.0 months [25.6-36.3] for TKI + CPI, 8.3 [6.5-10.9] and 21.9 months [16.3-34.5] for CPI + CPI, and 8.5 [6.4-10.0] and 31.7 months [21.0-40.0] for TKI monotherapy. Compared to CPI + TKI, survival tended to be worse for CPI + CPI (rwPFS: hazard ratio (HR) 1.25 [1.00-1.58]; OS: HR 1.25 [0.95, 1.63]). This finding was more pronounced for rwPFS in patients at intermediate risk. Median TTD of HRQoL did not substantially differ between the strategies. Despite the lack of statistically significant HR differences in rwPFS and OS, there was a trend toward superior survival with first-line CPI + TKI compared to CPI + CPI. TKI monotherapy may remain a viable first-line treatment option in selected patient populations. Further analyses, preferentially randomized clinical trials, are warranted.

PMID:41159297 | DOI:10.1002/ijc.70211

J Helminthol. 2025 Oct 29;99:e118. doi: 10.1017/S0022149X25100850.

ABSTRACT

This study presents data on helminth communities from 93 Hooded Crows (Corvus cornix). The dataset includes historical and contemporary records from three localities in Ukraine with different levels of urbanisation: Kyiv, the Middle Dnipro River, and Polissya. Thirty-two helminth species were identified, including 14 trematodes, six cestodes, 11 nematodes, and one acanthocephalan. The nematodes Eufilariella delicata and Hadjelia truncata are documented in Hooded Crows for the first time. During the statistical analysis, it was revealed that the used dataset is insufficient for robust inference regarding the impact of urbanisation on helminth communities due to its temporal and spatial biases. Despite the limitation, the data offer information for future research on the influence of urbanisation on helminth biodiversity in avian hosts.

PMID:41159293 | DOI:10.1017/S0022149X25100850