Nevin Manimala

Clin Implant Dent Relat Res. 2025 Jun;27(3):e70049. doi: 10.1111/cid.70049.

ABSTRACT

OBJECTIVES: To investigate the trueness of intraoral photogrammetry (IPG) technology for complete-arch implant digital impression and evaluate the effect of implant number.

MATERIAL AND METHODS: All data were fully anonymized in compliance with ethical standards, and a total of 30 complete-arch patient models with 4 (n = 13), 5 (n = 9), or 6 (n = 8) implants were selected from the archive. Digital impressions were taken with IPG and a desktop scanner. Test and reference standard tessellation language (STL) files were superimposed using a best-fit algorithm. For each implant position, mean linear (ΔX, ΔY, ΔZ axes) and angular deviations (ΔANGLE) and three-dimensional (3D) Euclidean distances (ΔEUC) were measured as primary outcomes with a dedicated software program (Hyper Cad S, Cam HyperMill, Open Mind Technologies) and reported as descriptive statistics. Secondary aim was to determine using linear mixed models whether implant number affected trueness. All statistical analyses were conducted using Stata 18 (Stata Corp, College Station) and significance was set at 0.05.

RESULTS: A total of 30 definitive casts with 4 (n = 13), 5 (n = 8), and 6 (n = 9) multi-unit abutment (MUA) analogs were analyzed (n = 146 implant positions). The mean deviations along the X-axis were -3.97 ± 32.8 μm, while along the Y-axis, they were -1.97 ± 25.03 μm. For the Z-axis, a greater deviation of -33 ± 34.77 μm was observed. The 3D Euclidean distance deviation measured 57.22 ± 27.41 μm, and the angular deviation was 0.26° ± 0.19°. Statistically significant deviations were experienced for ΔZ, ΔEUC, and ΔANGLE (p < 0.01). Additionally, the number of implants had a statistically significant effect only on the Z-axis deviation (p = 0.03).

CONCLUSIONS: Within study limitations, IPG technology was feasible for complete-arch digital implant impression with mean linear, angular, and 3D deviations far below the acceptable range for a passive fit. Reported IPG trueness might avoid a rigid prototype try-in. The implant number had no influence on trueness except for Z-axis deviations. Integrating photogrammetry with intraoral optical scanning (IOS) improved practicality, optimizing the digital workflow. Further clinical trials are needed to confirm these findings.

PMID:40338525 | DOI:10.1111/cid.70049

Curr Rev Musculoskelet Med. 2025 May 8. doi: 10.1007/s12178-025-09973-8. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Virtual reality (VR) simulation in orthopedic education has gained recent interest in the literature. VR simulation provides a virtual space to practice surgical steps accurately, creating a user-controlled environment for novice surgical trainee skill development. Despite the reported benefits, VR is not routinely incorporated into orthopedic residency core curriculum. This study reviews and synthesizes contemporary data assessing the efficacy of VR simulation in orthopedic surgical training.

RECENT FINDINGS: Twenty-three studies across six subspecialty areas were included. Seven hundred and forty-eight participants trained on over nine different VR simulators. Control groups included no additional training, surgical technique guides, surgical videos, and benchtop simulators. Outcome measurements included procedure-specific checklists, objective grading scales, time-to-task completion, and accuracy of implant placement, among others. No outcomes directly focused on patient safety or involved live patients. Across disciplines, VR simulation training improved outcomes when compared to controls, conferring quicker procedure times, higher correct step completion, and more accurate implant placement, although not always statistically significant. Virtual reality is a tool employed by various industries that offers immersive, interactive, and realistic learning experiences. In orthopedics, VR has the potential to enhance skills, improve safety, and increase trainee confidence. In most of the included studies, trainees performed better in the VR simulation groups when compared to control education modalities, and participants readily embraced VR. However, there is mixed evidence on its use, and future studies are needed involving longitudinal VR education to better assess the actual impact on trainee skills, as well as performance in the operating room and its impact on patient outcomes.

PMID:40338491 | DOI:10.1007/s12178-025-09973-8

Maxillofac Plast Reconstr Surg. 2025 May 8;47(1):9. doi: 10.1186/s40902-025-00463-y.

ABSTRACT

OBJECTIVE: Concha bullosa, a common anatomical variation characterized by air-filled cavities in the turbinate bones, can influence sinonasal function and surgical planning. This study aims to evaluate the distribution, laterality, and cranial skeletal type associations of concha bullosa (CB) among patients with confirmed CB findings on computed tomography (CT) scans.

METHODS: A retrospective cohort study was conducted on 774 patients who underwent cranial and facial CT scans between March 2023 and March 2024. Patients were classified into mesocephalic, brachycephalic, and dolichocephalic groups based on the cephalic index. The distribution and laterality of concha bullosa were assessed using CT scans, and statistical analyses were performed using the Chi-square test, with a significance level set at P < 0.05.

RESULTS: Among CB-positive patients, left-sided concha bullosa was most common (49.48%), followed by right-sided (31.91%) and bilateral (18.6%) involvement. Mesocephalic individuals constituted the largest proportion of CB-positive cases (55.56%), followed by dolichocephalic (22.86%) and brachycephalic (21.57%) individuals. A significant gender difference was observed in the mesocephalic (P = 0.001) and brachycephalic (P = 0.013) groups, with males exhibiting a higher prevalence of right-sided and bilateral concha bullosa.

CONCLUSION: Concha bullosa distribution varies significantly among cranial skeletal types among CB-positive patients, with mesocephalic individuals exhibiting the highest overall prevalence. Our findings underscore the influence of cranial morphology on the presentation of CB. This insight may enhance radiological evaluation and individualized surgical planning in CB-positive patients.

PMID:40338478 | DOI:10.1186/s40902-025-00463-y

Discov Oncol. 2025 May 8;16(1):688. doi: 10.1007/s12672-025-02453-y.

ABSTRACT

OBJECTIVE: To construct a machine learning (ML) model to predict the progression of chronic atrophic gastritis (CAG) to gastric cancer (GC), given its precancerous significance.

METHODS: Using medical records from the Affiliated Hospital of Qingdao University, common laboratory indicators were extracted. LASSO regression identified 10 core risk factors, which were further analyzed using binary logistic regression to develop a nomogram model in R. The model’s performance was evaluated using receiver operating characteristic (ROC) curves, the concordance index (C-index), calibration curves, and decision curve analysis (DCA).

RESULTS: The model showed excellent performance, with a C-index of 0.887. The key factors included sex, coagulation, blood cell indexes, and blood lipid levels. The ROC areas were 0.892 (quantitative) and 0.853 (qualitative), confirming model reliability.

CONCLUSION: A new nomogram model for assessing GC risk in CAG patients was successfully developed. However, due to data collection and time limitations, future studies should expand the sample size, perfect the validation process, and optimize the model to achieve more accurate risk prediction.

PMID:40338419 | DOI:10.1007/s12672-025-02453-y

Int Ophthalmol. 2025 May 8;45(1):179. doi: 10.1007/s10792-025-03532-3.

ABSTRACT

PURPOSE: Pars plana vitrectomy (PPV) with various forms of tamponade and retinopexy is often the primary treatment for retinal detachment. However, a rare but serious complication is sterile keratolysis. We therefore aimed to evaluate the prevalence and potential risk factors for the development of corneal ulceration following vitreoretinal surgery for retinal detachment.

METHODS: This is a single-centre retrospective study including 14 cases of patients presenting to our department with sterile keratolysis involving the stroma after one or more PPVs for retinal detachment or vitreous hemorrhage. Time of primary procedure, time of onset of corneal complications, comorbidities, type of tamponade used, use of endophotocoagulation, cryoretinopexy and number of surgeries were recorded. Patients with additional comorbidities confounding a possible correlation were excluded from the case series.

RESULTS: A total of 14 patients were identified with corneal complications after pars plana vitrectomy for retinal detachment. Multiple vitrectomies were performed in 86% (12/14) of the cases. Surgical treatment consisted of six (43%) perforating keratoplasties and seven (50%) amniotic membrane keratoplasties in all but one patient. At an average of three months after the onset of corneal symptoms, the first corneal surgery was performed. Repeated corneal surgery was required in 4 patients (29%) and consisted of two penetrating keratoplasties and four amniotic membrane transplantation. Visual acuity at the first presentation of corneal complications was reduced (2.1 ± 0.6 logMAR), but was not statistically different from the visual acuity at baseline (1.6 ± 0.7 logMAR). At the last follow-up, visual acuity remained reduced at 1.8 ± 0.8 logMAR (p = 0.2).

CONCLUSIONS: The risk of sterile keratolysis seems to increase with excessive laser or cryo-retinopexy, use of silicone oil and repeated procedures. The initial vitrectomy was a complex surgery in all cases and required a longer operating time. Ciliary nerve damage of neurotrophic origin may be the cause of sterile keratolysis, and controlled retinopexy sparing the long ciliary nerves and avoiding cryotherapy may reduce the risk. Controlled studies are needed to investigate the causality between vitreoretinal surgery and sterile keratolysis.

PMID:40338390 | DOI:10.1007/s10792-025-03532-3

Int Ophthalmol. 2025 May 8;45(1):180. doi: 10.1007/s10792-025-03534-1.

ABSTRACT

PURPOSE: The aim of this study was to assess the tear film and meibomian gland function before and after cataract surgery using the Lacrydiag ocular surface analyzer.

METHODS: This was an observational prospective study including 34 eyes that underwent phacoemulsification at the Ophthalmology Department of Menoufia University Hospital from October 2023 to January 2024. The patients were evaluated pre-operatively as well as 1 week, 1 month, and 3 months postoperatively. Dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire. Traditional tear break up time (TBUT) was performed as well as Schirmer I test. The Lacrydiag Ocular Surface Analyzer was used for assessment of the tear film and meibomian glands.

RESULTS: Ocular surface analyzer evaluations revealed statistically significant changes at 1 week, 1 month, and 3 months after surgery in comparison to the values before surgery. Significant reductions were observed in non-invasive tear break-up time (NITBUT) and tear meniscus height, as well as in Schirmer’s test without anesthesia, and fluorescein break-up time at each postoperative interval. Some improvements were observed at 1 month and 3 months, however, measurements did not return to the initial preoperative levels. Ocular Surface Disease Index (OSDI) scores significantly increased after 1 week, 1 month, and 3 months post-surgery compared to preoperative levels. The proportion of meibomian gland area loss did not significantly increase after surgery (no structural alterations were noted).

CONCLUSION: The study shows that phacoemulsification impacts both tear quantity and quality, affecting overall tear film stability and ocular surface health.

PMID:40338375 | DOI:10.1007/s10792-025-03534-1

J Psycholinguist Res. 2025 May 8;54(3):34. doi: 10.1007/s10936-025-10145-5.

ABSTRACT

This is a condensed version of a series of talks given by Bernard Maskit at the Referential Process Workshop Conference, at the New York Psychoanalytic Society and Institute (July, 2023). Dr. Maskit discusses the Discourse Attributes Analysis Program (DAAP) which he created to evaluate psychotherapy and other texts utilizing measures of the Referential Process, a theory developed in the context of multiple code theory (Bucci in Psychoanalysis and cognitive science: a multiple code theory, Guilford Press, New York, 1997, 2023). Dr. Maskit’s emphasis is for his audience to understand how his system can be used technically and conceptually, and to provide updates on how measures can be aligned with time to produce new insights. In the first days of the Workshop, Dr. Maskit reviewed the development of the DAAP and its measures; sections of these talks are summarized here with references to relevant publications. He then went on to focus on development of the new TimeDAAP and its crucial role in the Referential Process project. We note with sadness that Dr. Maskit died before he could review and edit his presentation for publication. Wilma Bucci participated in the work presented here and prepared Dr. Maskit’s talks for publication. We thank Sean Murphy, Michael Peral and Perry Suskind for their invaluable contributions to this paper.

PMID:40338374 | DOI:10.1007/s10936-025-10145-5

Mikrochim Acta. 2025 May 8;192(6):344. doi: 10.1007/s00604-025-07195-w.

ABSTRACT

Inspired by analyte-induced in situ formation/growth of silver nanoparticles (AgNPs), the traditional Tollens’ reagent of diamminesilver(I) complex cation [Ag(NH₃)₂]⁺ was shown to be capable of detecting explosives. Thus, a color test based on in situ formation of AgNPs was developed for 1,3,5-trinitroperhydro-1,3,5-triazine (RDX) and 2,4,6-trinitrotoluene (TNT). The resultant yellow-colored AgNPs were characterized using UV-visible spectrophotometry, scanning transmission electron microscopy, and dynamic light scattering measurements. The system displays turn-on absorbance behavior with RDX and TNT, yielding detection limits of 50.3 and 67.2 nmol L^-1, respectively. The assay could distinguish between RDX and TNT using a simple extraction-based recovery procedure. Good recoveries for RDX and TNT were obtained from real (Composite B, Composite A5, and Octol) and synthetically prepared formulations. Method validation was performed by statistically comparing the analytical results obtained by the reference liquid chromatography-tandem mass spectrometric method applied to RDX standards and RDX-contaminated soil samples. As a novelty of this system, direct spectrophotometric detection of RDX through its decomposition product, formaldehyde, was successfully performed for the first time. Compared with the widely used indirect spectrophotometric methods based on nitrite formation from RDX degradation, the system is superior in that it does not require pre-hydrolysis of RDX and does not respond to 1,3,5,7-tetranitro-1,3,5,7-tetraazacyclooctane (HMX). It is also noteworthy that the system responds to TNT in a way that constitutes an innovative alternative to the existing mechanism of Meisenheimer/Janowsky complex formation in the literature.

PMID:40338365 | DOI:10.1007/s00604-025-07195-w

Eur Radiol. 2025 May 8. doi: 10.1007/s00330-025-11651-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To perform a Delphi-based consensus on published evidence on image-guided injections for facet joint pain (FJP) and provide clinical indications.

METHODS: We report the results of an evidence-based Delphi consensus of 38 experts from the European Society of Musculoskeletal Radiology and the European Society of Neuroradiology, who reviewed the published literature for evidence on image-guided injections for FJP. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when ≥ 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the consensus were used to write the paper.

RESULTS: Twenty statements on image-guided FJP treatment have been drafted. Eighteen statements received strong consensus, while two received broad consensus. Three statements reached the highest level of evidence, all of them regarding the lumbar spine. All radiological methods are used for image-guided injections for FJP, and regardless of the radiological method used, all show good safety and efficacy. Facet joint injections and medial branch blocks are used in all spinal regions to treat FJP, and both show similar clinical outcomes. Advanced technological solutions have been studied in the field of lumbar FJP; however, the level of evidence for these is low.

CONCLUSION: Despite promising results reported by published papers on image-guided injections for FJP, there is still a lack of evidence on injection efficacy, appropriateness of imaging methods, and optimal medication.

KEY POINTS: Question Image-guided injections to treat facet joint pain (FJP) are performed throughout the spine; however, the highest level of evidence exists for the lumbar spine. Findings Regardless of the imaging method used, image-guided injections for facet joint pain treatment are safe, with only minor adverse events in rare cases. Clinical relevance All imaging methods are used for injection guidance to treat FJP, each with advantages and disadvantages. These statements on image-guided injections for FJP provide a concise and up to date overview on the topic, serving as a list of clinical indications.

PMID:40338342 | DOI:10.1007/s00330-025-11651-9

Eur Radiol. 2025 May 8. doi: 10.1007/s00330-025-11650-w. Online ahead of print.

ABSTRACT

OBJECTIVES: Pulmonary artery adventitial hematoma (PAAH) is a potential complication of aortic dissection (AD) that has been shown to have a deleterious effect on prognosis. However, the specific relationship between PAAH secondary to the rupture of type A AD with early mortality has not been fully characterised. We aimed to evaluate the relationship betweeen PAAH and the short-term prognosis of patients with this condition, and to determine how PAAH impacts the prognosis of patients with type A AD compared with other complications of type A AD.

METHODS: We retrospectively studied 344 patients with type A AD who were hospitalised at a single institution (164 men and 180 women with a mean [SD] age of 71.0 [12.6] years). These patients were allocated to two groups, comprising those who died within 1 week of the onset of symptoms (early mortality group; n = 33) and those who survived (survival group; n = 311). PAAH was classified according to the CT findings as stage 1 (only in the mediastinum), stage 2 (extending into the lung field ± the interlobular septa), or stage 3 (extending into the alveoli).

RESULTS: The patient cohort was comprised of 90 (26.2%) patients with PAAH of 344 patients with type A AD. 16 (48.5%) of 33 patients had PAAH in the early mortality group, and 74 (23.8%) of 311 patients had PAAH in the survival group. The early mortality group had higher prevalences of PAAH (p = 0.002), stage 3 PAAH (p < 0.001), pericardial haemorrhage (p = 0.001), mediastinal haemorrhage (p < 0.001), haemothorax (p < 0.001), renal ischaemia (p = 0.002), limb ischaemia (p = 0.001) and myocardial ischaemia (p = 0.004) than the survival group. Furthermore, multivariate analysis showed that age (p = 0.002), stage 3 PAAH (p < 0.001), limb ischaemia (p = 0.010), and myocardial ischaemia (p = 0.001) were risk factors for early mortality.

CONCLUSIONS: PAAH is not a rare complication of type A AD, and stage 3 PAAH is a risk factor for early mortality.

KEY POINTS: Question PAAH due to ruptured type A AD can occur and has been reported to correlate with prognosis. Findings PAAH is not a rare complication of Stanford type A AD, and Stage 3 PAAH is a risk factor with the greatest prognostic value on early mortality. Clinical relevance Knowing that PAAH often occurs with type A AD can help us avoid misdiagnosing stage 3 PAAH as pneumonia or pulmonary oedema.

PMID:40338341 | DOI:10.1007/s00330-025-11650-w