Nevin Manimala

J Forensic Sci. 2025 Mar 16. doi: 10.1111/1556-4029.70010. Online ahead of print.

ABSTRACT

Determining the extent to which sources of aluminum (Al) powders, often used as fuel in improvised explosive devices (IEDs), can be differentiated is important for forensic investigations and gathering intelligence. Previous work developed effective methods of characterizing Al powders using micromorphometric features of the Al particles and a multistage sampling approach. Since then, ~100 additional samples from Al powder sources representing five powder types used in IEDs and 33 product distributors have been added to the dataset. Using this large dataset, a study confirmed that 200 randomly selected fields of view (FOV) are needed to accurately characterize the powder. Three different statistical methods, each using a different method of summarizing the large volumes of data, are used: a modified Wasserstein distance score nearest neighbor classifier for the FOV means, an ASTM-style match interval for means of the FOV means, and a linear discriminant analysis for the means of means of means. Two of the methods classify each questioned subsample to an Al powder sample, whereas the ASTM-style method classifies questioned/known-source subsample pairs as matching or non-matching. All three classifiers show that Al powder sources can be discriminated, although samples of the same powder type or made of Al products from the same distributor are often confused. Analysis of Al powder samples from three casework IEDs shows they were likely made using Al powder from Al-containing paint products. These results are integral to closed-set classification of Al powders where the source of a questioned subsample is contained in the database.

PMID:40090868 | DOI:10.1111/1556-4029.70010

Ann Ital Chir. 2025;96(3):339-344. doi: 10.62713/aic.3339.

ABSTRACT

AIM: To study the effect of timing of percutaneous coronary intervention (PCI) to prognosis of Non-ST segment elevation myocardial infarction (NSTEMI) patients.

METHODS: 295 Patients were derived from our hospital who were diagnosed as NSTEMI and accepted PCI therapy in 24 hours from admission during March 2017 to May 2020. According to results of coronary angiography, patients with NSTEMI were divided into culprit artery occlusion (CO, n = 117) and non-culprit artery occlusion (N-CO, n = 178) two groups and then according to timing of PCI into three categories: <6 h, 6-12 h and 12-24 h from admission. We defined major adverse cardiovascular events (MACE) in 1 year follow.

RESULTS: In this study, with earlier time to PCI, the incidence of MACE was lower in NSTEMI patients with CO. The incidence of MACE was higher in the CO group than in the N-CO group (25.8% vs. 36.8%, p = 0.046). The incidence of MACE was 11.8% in T1 (<6 h) group (n = 50), less than 29.4% in T2 (6-12 h) group (n = 30) and 43.4% in T3 (12-24 h) group (n = 215), with a statistically significant difference (p = 0.044). However, this phenomenon does not occur in N-CO group. As the duration of PCI increased, patient survival decreased progressively over the course of follow-up in NSTEMI with CO (p = 0.048).

CONCLUSIONS: Our study found that early PCI improves the prognosis of NSTEMI patients with culprit artery occlusion.

PMID:40090853 | DOI:10.62713/aic.3339

Ann Ital Chir. 2025;96(3):391-399. doi: 10.62713/aic.3881.

ABSTRACT

AIM: This study aims to explore the factors impacting implant plaque re-formation after implant polishing surgery for peri-implantitis and to establish a predictive model using crucial factors, thereby providing an evidence-based reference for managing this condition.

METHODS: This retrospective study analyzed clinical data from 203 patients who underwent implant polishing and shaping procedures in Suzhou Stomatological Hospital between November 2018 and October 2023. Study subjects were divided into a training set (n = 142) and a validation set (n = 61) in a 7:3 ratio. Univariate and multivariate logistic regression analyses were used to assess the risk factors associated with biofilm formation after implant polishing and shaping surgery. Incorporating significantly linked factors, a risk prediction model was developed. Furthermore, the predictive model was evaluated in the training and validation sets using the Hosmer-Lemeshow (H-L) goodness-of-fit test, Receiver Operating Characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) to determine its discriminatory capability, goodness-of-fit, and predictive utility.

RESULTS: Multivariate logistic regression analysis revealed that calculus [Odds Ratio (OR) = 3.071, 95% Confidence Interval (CI): 1.104-8.541, p = 0.032], difficult-to-clean implant location (OR = 5.807, 95% CI: 1.895-17.798, p = 0.002), external connection implant abutment (OR = 4.378, 95% CI: 1.440-13.308, p = 0.009), and implant diameter (OR = 4.511, 95% CI: 2.141-9.504, p < 0.001) were significant factors affecting biofilm formation after implant polishing and shaping surgery. A regression equation (predictive model) was constructed, incorporating the four crucial risk factors and regression coefficients. ROC curve analysis demonstrated that the area under curve (AUC) of the predictive model was 0.9143 (95% CI: 0.8221-0.9782) in the training set and 0.8095 (95% CI: 0.7342-0.9051) in the validation set. Furthermore, the Hosmer-Lemeshow test indicated a good fit of the established model, with no statistically significant difference between predicted and observed values in both the training set (p = 0.399) and the validation set (p = 0.317). Additionally, DCA demonstrated that the predictive model provides a significant net benefit.

CONCLUSIONS: The predictive model developed using the key risk factors contributing to plaque formation after implant polishing exhibits strong predictive capability, which provides an evidence-based reference in preventing and managing postoperative plaque formation.

PMID:40090844 | DOI:10.62713/aic.3881

Ann Ital Chir. 2025;96(3):345-351. doi: 10.62713/aic.3916.

ABSTRACT

AIM: To investigate predictive value of the systemic immune-inflammation index (SII) combined with the distal ureteral diameter ratio (UDR) for early breakthrough urinary tract infection (BT-UTI) in children with primary vesicoureteral reflux (VUR).

METHODS: A retrospective analysis was conducted on 150 VUR patients admitted to ShangHai Children’s Hospital from January 2021 to December 2023. Patients were divided into the early BT-UTI group (n = 52) and the non-earlyBT-UTI group (n = 98) based on whether early BT-UTI occurred. Univariate and binary logistics regression analyses were performed to identify factors influencing early BT-UTI in VUR children. Pearson correlation analysis was used to assess the relationship between variables, and receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of SII combined with UDR for early BT-UTI in VUR children.

RESULTS: Comparisons of age, gender, body mass index (BMI), neutrophils (NEU), lymphocytes (LYM), red blood cells (RBC), white blood cells (WBC), comorbidities, length of hospital stay, and caregiver education level showed no statistically significant differences (p > 0.05). Differences in reflux grade, UDR, SII, and platelets (PLT) between the groups were statistically significant (p < 0.05). According to Pearson linear correlation analysis, SII was negatively correlated with LYM, and positively correlated with PLT and NEU (r = 0.366 and 0.839, respectively; p < 0.05). UDR was unrelated to NEU and LYM, and positively correlated with PLT (r = 0.280, p < 0.05), and SII was positively correlated with UDR (r = 0.162, p < 0.05). Binary logistic regression analysis indicated that UDR and SII were factors influencing early BT-UTI in VUR children (OR = 1.171 and 5.306, respectively; 95% confidence interval (CI) = 1.099-1.249 and 2.841-9.912, respectively; p < 0.05). The combined variables had an area under the curve (AUC) of 0.832 with a standard error of 0.032 (95% CI: 0.768-0.895), Youden index = 0.53, sensitivity of 90.4%, and specificity of 62.2%. The combined index had an AUC closest to 1, indicating the highest predictive value.

CONCLUSIONS: UDR combined with SII boasts a high predictive value for early BT-UTI in VUR children.

PMID:40090838 | DOI:10.62713/aic.3916

Encephale. 2025 Mar 15:S0013-7006(25)00033-8. doi: 10.1016/j.encep.2024.12.007. Online ahead of print.

ABSTRACT

BACKGROUND: Stigma by association (also known as secondary, family, or courtesy stigma) adds to public stigma and self-stigma. First described by Erwin Goffman in 1963, it affects those close to stigmatized individuals, particularly people with mental health conditions. King et al.’s scale from 2007 models public stigma based on three components: Discriminatory Reactions, Disclosure Concerns, and Positive Aspects.

METHOD: King’s scale was adapted for use by family members and administered through UNAFAM’s (National Union of Families and Friends of People with Mental Health Conditions) online survey. The sample included 3650 participants (2962 women). Confirmatory and exploratory factor analyses were conducted to examine the scale’s structure. We explored the effects of sex and kinship on factor scores using ANOVA/ANCOVA models.

RESULTS: While confirmatory factor analyses showed significant deviation from the original structure, exploratory analyses largely recovered the three original dimensions. The “Discrimination” dimension revealed experienced and perceived prejudice along with resulting reactions. The “Disclosure” dimension demonstrated persistent difficulties in discussing a family member’s mental health condition due to fears of personal and professional consequences. The “Positive Aspects” dimension showed that respondents became more understanding and tolerant toward their family member with a mental health condition, although only 40% reported becoming more resilient through this experience.

CONCLUSIONS: The adapted King’s scale can now be used to investigate determinants and consequences of stigma by association in other populations, including neurodevelopmental disorders (such as autism spectrum disorder and attention-deficit/hyperactivity disorder), schizophrenia, mood disorders, substance use disorders, and dementias.

PMID:40090827 | DOI:10.1016/j.encep.2024.12.007

J Prosthet Dent. 2025 Mar 15:S0022-3913(25)00111-8. doi: 10.1016/j.prosdent.2025.02.012. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Data are lacking on interdental papillae color, including the effect of sociodemographic or behavioral factors, and which ceramic gingival specimens best match it.

PURPOSE: The purpose of this clinical study was to determine the color coordinates of healthy gingival papillae and compare them according to sex, age, dental hygiene, and smoking habits, to compare the color coordinates of the papillae to other gingival zones, and to present a valid set of pink ceramic specimens for use in subjective color selection with the gingival papillae.

MATERIAL AND METHODS: Color coordinates of the attached gingiva and interdental papillae adjacent to the maxillary incisor were recorded by using spectrophotometry (Spectroshade; MHT Optic Research) in 62 White participants (124 papillae). To determine which color specimens best represented the interdental papillae, according to the acceptability thresholds (AT), 2 published databases were used: 15 validated ceramic gingival specimens and 133 ceramic gingival specimens. MANOVA was used for comparisons of color coordinates, and the coverage error was calculated to evaluate the guide.

RESULTS: The color-coordinate ranges of the interdental papillae were: L*: 42.2 to 57.5; a*: 16.8 to 30.6; and b*: 11.2 to 18.1. Statistically significant differences were found between all gingival zones for all color coordinates (P<.05). The interdental papillae were less yellow than the middle zone of attached gingiva and the free gingival margin, and redder than the mucogingival line. Using the Euclidean formula, the coverage error of the 15-specimen gingival guide was 2.71.

CONCLUSIONS: The gingival papillae of women were significantly lighter than of men, and the b* coordinate was higher in the papillae of smokers than non-smokers. Age or dental hygiene did not significantly affect interdental papillae color coordinates. Color differences exceeding the AT between the interdental papillae and each of the 3 attached gingival zones were found in a large part of the population. The 15 specimens were useful for subjective shade selection with the interdental papillae.

PMID:40090802 | DOI:10.1016/j.prosdent.2025.02.012

J Cardiothorac Vasc Anesth. 2025 Feb 22:S1053-0770(25)00170-3. doi: 10.1053/j.jvca.2025.02.030. Online ahead of print.

ABSTRACT

OBJECTIVES: Outcomes of stopping sodium-glucose cotransporter 2 inhibitors (SGLT2i) 5 days before open heart surgery (euglycemic diabetic ketoacidosis [eDKA] rate, mortality, infection, hospital, and cardiovascular intensive care unit [CVICU] length of stay [LOS]).

DESIGN: Retrospective study.

SETTING: Academic university hospital.

PARTICIPANTS: Adult open heart surgery patients.

EXPOSURES: Patients on SGLT2i who stopped medications 5 days before open heart surgery versus non-SGLT2i-using patients.

MEASUREMENTS AND MAIN RESULTS: We evaluated patients who were told to stop SGLT2i 5 days before receiving open heart surgery for eDKA development within 24 hours of hospital admission (12/14/2022 to 10/25/2023). Non-eDKA outcomes were compared between SGLT2i users and non-users using Wilcoxon rank sum and Chi-square testing as appropriate. Of 540 open heart surgery patients, 48 (8.9%) were prescribed SGLT2i’s before surgery; of these, 0 (0%) developed eDKA within 24 hours of hospital admission. Hospital LOS was statistically longer for patients with SGLT2i use (median [interquartile range]: 4 [4-5] v 4 [3-6] days, p = 0.003; mean [standard deviation]: 4 [3] v 5 [2], p = 0.03). We found no significant difference between patients with and without SGLT2i use in CVICU LOS (median [interquartile range]: 1.67 [0.95-2.09] v 1.17 [0.96-1.88] days, p = 0.14), in-hospital mortality (2.1% [1] v 0.6% [3], p = 0.3), or sternal infections (0 [0.0%] v 2 [0.4%], p > 0.9).

CONCLUSION: Postoperative eDKA was absent in SGLT2i patients told to stop medications 5 days before open heart surgery. LOS and infection and mortality rates appeared similar between the two cohorts. Stopping SGLT2i medications 5 days before open heart surgery appears safe.

PMID:40090790 | DOI:10.1053/j.jvca.2025.02.030

J Hepatol. 2025 Mar 15:S0168-8278(25)00140-0. doi: 10.1016/j.jhep.2025.02.031. Online ahead of print.

NO ABSTRACT

PMID:40090770 | DOI:10.1016/j.jhep.2025.02.031

Clin Psychol Psychother. 2025 Mar-Apr;32(2):e70052. doi: 10.1002/cpp.70052.

ABSTRACT

Recent research highlights the role of childhood trauma in the development of eating disorders (EDs), suggesting that adverse experiences can disrupt emotional and cognitive development, leading to early maladaptive schemas (EMSs) and interpersonal problems. EMSs are psychological structures encompassing cognition, emotions, images, and bodily sensations. These EMSs are hypothesized to mediate the relationship between childhood trauma and ED pathology. This study aimed to extend the investigation of how childhood trauma leads to interpersonal difficulties, mediated by EMSs. This cross-sectional study recruited 321 patients with EDs: n = 77 Anorexia Nervosa-Restricting (AN-R), n = 26 AN-Binge/Purge (AN-BP), n = 94 Bulimia Nervosa (BN), and n = 124 Binge Eating Disorder (BED). They completed the Eating Disorder Examination (EDE), Inventory of Interpersonal Problems (IIP-32), Young Schema Questionnaire (YSQ-S3), and Childhood Trauma Questionnaire (CTQ-SF). Path analyses were conducted to examine associations between childhood trauma, EMSs, and interpersonal problems. Results indicated that patients with BED reported the highest levels of sexual abuse. Those with BN exhibited higher scores across all EMS domains. Positive correlations were found between childhood adversities, EMS domains, and interpersonal problems, except for the relationship between sexual abuse and schema domains. Mediation analyses revealed significant indirect effects of emotional abuse on interpersonal problems through disconnection and rejection domain. This study consolidates the notion that EMSs mediate the relationship between childhood trauma and interpersonal problems in ED patients, highlighting the importance of addressing early trauma and EMSs to improve therapeutic outcomes. Future research should focus on longitudinal analyses to better understand the temporal development of these relationships.

PMID:40090762 | DOI:10.1002/cpp.70052

Clin Breast Cancer. 2025 Apr;25(3):e288-e300.e1. doi: 10.1016/j.clbc.2024.11.012. Epub 2024 Nov 26.

ABSTRACT

INTRODUCTION: Mobile mammography (MM) can reach women who otherwise would not or could not utilize facility-based mammography (FBM) due to various socioeconomic factors and access barriers. Most literature evaluates individual MM programs and has not explored the potential impact of MM in a large, nationally representative, claims dataset.

OBJECTIVE: To examine factors associated with MM utilization among female Medicare beneficiaries and whether MM is associated with increased mammography utilization compared use of FBM only.

MATERIALS AND METHODS: This retrospective analysis of Centers for Medicare & Medicaid Services (CMS) 5% Research Identifiable File data from years 2004 to 2021 used logistic regression to assess likelihood of receiving MM compared with FBM. Linear regression assessed factors associated with decreased mammography utilization. Heat maps demonstrated the geographic density of MM use compared with FBM-only use.

RESULTS: Among 2,630,670 screening eligible women, 1,302,069 (49.5%) had a mammogram, of which 4,973 (0.4%) used MM. MM use was associated with age from 50 to 64 years, American Indians or Alaska Natives, fewer comorbidities, rural geography, residence in the West, and lower community income. On multivariate regression, American Indian or Alaska Native race was most predictive of MM (odds ratio 5.53; 95CI 4.73-6.47). Heat maps showed that areas of MM usage overlap areas of FBM-only usage.

CONCLUSION: Our results suggest MM is utilized by traditionally underserved beneficiaries (ie, non-White in less economically resourced areas), but it is not a replacement for FBM. MM is an augmentative service, potentially offering screening mammography to women who may not have otherwise been screened due to access issues stemming from socioeconomic, geographic, or cultural barriers.

PMID:40090755 | DOI:10.1016/j.clbc.2024.11.012