Nevin Manimala

Chin Med J (Engl). 2025 Dec 12. doi: 10.1097/CM9.0000000000003855. Online ahead of print.

ABSTRACT

BACKGROUND: Chimeric antigen receptor T (CAR-T) cells have been demonstrated to be an effective treatment for relapsed B-cell acute lymphoblastic leukemia (B-ALL) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). T cells for CAR-T therapy can be derived from the peripheral blood (recipient) of the patient or donor. Despite having identical genomes, the different maturation environments of these T cells can lead to functional differences. This study aimed to compare the clinical outcomes of CAR-T cells derived from these two sources.

METHODS: This multicenter, retrospective cohort study collected clinical data from 36 patients who experienced B-ALL relapse after allo-HSCT and received CD19 CAR-T cell therapy between January 2016 and October 2023 across seven centers. The primary endpoint was complete remission (CR)/CR with an incomplete hematologic recovery (CRi) rate at 28 days post-CAR-T cell infusion. Secondary endpoints included the 2-year overall survival (OS) rate, 2-year event-free survival (EFS) rate, incidence of graft-versus-host disease (GVHD), cytokine release syndrome (CRS), and CAR-T cell-related encephalopathy syndrome (CRES).

RESULTS: A retrospective analysis was performed on 36 patients: 12 in the recipient group and 24 in the donor group. The recipient and donor groups showed no statistically significant differences in CR/CRi rates (83.3% vs. 100.0%, P = 0.105), 2-year EFS rates (50.8% vs. 51.6%, P = 0.617), or 2-year OS rates (49.5% vs. 63.6%, P = 0.215). In addition, the incidences of GVHD, CRS, and CRES did not significantly differ between the two groups. Further analysis within the donor group revealed 12 matched sibling donors (MSDs) and 12 haploidentical donors (HIDs). The 2-year EFS rate was statistically significantly greater in the HID group than in the MSD group (75.0% vs. 30.7%, P = 0.043), whereas no significant differences were observed in the CR/CRi rates, 2-year OS, or the incidence of GVHD, CRS, and CRES between these subgroups.

CONCLUSIONS: Both recipient-derived and donor-derived CD19 CAR-T cell therapies are effective treatment options for B-ALL relapsed post-allo-HSCT patients. HID-derived CAR-T cells offer a longer EFS and may be considered the optimal choice.

PMID:41384350 | DOI:10.1097/CM9.0000000000003855

Eur J Paediatr Dent. 2025 Dec 1;26(4 Suppl):41-48. doi: 10.23804/ejpd.2025.S05.

ABSTRACT

AIM: The purpose of this study was to survey Italian dental practitioners on behaviour guidance techniques (BGTs). Use of tell-show-do (TSD), sedation with nitrous oxide and oxygen according to the Langa technique, audio-visual distraction (AVD) and referral to general anaesthesia (GA) were enquired, particularly focusing on nitrous oxide usage in paediatric dental patients.

METHODS: The research was conducted between September 2022 and December 2023. Data from 153 surveys were eligible to be processed using the STATA/BE software program, version18.0. The sample was stratified based on time in practice (≤10 and >10 years in practice), gender, practicing area (northern, central or southern Italy). Descriptive and inferential analysis were conducted comparing groups using X2 test or Fisher’s exact test as appropriate. The level of statistical significance was set at P value <0.05.

RESULTS: One hundred fifty-three complete surveys were analysed. Of the respondents, 79.8% (121) were female and 20.92% (32) were male. Regarding years in practice, 53.59% (82) were in practice for less than or equal to 10 years and 46.41% (71) were in practice for more than 10 years. As for location of the practice, 45.10% (69) worked in northern Italy, 23.53% (36) practiced in central Italy and 31.37% (48) were from southern Italy, Sicily and Sardegna included. Significant difference was found between genders, with 55.37% (67) female practitioners who assessed to have more than 50% of their patients in paediatric age, compared to 28.12% (9) male participants. Statistical significance was also found between years in practice and referral to general anaesthesia: 29.27% (24) respondents in practice for equal or less than 10 years stated to refer no patients to general anaesthesia compared to 9.86% (7) providers in practice for more than 10 years. In the sample stratified by geographical area, statistical significance was noticed among practitioners who do not refer any paediatric patient to GA: 37.50% (18) Southern Italian practitioners versus 27.78% (10) central Italian practitioners and 4.35% (3) northern Italian practitioners. Northern Italy was found to be the territory with the highest referral to GA: the answer category <10% paediatric patients indicated for GA was selected by 71.01% (49) northern practitioners versus 66.67% (24) central respondents and 45.83% (22) southern participants in the survey.

CONCLUSIONS: Behaviour guidance technique selection and utilisation among Italian practicing paediatric dentists is influenced by multiple factors, including gender, time in practice and geographic location of practice. The results showed Tell-Show-Do as the preferred behaviour guidance technique among Italian practitioners. GA referral was assessed to be significantly higher among northern practitioners. Responders in practice for more than 10 years referred to GA a statistically higher percentage of paediatric patients, who were more prevalent in female providers’ practices. Sedation with nitrous oxide and oxygen according to the Langa technique was noticed to be the least prevalent among the enquired BGTs; there is a need to implement the use and knowledge of nitrous oxide/oxygen analgesia among Italian practitioners.

PMID:41384332 | DOI:10.23804/ejpd.2025.S05

Am J Biol Anthropol. 2025 Dec;188(4):e70182. doi: 10.1002/ajpa.70182.

ABSTRACT

OBJECTIVES: This study examines the financial barriers faced by graduate students in bioarchaeology and forensic anthropology, addressing a critical gap by incorporating recent perspectives. Prior research has highlighted financial inequities within the field, yet few studies focus on burdens impacting students’ well-being, academic success, and career paths. This research aims to amplify student voices and identify actionable, student-centered solutions to alleviate financial strain and support retention.

MATERIALS AND METHODS: A 29-question anonymous survey was distributed to current and recent biological anthropology graduate students (n = 103) across the United States. Questions covered various financial factors, including institutional costs, students’ lived experiences with strain, and career advancement expenses. Responses were analyzed using descriptive statistics for quantitative data and thematic coding for qualitative responses.

RESULTS: The survey revealed that nearly all participants depend on some form of financial aid (assistantships, grants, fellowships, or scholarships), with many reporting insufficient stipends, unmet living costs, and a need for external employment. Over half-expressed concerns about financial impacts on career opportunities, with many using loans or credit to cover essential costs like conferences, travel, and program fees. Financial strain significantly impacted well-being, with 58% considering leaving the field due to financial pressures.

DISCUSSION: The findings underscore the urgent need for institutional reforms to ensure livable wages, transparent funding, and professional development support. Addressing these barriers is essential for retaining diverse talent and fostering a sustainable future in bioarchaeology and forensic anthropology. This study advocates practical solutions to reduce financial inequity and promote a more inclusive academic environment.

PMID:41384300 | DOI:10.1002/ajpa.70182

Nanomedicine (Lond). 2025 Dec 12:1-17. doi: 10.1080/17435889.2025.2582466. Online ahead of print.

ABSTRACT

INTRODUCTION: This meta-analysis examined the antibacterial efficacy of Cerium Oxide Nanoparticles (CeO₂ NPs) through statistical analysis of published data.

METHOD: Following a comprehensive literature search and systematic screening, data were extracted and analyzed using STATA software to calculate pooled standard mean differences and effect sizes.

RESULTS: Analysis of data from 58 articles (218 experiments) demonstrated significant antibacterial activity. Analysis of 189 agar diffusion tests showed substantial effect (EF = 15.04; 95% CI = 14.793-15.277; p < 0.0001). Subgroup analysis revealed greater efficacy for particles larger than 50 nm and rod-shaped nanoparticles. CeO₂ NPs were effective against both Gram-positive (EF = 18.194) and Gram-negative (EF = 14.049) bacteria, including Escherichia coli and Staphylococcus aureus. Compared to conventional antibiotics, CeO₂ NPs were generally less effective (SMD = -2.846, p < 0.0001) but performed comparably to Amoxicillin, Streptomycin, Linezolid, and Clindamycin. MIC and CFU tests confirmed significant growth-inhibitory effects across multiple bacterial species.

CONCLUSION: CeO₂ NPs demonstrate significant broad-spectrum antibacterial activity, suggesting potential against antibiotic-resistant bacteria. Future research should explore synergistic effects with standard antibiotics.

PMID:41384286 | DOI:10.1080/17435889.2025.2582466

Res Rep Urol. 2025 Dec 6;17:481-493. doi: 10.2147/RRU.S568396. eCollection 2025.

ABSTRACT

PURPOSE: To evaluate survival outcomes and identify prognostic factors among bladder cancer patients.

PATIENTS AND METHODS: A total of 488 bladder cancer patients admitted between 2007 and 2017 were followed until December 31, 2020, using both active and passive follow-up. The Kaplan-Meier method was used to estimate observed survival (OS), with group comparisons performed using the Log rank test. Variables included sex, age group, number of hospital admissions, TNM stage, and geographic origin.

RESULTS: Of 488 patients, 485 (99.38%) were successfully followed. The majority were male (80.21%) with a mean age of 66.5 years. The average number of hospital admissions was 1.81. Overall 1-, 3-, 5-, and 10-year OS rates were 79.95%, 63.50%, 56.32%, and 45.54% for males, and 69.79%, 58.33%, 56.01%, and 56.01% for females, respectively (P = 0.697). Age significantly affected prognosis (P < 0.01), with 5-year OS declining from 66.67% (age ≤34) to 29.53% (≥80). Patients with ≥3 admissions had worse survival (44.87%) than those with one (61.93%) or two admissions (58.97%) (P < 0.01). TNM stage was strongly with survival: 5-year OS rates were 86.43% (Stage I), 55.48% (Stage II), 38.25% (Stage III), and 13.85% (Stage IV) (P < 0.01). Regional differences were not statistically significant (P > 0.05).

CONCLUSION: Advanced age and late-stage diagnosis were associated with poorer survival, while early-stage detection correlated with better outcomes. These findings underscore the importance of early screening, timely treatment, and comprehensive care strategies to improve bladder cancer survival, especially in resource-limited settings. Limitations include single-center design and absence of multivariate adjustment.

PMID:41384284 | PMC:PMC12691630 | DOI:10.2147/RRU.S568396

J Innov Card Rhythm Manag. 2025 Nov 15;16(11):6509-6519. doi: 10.19102/icrm.2025.16114. eCollection 2025 Nov.

ABSTRACT

Patients with heart failure (HF) may experience depression or anxiety due to various reasons associated with their or caregivers’ characteristics. The purpose of this study was to explore patients’ and caregivers’ characteristics associated with hospitalized HF patients’ anxiety and depression. A total of 300 hospitalized HF patients with their caregivers were enrolled in the study. Data were collected using the Hospital Anxiety and Depression Scale, which also included patients’ and caregivers’ characteristics. The statistical significance level was set at P < .05. A statistically significant association was observed between patients’ anxiety and age (P = .044), level of education (P = .015), type of diagnosis (P = .001), New York Heart Association (NYHA) class (P = .001), prior hospitalization within the current year (P = .013), current smoking (P = .001), frequency of physical exercise (P = .001), and their self-reported ability for symptom management after hospital discharge (P = .001). A statistically significant association was observed between patients’ depression and age (P = .018), type of diagnosis (P = .001), NYHA class (P = .001), prior hospitalization within the current year (P = .004), current smoking (P = .001), occasional alcohol consumption (P = .026), frequency of physical exercise (P = .001), and their self-reported ability for symptom management after hospital discharge (P = .001). In terms of caregivers’ characteristics, a statistically significant association was observed between patients’ anxiety/depression and the relationship with caregivers (P = .006 and P = .001, respectively), whether caregivers declared added responsibilities among family members (P = .041 and P = .002, respectively), and whether they felt uncertain about patients’ clinical outcome (P = .001 and P = .001, respectively). Finally, a statistically significant association was observed between patients’ depression and the occupation of their caregivers (P = .038). Patients’ characteristics associated with anxiety/depression were demographic and clinical, while caregivers’ characteristics associated with patients’ anxiety/depression were their self-reports and demographic characteristics. Knowledge of factors that influence anxiety and depression can enable health care professionals to offer appropriate interventions tailored to their needs.

PMID:41384283 | PMC:PMC12694892 | DOI:10.19102/icrm.2025.16114

Front Health Serv. 2025 Nov 26;5:1466958. doi: 10.3389/frhs.2025.1466958. eCollection 2025.

ABSTRACT

INTRODUCTION: The Affordable Care Act (ACA) represents the most comprehensive U.S. health reform since Medicare and Medicaid. However, evidence on its impact on population health in the general U.S. population, particularly mental health, remains limited.

METHODS: We analyzed a nationally representative sample of non-elderly adults aged 18-64 from the Medical Expenditure Panel Survey (2007-2019). Outcomes included two health-related quality of life (HRQOL) measures derived from the SF-12 v2: physical component summary (PCS) and mental component summary (MCS) scores. Using conditional-mean and quantile-regression difference-in-differences models, we examined the effect of the ACA by comparing pre-post changes in PCS and MCS scores among non-elderly adults relative to counterfactuals from TRICARE beneficiaries not subject to ACA provisions.

RESULTS: Our conditional-mean DID estimates indicate that the ACA was associated with a 2.7% increase in PCS scores among non-elderly adults during 2011-2013. Although statistically insignificant, MCS scores exhibited increases of growing magnitude following the implementation of the major ACA major provisions in 2014. Notably, simultaneous-quantile DID estimates suggest that the increases in PCS and MCS scores attributable to the ACA were concentrated among individuals with relatively lower health levels, particularly those around the 30th to 60th percentiles of the score distributions.

DISCUSSION: Findings indicate that the ACA led to measurable gains in physical and mental health, particularly among relatively lower-middle levels of physical and mental health. Policymakers assessing the value of the ACA, or more generally debating the value of expanding access to health insurance in the population, should consider these positive gains in population health.

PMID:41384265 | PMC:PMC12689885 | DOI:10.3389/frhs.2025.1466958

Dent Res J (Isfahan). 2025 Nov 25;22:46. doi: 10.4103/drj.drj_428_24. eCollection 2025.

ABSTRACT

BACKGROUND: This study aimed to synthesize mesoporous zinc oxide nanoparticles (ZnO NPs) and evaluate their effect as dentin pretreatments on the microshear bond strength (μSBS) of a universal adhesive.

MATERIALS AND METHODS: This in vitro experimental study used 100 extracted human molars sectioned to expose mid-coronal dentin. Samples were divided into five groups (n = 20) based on pretreatment: no treatment, chlorhexidine (CHX), calcined mesoporous ZnO NPs, noncalcined mesoporous ZnO NPs, and ZnO NPs. Each group was subdivided into two subgroups (n = 10) based on the universal adhesive application mode: etch-and-rinse (E and R) or self-etch (SE). Pretreatments were applied for 1 min. Composite resin was bonded using a universal adhesive. After 24 h of storage in distilled water at 37°C, μSBS testing was performed. Statistical analysis included the Shapiro-Wilk test for normality, two-way analysis of variance with Tukey’s post hoc test, and t-tests, with significance set at P < 0.05.

RESULTS: The noncalcined mesoporous ZnO NP group showed the highest μSBS, followed by the ZnO NP group, with significant differences compared to other groups (P < 0.05). Lower μSBS values were observed in the calcined mesoporous ZnO NP, CHX, and untreated groups. The adhesive application mode had a significant effect only in the untreated and calcined mesoporous ZnO NP groups (P < 0.05), with SE yielding higher μSBS than E and R.

CONCLUSION: Noncalcined mesoporous ZnO NPs enhanced dentin bond strength more effectively than other pretreatments, including CHX, indicating their potential as a promising alternative in adhesive dentistry.

PMID:41384264 | PMC:PMC12694918 | DOI:10.4103/drj.drj_428_24

Dent Res J (Isfahan). 2025 Nov 25;22:43. doi: 10.4103/drj.drj_319_24. eCollection 2025.

ABSTRACT

BACKGROUND: Bone remodeling is essential for orthodontic tooth movement. Techniques such as micro-osteoperforation (MOP) and vibration have been introduced to accelerate treatment by stimulating biological responses.

MATERIALS AND METHODS: Randomized clinical trial study adult orthodontic patients who required bilateral extraction of maxillary first premolars were randomly assigned to two groups (n = 10) of intervention and control. Both groups received MOP at the onset of canine retraction. The intervention group also used a VPro5 vibrator for 28 days after the onset of canine retraction in addition to MOP. GCF samples were collected before the onset of orthodontic treatment (T0), right before canine retraction (T1), and after 24 h (T2), 7 days (T3), and 28 days (T4) by a paper point, and the GCF levels interleukin (IL)-1 B, receptor activator of nuclear factor kappa-B ligand (RANKL), C-C motif chemokine ligand (CCL) 2, and tumor necrosis factor-alpha (TNF)-α were measured. Data were analyzed using SPSS v25. Repeatedmeasures Analysis of Variance was employed to compare quantitative outcomes between groups and over time, with statistical significance set at P < 0.05.

RESULTS: The GCF level of the four inflammatory factors was not significantly different between the two groups at any time point (P > 0.05). The trend of change in GCF level of the four inflammatory factors was also the same in the two groups over time, such that the lowest level of all four markers was recorded at T0. The highest level of TNF-α was recorded at T2, and the highest level of RANKL, IL1-B, and CCL2 was recorded at T2 and T3.

CONCLUSION: It does not seem that combined MOP with vibration can increase the level of inflammatory factors in GCF.

PMID:41384263 | PMC:PMC12694923 | DOI:10.4103/drj.drj_319_24

Dent Res J (Isfahan). 2025 Nov 25;22:45. doi: 10.4103/drj.drj_225_25. eCollection 2025.

ABSTRACT

BACKGROUND: This study assessed the linear accuracy of three-dimensionally (3D)-printed mandibular models from cone-beam computed tomography (CBCT) scans with two voxel sizes.

MATERIALS AND METHODS: In this in vitro study, five dry human mandibles underwent CBCT with 0.2- and 0.3-mm voxel sizes. The images were converted to STL format, and the distances between (I) mental foramen (MF) and alveolar ridge crest, (II) MF and inferior border of the mandible (IBM), and (III) alveolar crest and IBM at the midline, as well as the (IV) left central incisor socket depth, (V) left second premolar buccolingual socket width, and (VI) right third molar buccolingual socket width were measured on the CBCT scans, 3D-printed models, and dry mandibles. Two observers recorded the measurements twice, 1 week apart. We analyzed the data using the intraclass correlation coefficient and Pearson’s correlation test. Statistical significance was set at P < 0.05.

RESULTS: Since the interobserver agreement was high, the mean data was used for the comparisons. The linear accuracy was high for MF-IBM, MF-alveolar crest, and alveolar crest-IBM distances, and second premolar and third molar buccolingual socket width. CBCT scans demonstrated reliable accuracy for left central incisor socket depth measurement, but a lack of significant correlation was found between the 3D-printing and gold-standard measurements of this variable.

CONCLUSION: The linear accuracy of CBCT scans taken with 0.3- and 0.2-mm voxel sizes was comparable, and they may be used for the fabrication of linearly accurate 3D-printed models of mandible. 3D-printed models demonstrated high precision in all measured parameters except socket depth.

PMID:41384259 | PMC:PMC12694914 | DOI:10.4103/drj.drj_225_25