Nevin Manimala

Front Oncol. 2025 Jan 30;14:1491159. doi: 10.3389/fonc.2024.1491159. eCollection 2024.

ABSTRACT

BACKGROUND: Prostate cancer is the second most diagnosed cancer in men globally, with high prevalence in North America, Europe, and Australia. Occupational exposures, including metalworking fluids (MWFs), have emerged as a potential risk factor for prostate cancer, yet comprehensive studies on this association are limited.

OBJECTIVE: This study aims to systematically review and conduct a meta-analysis to examine the incidence and mortality of prostate cancer linked to MWF exposure.

METHODS: A systematic review and meta-analysis were conducted following the PRISMA guidelines. A comprehensive search strategy was developed to identify relevant studies from PubMed, Scopus, Embase, and Web of Science. Inclusion criteria encompassed studies reporting on the association between MWF exposure and prostate cancer incidence or mortality. Data extraction and risk of bias assessment were performed independently by two reviewers, with discrepancies resolved by a third reviewer. Statistical analyses were conducted using STATA version 17.

RESULTS: The search identified 1376 unique references, with 5 studies meeting the inclusion criteria for the meta-analysis. These studies, conducted in the USA, primarily involved auto workers and reported Standardized Mortality Ratio (SMR), Relative Risk (RR) and 95% Confidence Interval (95%CI) measures. Meta-analysis revealed an overall RR of 1.06 (95% CI: 1.01-1.11) for prostate cancer incidence and an overall SMR of 1.20 (95% CI: 1.09-1.31) for prostate cancer mortality, indicating a statistically significant increased risk and mortality among MWF-exposed workers.

CONCLUSIONS: These findings carry significant implications for workplace safety regulations. Given the observed association between MWF exposure and prostate cancer risk, it is imperative to minimize occupational exposure through the implementation of effective engineering controls, personal protective equipment, and substitution of less hazardous fluids. Regular health surveillance and education programs for workers in industries utilizing MWFs are also essential to mitigate risk. Additionally, regulatory agencies should consider revising exposure limits and safety guidelines to account for emerging evidence on the carcinogenic potential of newer MWF formulations.

PMID:39950100 | PMC:PMC11821483 | DOI:10.3389/fonc.2024.1491159

Clin Implant Dent Relat Res. 2025 Feb;27(1):e70010. doi: 10.1111/cid.70010.

ABSTRACT

OBJECTIVE: In this update of a previous systematic review, we compared the effects of surgical and non-surgical treatments for peri-implantitis through the component network meta-analysis (CNMA) with probing depth (PD) reduction as the outcome.

MATERIALS AND METHODS: Literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials, and Embase databases from August 2010 to June 2023. Randomized controlled trials (RCTs), comparing non-surgical or surgical treatments for peri-implantitis with 6-12 months of follow-up and reported changes in PD, were included. Treatment effects were assessed using a CNMA model based on additivity assumption. We calculated the intraclass correlation coefficient (ICC) to adjust the standard errors for multiple implants within the same patient.

RESULTS: Our systematic review identified 44 RCTs, which included 46 treatment regimens consisting of 15 components. These RCTs formed a disconnected network consisting of 11 subnetworks. Surgical treatments with bone grafts and membranes generally attained greater PD reduction than non-surgical treatments, although bone grafts and membranes as components provided moderate benefits. The effect size of antibiotics is greater in non-surgical than surgical treatments, while there is considerable uncertainty regarding the effect size of implantoplasty. Additionally, the effectiveness of components varied between surgical and non-surgical treatments.

CONCLUSION: Current evidence does not yield sufficiently robust estimates for identifying optimal surgical and non-surgical treatment regimens for peri-implantitis, so the findings of our study should be interpreted cautiously. A coordinated strategy is required for designing future trials to fill the gaps in our current knowledge and develop more reliable recommendations.

PMID:39948703 | DOI:10.1111/cid.70010

J Diet Suppl. 2025 Feb 13:1-10. doi: 10.1080/19390211.2025.2465412. Online ahead of print.

ABSTRACT

Tamoxifen, a common treatment for estrogen receptor (ER)‑positive breast cancer, is associated with an increased risk of developing nonalcoholic fatty liver disease (NAFLD). Curcumin, a compound in turmeric, has shown potential in mitigating liver disease progression. This study aims to evaluate the efficacy and safety of curcumin in preventing NAFLD in breast cancer patients initiating tamoxifen therapy.In this 6‑month triple‑blind, randomized placebo‑controlled trial, 44 ER+ breast cancer patients scheduled to receive tamoxifen were assigned to receive either curcumin (500 mg daily) or a placebo. NAFLD grade was assessed via ultrasound at baseline and after 6 months. Laboratory values and demographic data were collected, and adverse effects were monitored. Statistical analyses was performed using SPSS version 16.Data of a total of 44 participants (22 participants in each group, mean age: 47.1 ± 6.0 years) were analyses. There were no significant differences between the placebo and curcumin groups regarding the demographic and baseline laboratory values. At study completion, significantly fewer patients in the curcumin group showed an increased NAFLD grade compared to the placebo group (13.6% vs. 54.5%; p = 0.03). Additionally, the prevalence of NAFLD grade ≥ 2 was lower in the curcumin group (13.6% vs. 40.9%; p = 0.04). No adverse effects related to curcumin were reported. Curcumin supplementation demonstrated a protective effect against tamoxifen‑induced NAFLD in ER+ breast cancer patients, suggesting its potential as a prophylactic adjunct to tamoxifen therapy. Larger multi‑centric trials are warranted to confirm these findings.

PMID:39948699 | DOI:10.1080/19390211.2025.2465412

J Prosthodont. 2025 Feb 13. doi: 10.1111/jopr.14026. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the longevity of terminal abutment teeth retaining maxillary obturator prostheses.

MATERIALS AND METHODS: This was a retrospective study of patients who underwent maxillectomy followed by delivery of definitive obturator prostheses between 1994 and 2020. Details on patient demographics, primary tumor, and radiation therapy were collected. The tooth closest to the defect was identified as the terminal abutment, and information such as tooth type, condition of tooth at the time of maxillectomy, Aramany classification, and cause of abutment loss were noted from the dental charts. Survival time of the terminal abutment tooth was calculated from the date of maxillectomy to the last dental follow-up visit or the date of abutment loss. Univariate analyses were performed to test for the association between survival time and each of the four covariates.

RESULTS: In the 26-year study period, 148 teeth in 130 patients met the inclusion criteria. Ninety-eight (66.2%) terminal abutment teeth survived, and 50 (33.8%) were lost. Squamous cell carcinoma was the leading tumor diagnosis (51%). Aramany Class II was the most predominant arch configuration (51%). The majority of the terminal abutment teeth were maxillary incisors (43%). The chief cause of terminal abutment loss was bone loss and mobility (46%). The 10-year survival probability was 65%. Radiation therapy did not statistically contribute to terminal abutment loss. Terminal abutment teeth with dental treatment showed higher failure than those without any prior treatment or dental disease.

CONCLUSION: Clinicians must be aware of the various factors affecting the survival of terminal abutment teeth which can ultimately affect the success of the maxillary obturator prostheses.

PMID:39948686 | DOI:10.1111/jopr.14026

Lipids Health Dis. 2025 Feb 13;24(1):46. doi: 10.1186/s12944-025-02441-9.

ABSTRACT

BACKGROUND: In cardiovascular diseases (CVD) and insulin resistance (IR), elevated blood lipids and glucose are common. These abnormalities accelerate atherosclerosis and may impair insulin signaling via oxidative stress and inflammation. The triglyceride-glucose (TyG) index is a cost-effective marker for assessing IR and CVD risk, reflecting insulin resistance and early atherosclerosis. However, research on factors affecting the TyG index, especially mixed heavy metal exposure, is limited. Heavy metals might alter the TyG index by inducing oxidative stress and inflammation, affecting lipid and glucose metabolism. This study explores the link between heavy metal exposure and TyG index changes, focusing on inflammation’s mediating role, aiming to offer new strategies for CVD and IR prevention and management.

METHOD: This research explores the association between heavy metal concentrations and TyG indicators, drawing on data from the National Health and Nutrition Examination Survey spanning 2011 to 2016. It employs a range of statistical approaches, such as linear and non-linear analyses, multiple linear regression, weighted quantile sum regression, and Bayesian kernel machine regression. Additionally, a mediation analysis investigates the role of inflammation in modifying the effects of heavy metal exposure.

RESULT: The research analyzed data from a sample of 2,050 individuals, finding notable links between mixed heavy metals and variations in TyG markers. Specifically, the presence of heavy metal mixtures was associated with significant increases in these indicators. Additionally, six inflammatory markers were identified that act as intermediaries in the process leading from heavy metal exposure to alterations in TyG indicators.

CONCLUSION: The study establishes a clear association between heavy metal and adverse changes in TyG markers, influenced in part by inflammation. These insights highlight the urgent need for improved monitoring of environmental health and specific strategies to decrease heavy metal exposure, thus lessening their harmful impact on cardiovascular health. The research enhances understanding of the dynamic interactions between environmental exposures and metabolic health, laying groundwork for public health initiatives aimed at curtailing chronic disease risks linked to heavy metals.

PMID:39948676 | DOI:10.1186/s12944-025-02441-9

BMC Nurs. 2025 Feb 13;24(1):168. doi: 10.1186/s12912-025-02809-3.

ABSTRACT

AIMS: This study aimed to investigate the current state of nursing interns’ spiritual care competency (SCC) and its relationship with their spiritual health.

BACKGROUND: Spiritual care is a vitally important component of holistic nursing. Understanding the spiritual care competency of nursing interns can help nursing managers and educators identify weaknesses in spiritual care practices, develop intervention measures to enhance SCC, and improve the quality of nursing services. However, the relationship between spiritual health and SCC among nursing interns remains unclear.

METHODS: A total of 361 nursing interns were recruited from three general hospitals. An online questionnaire assessed nursing interns’ sociodemographic characteristics, spiritual care competency, and spiritual health. Statistical analyses included Pearson’s correlation analysis, T-test, analysis of variance (ANOVA), and multiple stepwise linear regression analysis.

RESULTS: The average spiritual care competency score among nursing interns was 107.24 ± 21.67 out of a possible 135, indicating a medium-high level of competency. Spiritual care competency was positively correlated with spiritual health (P < 0.01). The multiple stepwise linear regression model (n = 361) had an explained variance (R² = 0.300), showing that spiritual health and the manner of receiving spiritual training were the main factors influencing the interns’ spiritual care competency (P < 0.001).

CONCLUSION: The findings suggest that improving the spiritual health of nursing interns can enhance their spiritual care competency.

PMID:39948658 | DOI:10.1186/s12912-025-02809-3

BMC Chem. 2025 Feb 13;19(1):39. doi: 10.1186/s13065-024-01357-2.

ABSTRACT

Tuberculosis (TB) has become the biggest threat to human society because of the rapid rise in resistance to the causative bacteria Mycobacterium tuberculosis (MTB) against the available anti-tubercular drugs. There is an urgent need to design new multi-targeted anti-tubercular agents to overcome the resistance species of MTB through computational design tools. With this aim in mind, we performed a combination of atom-based three-dimensional quantitative structure-activity relationship (3D-QSAR), six-point pharmacophore (AHHRRR), and molecular docking analysis on a series of fifty-eight anti-tubercular agents. The created QSAR model had a R² value of 0.9521, a Q² value of 0.8589, and a Pearson r-factor of 0.8988, all of which are statistically significant. This means that the model was effective at making predictions. We performed the molecular docking study for the data set of compounds with the two important anti-tubercular target proteins, Enoyl acyl carrier protein reductase (InhA) (PDBID: 2NSD) and Decaprenyl phosphoryl-β-D-Ribose 20-epimerase (DprE1) (PDBID: 4FDO). We used the similarity search principle to do virtual screening on 237 compounds from the PubChem database in order to find strong anti-tubercular agents that act against multiple targets. The screened compound, MK3, showed the highest docking score of -9.2 and -8.3 kJ/mol towards both the target proteins InhA and DprE1, which were picked for a 100 ns molecular-dynamic simulation study using GROMACS. The data showed that the compound MK3 was thermodynamically stable and effectively bound to both target proteins in their active binding pockets without much movement. The analysis of the highest occupied molecular orbital (HOMO), lowest unoccupied molecular orbital (LUMO), and energy gap predicts the molecular reactivity and stability of the identified molecule. Based on the result of the above studies, the proposed compound MK3 can be successfully used for the development of a novel multi-targeted anti-tubercular agent with high binding affinity and favourable ADME-T properties.

PMID:39948649 | DOI:10.1186/s13065-024-01357-2

BMC Med Educ. 2025 Feb 13;25(1):229. doi: 10.1186/s12909-025-06842-3.

ABSTRACT

BACKGROUND: The retention of qualified faculty in medical colleges is hindered by low salaries and inadequate faculty-to-student ratios, despite intrinsic motivators like job satisfaction playing a critical role in faculty motivation. This study aims to understand and address the specific motivating factors and constraints within Saudi Arabia’s medical education sector.

METHODOLOGY: A cross-sectional, validated online survey was conducted from November 2023 to January 2024 among physicians in Saudi Arabia’s governmental and private sectors. Participants ranked teaching motivators and challenges using a Likert scale ranging from 5 (very important) to 1 (not very important). The collected data were analyzed using descriptive statistics and Chi-square test.

RESULTS: Of the 145 respondents, 62.1% were male, with a mean age of 38.2 years (SD = 8.9). Saudi nationals comprised 54.5% of the sample. Sharing knowledge (64%) and educating the next generation (63%) were the top motivators. Notably, student preparedness was crucial for 45.5%. In contrast, extrinsic factors like financial gain (20%) and recognition events (9.7%) ranked lowest. The main challenges were heavy clinical workload (31.3%) and lack of time (28%).

CONCLUSION: Preceptors were primarily motivated by intrinsic factors, with student preparedness being the most significant external factor. Time constraints and clinical workload were the major challenges to teaching. These insights can guide strategies to better support clinical educators.

PMID:39948639 | DOI:10.1186/s12909-025-06842-3

Perioper Med (Lond). 2025 Feb 13;14(1):20. doi: 10.1186/s13741-025-00501-3.

ABSTRACT

PURPOSE: Remimazolam toluene sulfonic acid is a short-acting benzodiazepine primarily studied for intravenous anesthesia. To date, few studies have focused on the effects of the combination of remimazolam and inhalation anesthesia or its impact on postoperative recovery. Our study aims to investigate the influence of remimazolam combined with sevoflurane for general anesthesia maintenance on postoperative recovery quality in elderly patients undergoing laparoscopic abdominal surgery.

METHODS: A total of 109 patients, aged 60 to 80 years old, scheduled for laparoscopic gallbladder or hernia surgery were randomly divided into two groups: remimazolam group (Group R) and remimazolam-sevoflurane combination group (Group S). Group R had remimazolam for anesthesia maintenance, while Group S received remimazolam and sevoflurane. Both groups followed the same induction protocol, with bispectral index (BIS) maintained between 40 and 60 during surgery. The primary outcome was assessed with the Quality of Recovery (QoR)-15 score. The secondary outcomes included loss of consciousness (LoC), perioperative hemodynamic variables, extubation time, and the incidence of postoperative adverse events. During the study, 7 patients were lost to follow-up, and finally, 102 patients were included in the statistical analysis. The data will be analyzed in a modified full analysis set.

RESULTS: Group S had higher QoR-15 and physical comfort scores on postoperative day (POD) 1 and POD3 compared to Group R (135.0[8.0] vs. 132.0[11.0], P = 0.004; 143.0[6.0] vs. 141.0[7.0], P = 0.007). Despite using less remifentanil (P = 0.021), Group S had a significantly longer extubation time (P = 0.048). There were no significant differences in induction time, perioperative hemodynamic variables, or postoperative adverse events between the groups.

CONCLUSION: Combining remimazolam with sevoflurane improves postoperative recovery quality in elderly patients undergoing laparoscopic abdominal surgery. This approach ensures optimal anesthesia depth and sedation while minimizing adverse events and complications.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200065332. Date of registration: 02/11/2022.

PMID:39948637 | DOI:10.1186/s13741-025-00501-3