Nevin Manimala

Lab Med. 2025 Nov 22:lmaf074. doi: 10.1093/labmed/lmaf074. Online ahead of print.

ABSTRACT

INTRODUCTION: Sepsis represents a critical response to infection; it is characterized by systemic inflammation, shock, and potential organ failure. Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) has been identified as a crucial marker in sepsis, connecting the activation of innate immunity to systemic inflammation.

METHODS: This prospective nested case control study was carried out in the intensive care unit and surgery department from March 2018 to June 2019. Adults undergoing abdominal surgery, with and without sepsis, were included in the study, and sTREM-1 and cytokine levels were measured.

RESULTS: A total of 120 patients were included in the study, comprising 31 noninfected individuals, 37 with sepsis, and 52 with septic shock. sTREM-1 levels were statistically significantly elevated in patients with sepsis and septic shock compared with noninfected individuals (P < .001). Receiver operating characteristic curve analysis revealed an area under the curve of 0.722 for sTREM-1 in the prediction of septic shock.

DISCUSSION: Elevated sTREM-1 levels are associated with the severity of sepsis and may function as a prognostic biomarker. Additional research is required to confirm these findings and investigate therapeutic interventions aimed at the sTREM-1 pathway.

PMID:41273150 | DOI:10.1093/labmed/lmaf074

Orthod Craniofac Res. 2025 Nov 22. doi: 10.1111/ocr.70060. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to assess the aesthetic judgements made by lay people and professionals relating to an asymmetric maxillary central incisors’ gingival margin position.

SETTING: Multi-center institutional study.

MATERIALS AND METHODS: A high-quality intra-oral photograph of a previously treated case was manipulated (six images). Parents of children undergoing conventional orthodontic treatment (PCT), parents of children undergoing combined surgical-orthodontic treatment for a unilateral impacted maxillary central incisor (PI) and professionals (dental and orthodontic specialists) were asked to evaluate and rank the images in terms of aesthetics and provide free-text responses to support their rankings (least and most attractive). All data was analysed statistically with regressions at 5% and a thematic analysis of the free-text responses was performed.

RESULTS: The responses from 120 participants (mean age 42.2 years; Standard Deviation [SD] 8.6 years; 62.2% female) were analysed (30/group). Image E (symmetrical gingival margins with the lateral incisor gingival margins 0.5-1.0 mm below both the gingival margin of the maxillary canine and central incisor which are at the same level in relation to each other) was ranked the most attractive (60.8%). The presence of an asymmetric gingival margin between the maxillary central incisors was rated the least attractive (Images D and F; 30.9% and 39.2%, respectively). The highest and lowest mean ranking scores (adjusted for gender) were Image E (5.12 points; 95% CI: 4.76-5.48 points) and F (1.83 points; 95% CI: 1.57-2.10 points) A similar trend was evident within groups. The PCT group scored Image D the lowest (2.17 points; 95% CI: 1.72-2.62 points). Gender influenced the ranking of the images. Themes to support the ranking of the most attractive image were related to the importance of overall symmetry. Themes to support the ranking of the least attractive image were based on overall asymmetrical (uneven) appearance (n = 117).

CONCLUSION: An asymmetric gingival margin position between the maxillary central incisors negatively influences the rating/perception of attractiveness by lay persons and professionals.

PMID:41273137 | DOI:10.1111/ocr.70060

Aust Endod J. 2025 Nov 22. doi: 10.1111/aej.70035. Online ahead of print.

ABSTRACT

This study assessed the diagnostic accuracy of periapical radiography and cone-beam computed tomography for detecting external cervical resorption. An electronic search was conducted in seven databases. The protocol was registered in PROSPERO, and the risk of bias was assessed with QUADAS-2. Retrospective studies using human dental images were included. A bivariate random-effects model estimated pooled diagnostic values using MetaDisc v1. Four studies met the inclusion criteria. Three demonstrated a high risk of bias in patient selection. The meta-analysis revealed specificity values of 0.93 for periapical radiography and 1.00 for cone-beam computed tomography, with corresponding sensitivity values of 0.85 and 1.00, respectively. Cone-beam computed tomography showed statistically superior diagnostic accuracy (p = 0.0016). The GRADE assessment rated the overall certainty of the evidence as ‘very low.’ Cone-beam computed tomography showed superior accuracy to periapical radiography in detecting external cervical resorption, but the very low certainty of evidence highlights the need for further studies.

PMID:41273117 | DOI:10.1111/aej.70035

Aust Endod J. 2025 Nov 22. doi: 10.1111/aej.70039. Online ahead of print.

ABSTRACT

This study evaluated the association of ambroxol hydrochloride with calcium hydroxide paste as intracanal medication to enhance antimicrobial action on biofilm without affecting pH, solubility and cytotoxicity. Calcium hydroxide (CH) paste and formulations with different ambroxol concentrations were placed into artificial teeth conditioned in distilled water. pH and solubility were measured. Dentine discs infected with E. faecalis were covered with pastes, and biofilm viability was analysed using live/dead assay and confocal microscope. Cytotoxicity was analysed using MTT assay on fibroblast and osteoblast-like cells. Data were statistically compared (p < 0.05). Ambroxol showed an acidic pH after 7 days, compared to CH, but the 30% concentration became more alkaline after 30 days. While CH’s pH decreased over time, ambroxol groups maintained stability. Solubility decreased for all groups over time. All groups showed significant antimicrobial differences from the control group. The association did not alter CH’s cytotoxicity. Further research is needed for optimal ambroxol concentration.

PMID:41273116 | DOI:10.1111/aej.70039

Neurorehabil Neural Repair. 2025 Aug 26:15459683251363241. doi: 10.1177/15459683251363241. Online ahead of print.

ABSTRACT

BackgroundStroke is the leading cause of long-term disability, making the search for successful rehabilitation treatment one of the most important public health issues. A better understanding of the neural mechanisms underlying impairment and recovery is critical for optimizing treatments. Objective: We studied the longitudinal changes in brain oscillatory modes, linked to GABAergic system activity, and determined their importance for residual upper-limb motor functions and recovery.MethodsTranscranial Magnetic Stimulation (TMS) was combined with scalp Electroencephalography (EEG) to analyze TMS-induced brain oscillations in a cohort of 66 stroke patients in the acute (N = 60), early (N = 48), and late subacute stages (N = 37).ResultsA data-driven parallel factor analysis (PARAFAC) approach to tensor decomposition extracted brain oscillatory modes, which significantly evolved longitudinally across stroke stages (permutation tests, p_Bonf < 0.05). Notably, the observed decrease of the α-mode, known to be linked with GABAergic system activity, was mainly driven by the recovering patients and was supportive of stroke recovery at the group level (Bayesian Kendall correlation, moderate to strong statistical evidence).ConclusionsOverall, longitudinal evaluation of brain modes provides novel insights into functional reorganization of brain networks after a stroke. Notably, we propose that the observed α-mode decrease could correspond to a beneficial disinhibition toward the late subacute stage that fosters plasticity and facilitates recovery. These results confirm the relevance of future individual and direct monitoring of post-stroke modulations in inhibitory system activity, with the ultimate goal of designing electrophysiological biomarkers and refining therapies based on personalized neuromodulation.

PMID:41273103 | DOI:10.1177/15459683251363241

Head Neck. 2025 Nov 21. doi: 10.1002/hed.70102. Online ahead of print.

ABSTRACT

BACKGROUND: Tracheostomy is frequently performed during flap-based reconstruction for head and neck cancer, but predictive factors and complications are not well established.

METHODS: A systematic review and meta-analysis was conducted per PRISMA guidelines. Studies of adult patients undergoing free or pedicled flap reconstruction were included. Pooled tracheostomy rates, predictors, and complications were analyzed using random-effects models. Heterogeneity was assessed with the I² statistic.

RESULTS: Twenty-six studies (27 029 patients) were included. The pooled tracheostomy rate was 54.6%, decreasing to 42.4% when routine tracheostomy studies were excluded. Advanced tumor stage, oropharyngeal site, bilateral neck dissection, prior radiotherapy, and smoking predicted tracheostomy. Flap type was not significantly associated. The overall complication rate was 16.3%, including airway issues (2.6%). No significant change in tracheostomy rates was observed over 30 years.

CONCLUSIONS: Tracheostomy use is influenced by tumor, surgical, and patient factors. Selective tracheostomy and validated risk tools may improve outcomes. Further prospective studies are needed.

PMID:41273066 | DOI:10.1002/hed.70102

Multivariate Behav Res. 2025 Nov 21:1-15. doi: 10.1080/00273171.2025.2570250. Online ahead of print.

ABSTRACT

Bayesian statistics have gained significant traction across various fields over the past few decades. Bayesian statistics textbooks often provide both code and the analytical forms of parameters for simple models. However, they often omit the process of deriving posterior distributions or limit it to basic univariate examples focused on the mean and variance. Additionally, these resources frequently assume a strong background in linear algebra and probability theory, which can present barriers for researchers without extensive mathematical training. This tutorial aims to fill that gap by offering a step-by-step guide to deriving posterior distributions. We aim to make concepts typically reserved for advanced statistics courses more accessible and practical. This tutorial will cover two models: the univariate normal model and the multilevel model. The concepts and properties demonstrated in the two examples can be generalized to other models and distributions.

PMID:41273045 | DOI:10.1080/00273171.2025.2570250

Womens Health (Lond). 2025 Jan-Dec;21:17455057251399891. doi: 10.1177/17455057251399891. Epub 2025 Nov 21.

ABSTRACT

BACKGROUND: Uterine rupture is a rare but serious complication in obstetrics, associated with maternal and fetal risks. This study evaluates its prevalence and outcomes in a Portuguese hospital.

OBJECTIVES: To assess the prevalence of uterine rupture in pregnancy, as well as the associated maternal and neonatal morbidity and mortality, in a hospital setting in Portugal.

DESIGN: A retrospective descriptive study was conducted.

METHODS: Retrospective review of complete uterine rupture cases (2019-2024) at the Local Health Unit of Tâmega e Sousa. Data included maternal characteristics, obstetric history and outcomes.

RESULTS: Among 10,447 deliveries, 13 cases of uterine rupture occurred (12.44/10,000), primarily in women with prior caesarean sections (84.6%). Abnormal cardiotocography (76.9%) and abdominal pain (23.1%) were common signs. Fetal extrusion occurred in 69.2%. No maternal deaths were recorded, but perinatal mortality was 7.7%. Post-partum haemorrhage affected 61.5%, with five transfusions required.

CONCLUSION: The prevalence of uterine rupture aligns with rates in developed countries. Caution is advised when using oxytocin in women with prior caesareans. Prompt detection and intervention are crucial to minimize complications.

PMID:41273021 | DOI:10.1177/17455057251399891

Brain Behav. 2025 Nov;15(11):e71042. doi: 10.1002/brb3.71042.

ABSTRACT

BACKGROUND: Mitochondrial D-loop methylation leads to abnormal cerebral angiogenesis. This study examines its role in vascular phenotypes of moyamoya disease (MMD).

METHOD: Blood samples from 96 intracranial artery stenosis/occlusion (ICASO) patients (35 MMD, 61 non-MMD) and healthy controls underwent methylation analysis. D-loop methylation levels were analyzed using chi-square, T-test, and Wilcoxon tests. Propensity score matching (PSM) adjusted for age and gender disparities. Combine clinical information with methylation data to build a diagnostic model. Further studies included the methylation levels in MMD patients carrying the RNF213 p.R4810K mutation and the methylation levels and possible mechanisms of human brain microvascular endothelial cells (hCMEC/D3) with RNF213 knockdown.

RESULTS: Healthy controls showed higher D-loop methylation than MMD (p < 0.05). Post-PSM, non-MMD ICASO patients showed higher D-loop methylation than MMD (p < 0.05). The AUC of the prediction model was 0.891 (95% CI, 0.821-0.961) after combining clinical information with methylation data. MMD patients with the RNF213 mutation exhibited reduced methylation at most sites, though not statistically significant (p > 0.05). RNF213 knockout in hCMEC/D3 enhanced proliferation, migration, and tube formation, while reducing apoptosis and DNMT1 expression, leading to decreased D-loop methylation and ROS level, increased ATP production and mitochondrial membrane potential.

CONCLUSION: There are differences in the methylation levels in the mitochondrial D-loop region between MMD and non-MMD ICASO. The methylation-metabolism-angiogenesis axis may represent a promising research direction for elucidating MMD pathogenesis.

PMID:41273014 | DOI:10.1002/brb3.71042

Brain Behav. 2025 Nov;15(11):e70851. doi: 10.1002/brb3.70851.

ABSTRACT

INTRODUCTION AND AIM: While chemotherapy contributes to the survival of cancer patients, it also leads to various psychological and physiological problems, increasing the need for supportive care. This study aimed to determine the relationship between psychological resilience, chemotherapy symptoms, and supportive care needs in patients undergoing chemotherapy.

METHOD: This is a descriptive and correlational study. Data were collected using the Descriptive Characteristics Form, the Psychological Resilience Scale (PRS), the Nightingale Symptom Assessment Scale (N-SAS), and the Supportive Care Needs Scale-Short Form (SCNS-SF). Data collection was conducted face-to-face in the chemotherapy unit of a university hospital. Analyses were performed using the Statistical Package for Social Sciences (SPSS) 29.0 and Hayes Process Macro V3.4.

RESULTS: A total of 113 patients participated in the study. The mean age of the participants was 56.91 years (SD = 10.917), the mean PRS score was 106.59 (SD = 5.194), the mean N-SAS score was 2.14 (SD = 0.423), and the mean SCNS-SF score was 72.58 (SD = 9.250). The effect of PRS on N-SAS was primarily direct and statistically significant (β = -0.019; p = 0.011). However, the effect of PDÖ on SCNS-SF was not statistically significant (β = 0.017; p = 0.752). Participants generally demonstrated high levels of psychological resilience, a low impact of symptoms on quality of life, and moderate levels of supportive care needs.

CONCLUSION: The psychological resilience levels of the patients were generally high. The impact of symptoms on patients’ quality of life was low. While an increase in symptoms negatively affected psychological resilience, the effect of psychological resilience on supportive care needs was limited and indirect.

PMID:41273000 | DOI:10.1002/brb3.70851