Nevin Manimala

J Neurooncol. 2025 Nov 25;176(1):97. doi: 10.1007/s11060-025-05348-8.

ABSTRACT

INTRODUCTION: For larger meningiomas, higher radiation doses need to be delivered to the tumor, increasing the chances of radiation induced toxicity. Hypofractionated stereotactic radiosurgery (HSRS) imparts overall high dose in small multiple fractions, minimising this risk over single session SRS (SSRS). This meta analysis was conducted to homogenize the role of SRS for large meningiomas (> 8 cc) and run a comparative analysis between HSRS and SSRS.

METHODOLOGY: Pubmed and Cochrane databases were systematically reviewed to include the relevant articles and meta analysis was performed to estimate pooled favorable clinical outcomes, tumor control and peritumoral edema (PTE) rates. Statistical tests were utilized to compare SSRS and HSRS modalities.

RESULTS: 791 lesions underwent SSRS while 273 tumors were administered HSRS. Significantly higher percentage of Skull base tumors underwent HSRS over SSRS (84.6% vs. 76%, p = 0.003) and mean tumor size was significantly higher in the HSRS cohort (17.6 cc vs. 14.6 cc, p = 0.014). The pooled tumor control and favorable clinical outcome rates were 90% and 85% respectively, with no significant differences in HSRS and SSRS cohorts (95% vs. 90%, logit difference: 0.645, p = 0.10 and 87% vs. 85%, logit difference: 0.26, p = 0.48 respectively). Post radiosurgical PTE incidence was statistically similar for both cohorts with an overall pooled incidence of 7.9% (logit difference = 0.03, p = 0.95). Follow up period was significantly higher in patients undergoing SSRS (67 vs. 49 months, p = 0.037).

CONCLUSION: Despite having significantly larger tumor volume, HSRS could achieve similar outcomes with SSRS. However, the inadequacy of data on direct comparative studies between HSRS and SSRS warrants prospective multicenter trials with international collaboration and long term follow up for HSRS.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41291309 | DOI:10.1007/s11060-025-05348-8

Evid Based Dent. 2025 Nov 25. doi: 10.1038/s41432-025-01191-y. Online ahead of print.

ABSTRACT

A COMMENTARY ON: Santonocito S, Cicciù M, Ronsivalle V. Evaluation of the impact of AI-based chatbot on orthodontic patient education: a preliminary randomized controlled trial. Clin Oral Investig 2025; 29:278.

DESIGN: Randomized controlled trial (RCT).

CASE SELECTION: A sample of 100 patients was enrolled in the study between June 2023 and August 2024. Participants were randomly allocated into two intervention groups of 50 each, using a computer-generated sequence to maintain a 1:1 ratio. The Chatbot group received oral hygiene (OH) and orthodontic treatment guidance via a chatbot accessed through a QR code, while the control group was given standard educational material by means of information leaflets compiled by the leading scientific societies in orthodontics. Each main group was further divided into two subgroups: Leaflet-fixed therapy (LF, n = 27), Leaflet-aligner (LA, n = 23), Chatbot-fixed therapy (CF, n = 24), and Chatbot-aligner (CA, n = 26). The chatbot was built on the open-source Botpress platform and was refined using expert-reviewed training materials. When the participant opens the chatbot application, the interface displays a menu containing 4 questions, with the 3rd question focusing on home oral hygiene procedures.

DATA ANALYSIS: The evaluation included a clinical examination at baseline (T0) and after 5 weeks of starting orthodontic treatment (T1), along with a questionnaire at T1 assessing participants’ oral hygiene knowledge and compliance. Modified gingival index (MGI) and plaque index (PI) were used for clinical examination of oral hygiene. The questionnaire comprised four domains: Knowledge Evaluation (KE_S), Understanding Scale (US_S), Compliance and Adherence Scale (CAAS_S), and Satisfaction Scale (SS_S). It employed a 5-point Likert scale, with scores ranging from 0 (strongly negative) to 4 (strongly positive), with intermediate values representing negative, neutral, and positive responses.

RESULTS: MGI and PI showed a statistically significant increase from T0 to T1 in both groups. While comparing the change in MGI from the start of treatment between the groups, a statistically significant increase was found in the control group than the chatbot group. Further analysis reported statistically lower increase in MGI in the CF and CA groups as compared to the LF and LA subgroups. There were no differences between the control and chatbot groups with respect to questionnaire section scores.

CONCLUSIONS: The study concluded that the use of an AI-based chatbot positively influences patient compliance with oral hygiene maneuvers. Furthermore, it could not be established whether the AI-based chatbot enhanced the patient’s knowledge, understanding, and satisfaction with the information received compared to the information leaflets.

PMID:41291283 | DOI:10.1038/s41432-025-01191-y

Parasitol Res. 2025 Nov 25;124(11):141. doi: 10.1007/s00436-025-08535-8.

ABSTRACT

Plasmodium vivax is a malaria parasite with a broad geographic distribution worldwide. The unique biological characteristics of P. vivax, such as early gametocytogenesis and its latent hypnozoite stage, make it more difficult to control compared to P. falciparum. Malaria remains a significant global health concern, particularly in regions with limited diagnostic infrastructure. This study aims to develop a computer-assisted method for characterizing and classifying malaria parasites using a machine learning approach based on light microscopic images of peripheral blood smears. One of the major challenges in malaria diagnostics is the inadequacy of current detection methods. To address this, the study introduces a convolutional neural network (CNN)-based pipeline for the automated detection and staging of malaria infections from Giemsa-stained blood smear images. The dataset used in this study was annotated into four classes: Ring Form, Trophozoite, Schizont, and Uninfected Red Blood Cells (RBCs), encompassing diverse staining qualities and morphological variations. The dataset was divided into training (70%), validation (15%), and testing (15%) subsets. The CNN achieved an overall classification accuracy of 92.4%, with precision, recall, and F1-scores exceeding 0.90 across all classes. Statistical metrics, including mean accuracy (92.4% ± 2.1%), precision (93.1% ± 1.8%), and recall (92.8% ± 1.9%), demonstrated the robustness of the model. Class-specific analysis revealed that the Schizont stage achieved the highest classification accuracy (94.7%), while the Ring Form stage showed slightly lower performance (91.2%), likely due to inherent morphological overlaps with early Trophozoite forms. Visualizations, including confusion matrices and class probability distribution overlays, provided detailed insights into the model’s decision-making processes. The pipeline was further evaluated using cross-validation techniques, showing high reliability across various dataset splits. This approach offers scalability and adaptability, with the potential for deployment in real-world diagnostic workflows, particularly in resource-constrained settings.

PMID:41291252 | DOI:10.1007/s00436-025-08535-8

Psychoneuroendocrinology. 2025 Nov 13;184:107693. doi: 10.1016/j.psyneuen.2025.107693. Online ahead of print.

ABSTRACT

IMPORTANCE: Although parent-child cortisol synchrony is essential for the development of children’s socio-emotional development, the research findings on what affects this synchrony are unclear. This lack of clarity makes it difficult to pinpoint the best areas to target when creating interventions to help improve synchrony between parents and their children.

OBJECTIVE: We aimed to characterize the literature on parent-child cortisol synchrony and how various family-related risks and protective factors were associated with parent-child cortisol synchrony.

EVIDENCE REVIEW: We searched 4 databases (CINAHL, PsycINFO, PubMed, and Web of Science) on August 25th, 2025. Backward and forward citation searching was also conducted. Eligible articles a) were peer-reviewed articles/theses/dissertations published in the English language, b) assessed children between 6 months and 8 years for diurnal cortisol, and between 0 months and 8 years for cortisol reactivity, c) included majority of children free of neurological, genetic, or major psychiatric disorders and born full-term, d) included parents with a mean age above 18 years, where the majority were free of neurological or genetic disorders, e) collected at least 2 salivary cortisol samples from both parent and child, in either home or lab, f) for cortisol reactivity, collected at least one saliva sample each before and after a challenging task, g) collected 2 saliva samples on the same day for diurnal cortisol, and h) reported any statistical association between parent and child cortisol. We used the Quality Assessment with Diverse Studies Tool for quality analysis.

FINDINGS: We identified 33 unique studies, including a total of 5206 participants. All studies were observational, with 7 longitudinal studies. The scarce literature suggested positive child-to-parent synchrony in families without risk factors, but synchrony was absent or reduced in families with risk factors. Protective factors (e.g., parental sensitivity) led to more adaptive synchrony in parent-child dyads.

CONCLUSIONS AND RELEVANCE: While the existing research suggested that parent-child cortisol synchrony is affected by both family risk and protective factors, too few studies existed to draw strong conclusions. More research is essential to develop better interventions for improving parent-child synchrony.

PMID:41289650 | DOI:10.1016/j.psyneuen.2025.107693

Neural Netw. 2025 Nov 14;196:108325. doi: 10.1016/j.neunet.2025.108325. Online ahead of print.

ABSTRACT

We conduct a comprehensive study on the quality inspection of lithium battery materials, which evaluates material conformity by analyzing particle sizes in scanning electron microscope (SEM) images. Currently, enterprises rely heavily on manual annotation to complete this task. However, manual annotation is labor-intensive and prone to subjective errors. To address these challenges, we reformulate the quality inspection task as the lithium battery materials SEM image segmentation (LBMS) task and aim to resolve it using artificial intelligence technology. To this end, we collect and construct a dedicated SEM image dataset for the LBMS dataset, called LBMS dataset. Then we propose a specialised model for the LBMS task, named LBMS-SAM. Specifically, we design an edge feature extraction module based on Sobel and Gabor convolutions (GSEFE), which aims to accurately extract and enhance image edge information. Additionally, We design a multi-layer denoised features fusion module (MDFF) that uses wavelet transform to denoise the output features of each global attention layer in the ViT model. The denoised features from different layers are then fused, enabling efficient extraction of global contextual information and suppressing noise introduced by the ViT architecture. The proposed model introduces minimal additional parameters, and extensive experiments on the LBMS dataset demonstrate that LBMS-SAM outperforms state-of-the-art (SOTA) methods across all relevant evaluation metrics.

PMID:41289643 | DOI:10.1016/j.neunet.2025.108325

Intensive Crit Care Nurs. 2025 Nov 24;93:104197. doi: 10.1016/j.iccn.2025.104197. Online ahead of print.

NO ABSTRACT

PMID:41289628 | DOI:10.1016/j.iccn.2025.104197

Eur J Radiol. 2025 Nov 17;194:112545. doi: 10.1016/j.ejrad.2025.112545. Online ahead of print.

ABSTRACT

OBJECTIVE: To characterize craniofacial, temporal-bone, vertebral, and systemic anomalies in oculo-auriculo-vertebral (OAV) spectrum using high-resolution computed tomography (HRCT) and to examine associations with clinical severity by the Tasse Objective Scoring System.

METHODS: We performed a retrospective study (2015-2024) at a national tertiary center including 223 clinically diagnosed OAV patients; 217 had bilateral temporal-bone HRCT suitable for analysis. HRCT assessed external auditory canal (EAC), ossicular, and intratemporal facial-nerve anatomy; inner-ear/vestibulocochlear-nerve abnormalities were evaluated in a subset. Vertebral anomalies were CT-confirmed when coverage was available; renal and cardiac findings were extracted from clinical records. Statistics included chi-square or Fisher tests with Cramér’s V, Cochran-Armitage trend tests across Tasse grades, and Spearman correlation for vertebral anomaly counts (two-sided α = 0.05).

RESULTS: Mean age was 7.6 ± 4.2 years; 55.2 % were male. In the HRCT subset, EAC stenosis/atresia and ossicular abnormalities were frequent and increased with Tasse severity (EAC: 48.4 %→59.8 %→82.8 %, p = 0.0078; ossicles: 40.3 %→49.6 %→82.8 %, p < 0.001), as did aberrant intratemporal facial-nerve course (24.2 %/27.4 %/53.3 %, p = 0.010). Inner-ear malformations were identified in 14.3 % and vestibular/vestibulocochlear-nerve anomalies in 42.9 % of those specifically evaluated. CT-confirmed vertebral anomalies occurred in 29.1 % overall; segmentation defects showed a strong grade-wise increase (p < 0.001) and the cumulative vertebral anomaly count correlated with Tasse severity (Spearman ρ = 0.41, p < 0.001). Renal anomalies were present in 16.6 % and rose across grades (p = 0.044; trend p < 0.001), whereas cardiac anomalies occurred in 14.8 % with no significant between-grade difference (p = 0.19).

CONCLUSION: Pairing HRCT phenotyping with Tasse severity stratification provides clinically actionable information for operative planning (canaloplasty/ossiculoplasty/device candidacy) and prioritizes systemic surveillance (spine and renal screening) in OAV spectrum. This integrated approach supports coordinated multidisciplinary care and offers a framework for future standardized screening and outcome-oriented research.

PMID:41289623 | DOI:10.1016/j.ejrad.2025.112545

J Chromatogr B Analyt Technol Biomed Life Sci. 2025 Nov 21;1269:124867. doi: 10.1016/j.jchromb.2025.124867. Online ahead of print.

ABSTRACT

Chronic inflammation is a significant contributor to various diseases but its assessment via blood sampling presents challenges, particularly in children. The evaluation of urinary biomarkers, including 3-bromotyrosine (Bty), 3-chlorotyrosine (Cty) and leukotriene E4 (LTE4), offers a non-invasive alternative. This study presents the optimization and validation of a sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the simultaneous quantification of Bty, Cty and LTE4 in urine. Under optimized conditions, sample preparation was based on SPE using Oasis MAX cartridges, followed by LC-MS/MS analysis. Method performance was validated using the ICH 10 guidelines, resulting in satisfactory results for all analytes in terms of recovery, linearity, limits of quantification, precision and accuracy. Recovery rates ranged from 82 % to 97 %, while matrix effects were observed within the range of -11 % to 26 %. Linear range spanned from 0.08 to 20 ng/mL for the three analytes. Application to 332 urine samples from the ENVIRONAGE birth cohort (Belgium), comprising of children aged 4-11 years, revealed detection frequencies of 18 % for LTE4, 19 % for Cty and 50 % for Bty. Notably, creatinine-corrected Cty and LTE4 exhibited statistically significant Spearman correlations with established systemic inflammation markers. Specifically, Cty was positively correlated with absolute monocyte count (ρ = 0.53, p < 0.05), while LTE4 showed a positive correlation with relative eosinophil levels (ρ = 0.46, p < 0.05) and a negative correlation with the relative neutrophil levels (ρ = -0.56, p < 0.01). These results highlight the validated method as a valuable tool for investigating distinct inflammatory pathways in epidemiological settings and clinical research.

PMID:41289620 | DOI:10.1016/j.jchromb.2025.124867

Neural Netw. 2025 Nov 8;195:108311. doi: 10.1016/j.neunet.2025.108311. Online ahead of print.

ABSTRACT

Identifying appropriate structures for generative or world models is essential for both biological organisms and machines. This work shows that synaptic pruning facilitates efficient statistical structure learning. We extend previously established canonical neural networks to derive a synaptic pruning scheme that is formally equivalent to an online Bayesian model selection. The proposed scheme, termed Bayesian synaptic model pruning (BSyMP), utilizes connectivity parameters to switch between the presence (ON) and absence (OFF) of synaptic connections. Mathematical analyses reveal that these parameters converge to zero for uninformative connections, thus providing reliable and efficient model reduction. This enables the identification of a plausible structure for the environmental model, particularly when the environment is characterized by sparse likelihood and transition matrices. Through causal inference and rule learning simulations, we demonstrate that BSyMP achieves model reduction more efficiently than the conventional Bayesian model reduction scheme. These findings indicate that synaptic pruning could be a neuronal substrate underlying structure learning and generalizability in the brain.

PMID:41289617 | DOI:10.1016/j.neunet.2025.108311

J Radiol Prot. 2025 Nov 25. doi: 10.1088/1361-6498/ae23d9. Online ahead of print.

ABSTRACT

Breast tissue is highly sensitive to ionizing radiation, making dose management in mammography crucial to reducing the risk of radiation-induced cancer and hereditary effects. Dose optimisation, guided by the ALARA principle, aims to minimise exposure while maintaining diagnostic quality. This study focuses on establishing National Diagnostic Reference Levels (NDRLs) for digital mammography in Nepal to support dose optimisation efforts. A retrospective analysis was conducted using data from 786 patients across six hospitals equipped with digital mammography systems. Both symptomatic and screening mammograms in cranial-caudal (CC) and mediolateral oblique (MLO) views were included for both breasts. Mean glandular dose (MGD) and entrance skin dose (ESD) were extracted from DICOM headers. For each mammogram view, data from a minimum of 50 patients were analysed. Technical parameters such as tube voltage (kVp), tube current (mAs), compression force (CF), and compressed breast thickness (CBT) were also documented. The established NDRLs for digital mammography are 1.03 mGy (RCC), 1.02 mGy (LCC), 1.18 mGy (RMLO), and 1.15 mGy (LMLO). The mean CBT and CF are 56±13 mm and 122±29 N, respectively. The overall NDRLs for CC and MLO views are 1.03 mGy and 1.17 mGy. Comparisons with other countries highlight the potential for further dose optimization to maintain diagnostically adequate images at lower exposure levels. Implementing such strategies can reduce patient radiation dose in digital mammography without compromising diagnostic performance.

PMID:41289610 | DOI:10.1088/1361-6498/ae23d9