Nevin Manimala

BMC Oral Health. 2025 Jan 9;25(1):50. doi: 10.1186/s12903-024-05378-0.

ABSTRACT

OBJECTIVES: This randomized prospective controlled trial investigated the effectiveness of different strategies of regenerative endodontic therapy on necrotic mature anterior teeth with chronic periapical periodontitis with 18 months follow up.

METHODS: A total analyzed 51 adult participant with mature single rooted teeth having necrotic pulp with chronic periapical periodontitis (PAI ≥ 3) were selected. Patients had been randomly categorized into three distinct groups (n = 17 each group). All groups received the same treatment on the first visit. After 2 weeks, regenerative treatment was performed using either blood clot technique, Standard-PRF and Advanced-PRF approach. A standardized radiograph was taken, and the patients instructed for 6, 12 and 18 months follow up periods. Fisher’s exact test was applied to compare the frequency of PAI scores at different follow-up intervals between the three groups.

RESULTS: The results showed radiographic success at 18 months (58.8% in blood group, 94.1% in S-PRF group and 76.5% in A-PRF group). There was no statistically significant difference between the three groups according to incidence of healing at 6, 12 and 18 months. Clinical success was 82.4% in blood group and 88.2% in both S-PRF and A-PRF groups. There was no significant difference between the three groups (p = 1). The overall success (clinical and radigraphic) was 76.5%. Incidence of the gaining sensitivity after 12 and 18 months was 29.4% with A-PRF group and 41.2% within the S-PRF group, 17.6% with BC group.

CONCLUSION: PRF based regenerative technique may outperform the blood clot technique in treatment of non-vital mature teeth with chronic periapical periodontitis. There is a need for future randomized clinical studies to consolidate procedures in this field with more prolonged evaluation periods.

CLINICAL TRIAL REGISTRATION: The study was retrospectively registered with ClinicalTrials.gov (ID: NCT04606719 ) in 28/10/2020.

PMID:39789544 | DOI:10.1186/s12903-024-05378-0

J Transl Med. 2025 Jan 9;23(1):34. doi: 10.1186/s12967-024-06012-x.

ABSTRACT

BACKGROUND: Recent research indicates a role of gut microbiota in development and progression of life-threatening diseases such as cancer. Carcinomas of the biliary ducts, the so-called cholangiocarcinomas, are known for their aggressive tumor biology, implying poor prognosis of affected patients. An impact of the gut microbiota on cholangiocarcinoma development and progression is plausible due to the enterohepatic circulation and is therefore the subject of scientific debate, however evidence is still lacking. This review aimed to discuss the suitability of complex cell culture models to investigate the role of gut microbiota in cholangiocarcinoma progression.

MAIN BODY: Clinical research in this area is challenging due to poor comparability of patients and feasibility reasons, which is why translational models are needed to understand the basis of tumor progression in cholangiocarcinoma. A promising approach to investigate the influence of gut microbiota could be an organoid model. Organoids are 3D cell models cultivated in a modifiable and controlled condition, which can be grown from tumor tissue. 3D cell models are able to imitate physiological and pathological processes in the human body and thus contribute to a better understanding of health and disease.

CONCLUSION: The use of complex cell cultures such as organoids and organoid co-cultures might be powerful and valuable tools to study not only the growth behavior and growth of cholangiocarcinoma cells, but also the interaction with the tumor microenvironment and with components of the gut microbiota.

PMID:39789543 | DOI:10.1186/s12967-024-06012-x

Sci Total Environ. 2025 Jan 8;961:178401. doi: 10.1016/j.scitotenv.2025.178401. Online ahead of print.

ABSTRACT

Poor water, sanitation, and hygiene (WASH) are the primary risks of exposure to enteric viral infection. Our study aimed to describe the role of WASH conditions and practices as risk factors for enteric viral infections in children under 5. Literature on the risk factors associated with all-cause diarrhea masks the taxa-specific drivers of diarrhea from specific pathogens, limiting the application of relevant control strategies. We analyzed data from children enrolled in the Global Enteric Multicenter Study (GEMS) across seven study sites between December 2007 and March 2011 as cases (moderate-to-severe diarrhea: MSD) and asymptomatic controls. MSD was defined as new and acute diarrhea, with at least one of the following criteria for MSD: dehydration based on the study clinician’s assessment, dysentery, or hospitalization with diarrhea or dysentery. Multiple logistic regression was used to examine the role of water quality, sanitation access, and hygiene facilities on the enteric viral pathogens adjusted for potential covariates. Among MSD symptomatic children (cases), longer water retrieval time (≥15 vs <15 min) was associated with increased Norovirus (aOR 1.33, 95 % CI 1.08-1.64) and Astrovirus (aOR 1.43, 95 % CI 1.01-2.02); scooping as drinking water retrieval method was associated with lower Rotavirus (aOR 0.77, 95 % CI 0.62-0.96), but higher Adenovirus (aOR 2.3, 95 % CI 1.32-4.11) infection compared to non-users. Among asymptomatic children (controls), consumption of non-tube well drinking water was associated with higher Norovirus infection (aOR 1.38, 95 % CI 1.01-1.89). Longer drinking water retrieval time (≥15 vs <15 min) increased Norovirus (aOR 1.47, 95 % CI 1.21-1.78) and Rotavirus (aOR 1.51, 95 % CI 1.20-1.89) infections. Pouring (aOR 0.51, 95 % CI 0.32-0.83) or scooping drinking water with a cup (aOR: 0.52; 95 % CI: 0.32, 0.86) lower Astrovirus infection; restricted water access (aOR 1.57, 95 % CI 1.21-2.02) higher Rotavirus infection. Handwashing before cooking was associated with lower Astrovirus (aOR 0.64, 95 % CI 0.47-0.88) infection in asymptomatic children. Our analysis did not find a significant effect of poor sanitation on different enteric viral pathogens examined. Norovirus and Astrovirus were detected more commonly in sub-Saharan Africa while Rotavirus was less prevalent than South Asia. Though we found statistically significant associations, we did not observe any overall pattern between WASH and enteric viral pathogens. Our findings provide insights to guide further research on targeted interventions for enteric viral pathogens, responsible for a major burden of pediatric diarrhea globally.

PMID:39787644 | DOI:10.1016/j.scitotenv.2025.178401

Lung Cancer. 2025 Jan 4;199:108080. doi: 10.1016/j.lungcan.2025.108080. Online ahead of print.

ABSTRACT

BACKGROUND: Manual extraction of real-world clinical data for research can be time-consuming and prone to error. We assessed the feasibility of using natural language processing (NLP), an AI technique, to automate data extraction for patients with advanced lung cancer (aLC). We assessed the external validity of our NLP-extracted data by comparing our findings to those reported in the literature.

METHODS: Patients diagnosed with stage IIIB or IV lung cancer between January 2015 to December 2017 at Princess Margaret Cancer Centre who received at least one dose of systemic therapy were included. Their electronic health records were provided to Pentavere’s NLP platform, DARWEN^TM, in March 2019. Descriptive statistics summarized baseline patient and cancer characteristics, molecular biomarkers, and first-line systemic therapies. Cox multivariate models were used to evaluate prognostic factors for advanced non-small cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) cohort.

RESULT: NLP extracted clinical information (n = 333 patients) in a total of 8 hours, with only a few missing data for smoking status (n = 2), and Eastern Cooperative Oncology Group (ECOG) status (n = 5). Baseline patient and cancer characteristics summarized from NLP-extracted data were comparable to those in previous studies and population reports. For NSCLC patients, being male (HR 1.44, 95 % CI [1.04, 2.00]), having worse ECOG (1.48 [1.22, 1.81]), and having liver (2.24 [1.45, 3.46]), bone (2.09 [1.48, 2.96]), or lung metastases (2.54 [1.05, 2.26]) were associated with worse survival outcomes. For SCLC patients, having older age (HR 1.70 per 10 years, 95 % CI [1.10, 2.63]) and liver metastases (3.81 [1.61, 9.01]) were associated with worse survival outcomes.

CONCLUSION: Our study demonstrated that automated data extraction using NLP is feasible and time efficient. Additionally, the NLP-extracted data can be used to identify valid and useful clinical endpoints for research. NLP holds significant potential to accelerate the extraction of real-world data for future observational studies.

PMID:39787636 | DOI:10.1016/j.lungcan.2025.108080

J Geriatr Oncol. 2025 Jan 8;16(2):102184. doi: 10.1016/j.jgo.2024.102184. Online ahead of print.

ABSTRACT

INTRODUCTION: The use of taxanes in the adjuvant setting of early breast cancer (BC) confers survival benefits, however, their role in older patients merits further study. This retrospective pooled analysis of randomized controlled trials conducted by the Hellenic Oncology Research Group (HORG) aims to assess the efficacy and safety of taxane-based adjuvant chemotherapy in older women with BC.

MATERIALS AND METHODS: Five phase III trials containing a taxane, conducted by HORG between 1995 and 2013, were included in a patient-data pooled analysis. The primary endpoint was disease-free survival (DFS) at three years, whereas secondary outcomes included overall survival (OS) at five years and toxicity.

RESULTS: A total of 3,026 randomized patients, of whom 701 (23 %) were ≥ 65 years old (median age 69 years; range 65-80), were included in the analysis. No statistically significant heterogeneity in survival was observed between older and younger patients. Within the cohort of older patients, taxane-based regimens were superior to 5-fluorouracil, epirubicin, and cyclophosphamide (FE₇₅C) regimen in terms of three-year DFS (92.02 % vs 77.17 %; p < 0.001) and five-year OS (94.38 % vs 72.64 %; p < 0.001), respectively. A higher number of older patients discontinued treatment compared to younger patients (5.7 % vs 2.9 %; p < 0.001), mainly due to toxicity (3.4 % vs 1.8 %; p = 0.01). The incidence of grade 3-4 neutropenia (35.4 % vs 29.8 %; p = 0.006) and thrombocytopenia (0.8 % vs 0.3 %; p = 0.049) was higher for patients aged ≥65 years compared to those aged <65 years; however, there was no difference in terms of febrile neutropenia and non-hematologic toxicity.

DISCUSSION: Taxane-based adjuvant chemotherapy offers significant survival benefits in older patients with BC, similar to younger patients, yet with increased toxicity.

PMID:39787634 | DOI:10.1016/j.jgo.2024.102184

Acta Pharm. 2025 Jan 9;74(4):613-633. doi: 10.2478/acph-2024-0039. Print 2024 Dec 1.

ABSTRACT

Biowaste produced in urban parks is composed of large masses of organic matter that is only occasionally used economically. In this work, extracts of six plants widely distributed in urban parks in Central Europe (Achillea millefolium, Cichorium intybus, Malva sylvestris, Medicago sativa, Plantago lanceolata, and Trifolium pratense), prepared using 10 % and 50 % ethanol, were screened for their antidiabetic and related properties. HPLC and UV-Vis analysis revealed the presence of caffeic acid, quercetin, luteolin, and apigenin derivatives. The extracts were active in DPPH antiradical, .-carotene-linoleic acid, ORAC, and reducing power assay. They inhibited lipoxygenase, collagenase, as well as heat-induced ovalbumin coagulation. They were also able to hinder carbohydrate degradation. For example, IC ₅₀ of anti-α-amylase activity of 10 % and 50 % ethanol extract of M. sativa extracts (204.10 ± 2.11 µg mL-1 and 78.27 ± 0.99 µg mL-1, respectively) did not statistically differ from the activity of the positive control, acarbose (284.74 ± 3.81 µg mL^-1). Similar results were observed for their anti-.-glucosidase activity. In most assays, the use of 50 % ethanol was shown to be better suited for the extraction of active metabolites. The results indicate that the biowaste obtained from urban parks represents a potential source of plant material for the preparation of high-value antidiabetic products.

PMID:39787626 | DOI:10.2478/acph-2024-0039

Cir Cir. 2025 Jan 9. doi: 10.24875/CIRU.23000648. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to elucidate the histopathological pre-diagnosis of cranial gliomas with magnetic resonance imaging (MRI) techniques in gliomas.

METHOD: A total of 82 glioma patients were enrolled to our study. Pre-operative conventional MRI images (non-contrast T1/T2/flair/contrast-enhanced T1) and advanced MRI images (DAG and ADC mapping, MRI spectroscopy and perfusion MRI [PMRI]) were analyzed.

RESULTS: Conventional MRI alone is useful in radiological pre-evaluation in low-grade glioma in 54.8% and 86.3% in high-grade glioma. Additional advanced MRI techniques were beneficial in comparing low-grade gliomas in 98% and 83.9% in high-grade glioma. On ROC analysis, ADC cutoff value 0.905 mm2/s (p = 0.001), rCBV cutoff value 1.77 (p = 0.001), Cho/NAA cut-off value 2.20 (p = 0.001), and Cho/Cr cutoff value 2.01 (p = 0.001) were achieved. Significant results were obtained when ADC, Cho/NAA, and Cho/Cr were analyzed into four histopathologically grade groups besides (p = 0.001). NAA/Cr values were not significant in pathological grading. rCBV measurements were statistically significant between Grades I and IV and between II and IV.

CONCLUSION: Using additional advanced MRI techniques such as PMRI, magnetic resonance spectroscopy, and DWI with conventional MRI could enhance the accuracy of histopathological grading in cranial glioma.

PMID:39787621 | DOI:10.24875/CIRU.23000648

Obstet Gynecol. 2025 Jan 9. doi: 10.1097/AOG.0000000000005819. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe the presentation, outcomes, and management strategies for cases of subcapsular liver hematoma associated with preeclampsia, eclampsia, or HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome.

METHODS: This was a case series of individuals with subcapsular liver hematoma managed at a single level IV center over a 10-year period, from 2013 to 2024. Presenting signs and symptoms, laboratory findings, time of onset, management strategies, acute perinatal and maternal outcomes, and long-term outcomes such as subsequent pregnancies were reviewed in the medical record and recorded. Data were summarized using descriptive statistics, with results reported as means, standard deviations, and ranges. Categorical variables were summarized as counts and percentages.

RESULTS: There were 13 cases of subcapsular liver hematoma associated with preeclampsia, eclampsia, and HELLP syndrome between 2013 and 2024. In 10 of the 13 pregnancies (76.9%), delivery was preterm. The most common presenting symptoms were epigastric or right upper quadrant pain (53.8%), followed by abdominal distention (38.5%). Diagnosis of subcapsular liver hematoma was made in the antepartum period for six patients and was made in the postpartum for seven patients. The diagnosis was confirmed in all cases by computed tomography. Conservative management with close hemodynamic monitoring and transfusion of blood and blood products was sufficient in 11 (84.6%) patients; two patients underwent surgical exploration. The mean duration of hospital stay was 10 days (range 2-21 days). Maternal complications included pleural effusions, acute kidney injury, and pulmonary edema. There were no maternal deaths. There were four stillbirths and no neonatal deaths. Four people had five subsequent pregnancies; delivery was preterm in all five pregnancies, two pregnancies were complicated by subsequent HELLP syndrome, and one patient developed recurrent subcapsular liver hematoma.

CONCLUSION: Subcapsular liver hematoma is a rare complication of preeclampsia, eclampsia, and HELLP syndrome that is associated with substantial maternal and perinatal morbidities. Conservative management with hemodynamic monitoring and transfusion of blood and blood products was sufficient for management in the majority of cases. All subsequent pregnancies resulted in preterm births.

PMID:39787605 | DOI:10.1097/AOG.0000000000005819

J Med Internet Res. 2025 Jan 9;27:e57263. doi: 10.2196/57263.

ABSTRACT

BACKGROUND: Intensive care units (ICUs) handle the most critical patients with a high risk of mortality. Due to those conditions, close monitoring is necessary and therefore, a large volume of data is collected. Collaborative ventures have enabled the emergence of large open access databases, leading to numerous publications in the field.

OBJECTIVE: The aim of this scoping review is to identify the characteristics of studies using open access intensive care databases and to describe the contribution of these studies to intensive care research.

METHODS: The research was conducted using 3 databases (PubMed-MEDLINE, Embase, and Web of Science) from the inception of each database to August 1, 2022. We included original articles based on 4 open databases of patients admitted to ICUs: Amsterdam University Medical Centers Database, eICU Collaborative Research Database, High time resolution ICU dataset, Medical Information Mart for Intensive Care (II to IV). A double-blinded screening for eligibility was performed, first on the title and abstract and subsequently on the full-text articles. Characteristics relating to publication journals, study design, and statistical analyses were extracted and analyzed.

RESULTS: We observed a consistent increase in the number of publications from these databases since 2016. The Medical Information Mart for Intensive Care databases were the most frequently used. The highest contributions came from China and the United States, with 689 (52.7%) and 370 (28.3%) publications respectively. The median impact factor of publications was 3.8 (IQR 2.8-5.8). Topics related to cardiovascular and infectious diseases were predominant, accounting for 333 (25.5%) and 324 (24.8%) articles, respectively. Logistic regression emerged as the most commonly used statistical model for both inference and prediction questions, featuring in 396 (55.5%) and 281 (47.5%) studies, respectively. A majority of the inference studies yielded statistically significant results (84.0%). In prediction studies, area under the curve was the most frequent performance measure, with a median value of 0.840 (IQR 0.780-0.890).

CONCLUSIONS: The abundance of scientific outputs resulting from these databases, coupled with the diversity of topics addressed, highlight the importance of these databases as valuable resources for clinical research. This suggests their potential impact on clinical practice within intensive care settings. However, the quality and clinical relevance of these studies remains highly heterogeneous, with a majority of articles being published in low-impact factor journals.

PMID:39787600 | DOI:10.2196/57263

J Med Internet Res. 2025 Jan 9;27:e67627. doi: 10.2196/67627.

ABSTRACT

BACKGROUND: The mental health crisis among college students intensified amid the COVID-19 pandemic, suggesting an urgent need for innovative solutions to support them. Previous efforts to address mental health concerns have been constrained, often due to the underuse or shortage of services. Mobile health (mHealth) technology holds significant potential for providing resilience-building support and enhancing access to mental health care.

OBJECTIVE: This study aimed to examine the trends in mental health and well-being outcomes over 3 years among college students, with an exploratory aim to assess the potential impact of the Roadmap mHealth app on these outcomes.

METHODS: A fully automated longitudinal observational study was conducted remotely from a large public academic institution in the Midwestern United States, evaluating mental health and well-being outcomes among college students using the Roadmap mHealth app over 3 fall semesters from 2020 to 2022. The study enrolled 2164 college students in Year I, with 1128 and 1033 students returning in Years II and III, respectively. Participants completed various self-reported measures, including the Patient Health Questionnaire-9 for depression, Generalized Anxiety Disorder-7 for anxiety, and additional metrics for coping, flourishing, and loneliness.

RESULTS: The findings indicated an evolving trajectory in students’ mental health. In Year I, depression and anxiety levels were higher compared with levels reported between 2014 and 2019, remaining stable into Year II. However, significant decreases were noted by Year III for both depression (Year I mean 7.78, SD 5.65 vs Year III mean 6.21, SD 4.68; t₁₀₈=-2.90; P=.01) and anxiety (Year I mean 6.61, SD 4.91 vs Year III mean 5.62, SD 4.58; t₁₁₆=-2.02; P=.046). Problem-focused coping decreased initially from Year I (mean 2.46, SD 0.58) to Year II (mean 2.36, SD 0.60; t₁₀₇₃=-5.87; P<.001), then increased by Year III (mean 2.40, SD 0.63; t₇₀₆=2.26; P=.02). Emotion-focused (Year I mean 2.33, SD 0.41 vs Year III mean 2.22, SD 0.47; t₉₉₄=-7.47; P<.001) and avoidant coping (Year I mean 1.76, SD 0.37 vs Year III mean 1.65, SD 0.38; t₉₉₇=-8.53; P=.02) consistently decreased. Loneliness significantly decreased from Year I (mean 5.79, SD 1.74) to Year III (mean 5.17, SD 1.78; t₁₀₁₃=-10.74; P<.001), accompanied by an increase in flourishing from Year I (mean 63.78, SD 14.76) to Year III (mean 66.98, SD 15.06; t₉₉₄=7.22; P<.001). Analysis of app usage indicated that the positive piggy bank and gratitude journal were the favored activities. Greater engagement with the app was positively correlated with enhanced flourishing, even after adjusting for demographic and sociobehavioral factors (β=.04, SE .016; t₃₉₇₄=2.17; P=.03).

CONCLUSIONS: In this study, students’ mental health and well-being improved, with notable reductions in depression, anxiety, and loneliness, associated with an increase in flourishing. The app did not appear to worsen students’ mental health. Based on the usage pattern, it is possible the app enhanced positive psychology-based practices. Future research should explore the efficacy of mHealth interventions through randomized controlled trials to further understand their impact on college students’ mental health outcomes.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/29561.

PMID:39787592 | DOI:10.2196/67627