Nevin Manimala

Res Nurs Health. 2025 Nov 22. doi: 10.1002/nur.70032. Online ahead of print.

ABSTRACT

Black, Hispanic, and multiracial women in the U.S. experience higher rates of discrimination and mistreatment in perinatal care compared to White women, which can lead to fear, anxiety, and reduced engagement with obstetric healthcare providers. Black women are also more likely to experience high-risk pregnancies and health complications such as gestational diabetes and hypertensive disorders. As a result, Black women face a heightened risk of birth trauma and subsequent posttraumatic stress disorder (PTSD) in the postpartum period. Despite these inequities, little is known about Black birthing individuals’ experiences of healthcare interactions. This study explores Black women’s accounts of negative experiences of perinatal care in the context of high-risk pregnancy. Fourteen individuals from across the U.S. participated in semi-structured interviews conducted within 6 months postpartum between September 2022 and December 2024. Interview responses were analyzed using directed content analysis, with coding of their emotional distress guided by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) definition of PTSD. Their accounts aligned with the four DSM-5-TR symptom clusters: intrusive symptoms, avoidance, negative alterations in cognition or mood, and alterations in arousal and reactivity. PTSD-like symptoms resulted from pregnancy complications, traumatic birth experiences, mistreatment by clinicians or a combination of these factors. The findings suggest that birth trauma and mistreatment in perinatal care have significant emotional and behavioral impacts on Black women. The study results underscore the urgent need for trauma-informed, antiracist approaches in perinatal care to address these disparities and improve outcomes for Black birthing individuals.

PMID:41273178 | DOI:10.1002/nur.70032

Mil Med. 2025 Nov 22:usaf572. doi: 10.1093/milmed/usaf572. Online ahead of print.

ABSTRACT

INTRODUCTION: The limb symmetry index (LSI) is a common tool for evaluating functional performance across a variety of populations. An LSI of ≥90% is a common, generally accepted clinical threshold for patients with musculoskeletal injuries to achieve before returning to activity. This study’s aims were to: (1) describe normative symmetry characteristics and evaluate the influence of sex and limb dominance during functional tasks in healthy, entry-level U.S. Marines, and (2) describe the relationship between symmetry performance across all functional tasks.

MATERIALS AND METHODS: This was a cross-sectional study including 651 active duty U.S. Marines with no current injuries (187F/464M, 19.9 ± 2.4 years, limb dominance 59L/592R, 4.8 ± 3.2 months of service). Limb dominance was defined as the preferred limb to kick a soccer ball. Participants completed 5 repetitions of bodyweight bilateral squats and maximal effort vertical jumps using a natural arm swing. Peak eccentric and concentric force (N) were recorded bilaterally on dual force plates for the squat and jump. Participants completed an isometric midthigh pull (IMTP) by standing atop force plates with their knees and hips flexed at approximately 40-50° and 35°, respectively. A fixed bar was positioned at the midpoint between the hips and knees. Participants pulled up as hard and as fast as possible and held a maximal effort for 3-5 seconds for 3 repetitions. Peak vertical force (N) was recorded bilaterally. Force values were normalized to participants’ body mass (N/kg). Limb symmetry index was calculated as nondominant limb/dominant limb*100%. Independent sample t-tests determined significant differences in LSI force variables and sexes. Paired t-tests evaluated significant differences in loading between dominant and nondominant limbs. Effect sizes were evaluated via Cohen’s d values. Pearson correlations coefficients (r) described the relationship between all dependent variables across all tasks.

RESULTS: Across all tasks and variables, there were no differences in LSI values across sexes (P > .05). Regardless of sex, participants loaded more of their body mass on their dominant limb compared to their nondominant limb with weak-to-small effect sizes (d: 0.22-0.34). Squat LSI had a weak-to-moderate positive relationship with LSI during the vertical jump (r: 0.13-0.69). No other significant relationships were observed (P > .05).

CONCLUSIONS: Our study provides stakeholders (e.g., military personnel, clinicians, researchers, etc.) normative ranges of LSI performance values during a bodyweight bilateral squat, vertical jump, and IMTP tasks in a large healthy active duty population. Sex does not appear to influence LSI performance; however, limb dominance may influence loading patterns during these specific functional tasks. Given the similarities between the squat and vertical jump performance, future work should be conducted to determine if stakeholders should eliminate one of these tasks from the testing battery to mitigate the temporal burden required when completing functional task assessments in healthy active individuals.

PMID:41273162 | DOI:10.1093/milmed/usaf572

Paediatr Anaesth. 2025 Nov 22. doi: 10.1111/pan.70080. Online ahead of print.

ABSTRACT

BACKGROUND: The bispectral index (BIS) represents a promising tool for monitoring the depth of hypnosis. However, its utility in guiding sevoflurane administration during general anesthesia in pediatric patients is not well known.

METHODS: We performed a systematic review and meta-analysis of randomized controlled trials comparing BIS-guided versus standard practice sevoflurane administration in pediatric patients. PubMed/MEDLINE, Embase, and the Cochrane Central Register of Clinical Trials were searched for trials published up to May 2025. Analyses were conducted using RevMan 5.4.1., and heterogeneity was assessed using the I² statistic.

RESULTS: We included nine studies randomizing a total of 730 pediatric patients, of whom 359 (49.2%) were managed with BIS monitoring. BIS-guided anesthesia was associated with significantly lower mean end-tidal sevoflurane concentrations, both during the maintenance phase (MD -0.46; 95% CI: -0.62 to -0.29; p < 0.00001) and at the end of surgery (MD -0.31; 95% CI: -0.47 to -0.14; p = 0.0003). Furthermore, the BIS-guided group experienced a shorter time to airway removal (MD -1.69 min; 95% CI: -2.84 to -0.55 min; p = 0.004) and a shorter time to post-anesthesia care unit discharge (MD -11.82 min; 95% CI: -17.80 to -5.84 min; p = 0.0001). No significant difference was observed in Pediatric Anesthesia Emergence Delirium score between groups (MD -0.35; 95% CI: -1.90 to 1.19; p = 0.65).

CONCLUSIONS: BIS-guided monitoring offers a strategy to reduce end-tidal sevoflurane concentrations, shortening time to airway removal and post-anesthesia care unit discharge in pediatric patients undergoing sevoflurane anesthesia.

STUDY REGISTRATION: PROSPERO, review no. CRD420251067409.

PMID:41273159 | DOI:10.1111/pan.70080

J Econ Entomol. 2025 Nov 22:toaf320. doi: 10.1093/jee/toaf320. Online ahead of print.

ABSTRACT

Drosophila suzukii (Matsumura), spotted-wing drosophila, is an invasive pest native to East Asia that causes significant economic losses in soft-skinned high-value fruit like blueberries. Current management strategies heavily rely on insecticide applications, raising concerns about resistance and sustainability. This study evaluated the efficacy of plant-derived volatile blends, including Decoy Attract and Kill (A&K) (Batch no. 24026021), Combi-protec (Batch no. SP2211XXUS), Decoy (Batch no. 42022121, 10% citric acid), and fermentation-based volatiles of Scentry experimental blend (SEB) (Batch no. SBI2024200-005), and Droski drink (acetic acid) as potential behavioral disruptors that reduce D. suzukii oviposition without insecticide use. These five volatile blends, except Decoy and Droski drink have undisclosed active ingredients. Three concentrations of Decoy A&K (0.5, 2, and 5 mM) and four other blends were tested using Drosophila activity monitor (DAM), electroantennography (EAG), laboratory behavioral trials, and exclusion cage semi-field oviposition trials. DAM quantified positional preference and dwell time to blends, while EAG measured antennal responses to Decoy A&K. Laboratory behavioral trials assessed oviposition and dwelling behaviors, while exclusion caged semifield trials evaluated oviposition behavior alone. Decoy A&K, Combi-protec, and Decoy significantly increased dwell time and reduced oviposition on blueberries, both in controlled and semi-field conditions. EAG responses showed that D. suzukii can detect Decoy A&K volatiles through olfaction, likely mediating the observed behavioral results. These findings highlight the potential of selected volatile blends as tools for behavioral disruption, supporting their application in integrated pest management strategies, including push-pull or attract-and-kill systems for D. suzukii.

PMID:41273152 | DOI:10.1093/jee/toaf320

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