Nevin Manimala

BMC Chem. 2025 Jul 30;19(1):227. doi: 10.1186/s13065-025-01570-7.

ABSTRACT

Today’s crystal engineering in coordination chemistry community offers diverse applications and innovative bonding concepts in crystal assembly. The current research delves into synthesizing one novel Cu(II) complex, [(NO₃)Cu(H₂O)(L^2,2-Me2)(μ-H₂O)Cu(L^2,2-Me2)](H₂O)ClO₄ (L^2,2-Me2 = Schiff base) with NaClO₄. A combination of standard spectroscopic methods, including SEM-EDX, XPS, and SCXRD (single-crystal X-ray diffraction) study, was used to characterize the complex. The X-ray structure reveals that the di-nuclear Cu(II) complex crystallizes in the triclinic space group P-1, and the crystal assembly is stabilized predominantly by C-H···π interactions, as well as hydrogen bonding interactions such as N-H⋯O and O-H⋯O. A comprehensive DFT analysis, a hallmark of our research, explored the complex semiconductors and sensing capabilities for cations (Co²⁺/Ni²⁺/Cd²⁺) and anions (Br^–/I^–), providing valuable insights into the ECT (Electronic Charge Transfer) processes within the complex. MEP surface and FMO energy gap support the complex sensing and semiconductor behaviour. Antimicrobial screening reveals comparable activity for the Schiff base and its Cu(II) complex against both Gram +ve/-ve bacterial and fungal strains based on zone of inhibition (ZOI) and minimum inhibitory concentration (MIC). Meanwhile, the in vitro anticancer activity of the Cu(II) complex was assessed using the Trypan blue exclusion and MTT methods on the HepG2 and H9c2 cancer cell lines. The IC₅₀ value indicates that the Cu(II) complex exhibits significant anticancer activity. The structure-activity relationship (SAR) through the chelation/Tweedie’s polarization theory, complex geometry, hydrogen bond-type supramolecular interactions, the redox role of Cu(II) metal ions, and the generation of reactive oxygen species (ROS) by Cu(II) metal ions, which adequately explain the biological activity of the complex. Subsequently, the complex was utilized for potential applications in sensors or therapeutics, and combined DFT and biological findings underscore the novel research on the Cu(II) complex.

PMID:40739274 | DOI:10.1186/s13065-025-01570-7

Cost Eff Resour Alloc. 2025 Jul 30;23(1):38. doi: 10.1186/s12962-025-00645-5.

ABSTRACT

INTRODUCTION: Hospitals provide essential health services, focusing on quality, safety, and patient-centered care. The rising prevalence of communicable and non-communicable diseases in Indonesia has led to increased National Health Insurance (NHI) costs, with communicable diseases representing a significant burden despite global progress in disease control. Tuberculosis remains a major global health concern, causing 1.25 million deaths in 2023, while Indonesia ranks second globally for tuberculosis burden, accounting for 10% of global TB cases with an estimated 969,000 cases annually. Despite efforts to improve quality, Haji and Labuang Baji Hospitals face challenges, including financial losses and suboptimal patient outcomes. This study aims to assess the impact of an Integrated Clinical Pathway (ICP)-based Professional Nursing Practice Model on clinical outcomes, hospital costs, and patient satisfaction at these hospitals.

METHODS: This study employed action research methodology by developing, implementing, and evaluating the clinical guidelines and ICP for 10 diseases that were categorized as high volume, high risk, and high cost based on secondary data analysis using the NHI databases. Data was collected through observation of the ICP implementation on 40 patients and interviews of Professional Care Providers (PCPs) and was analyzed using IBM SPSS Statistics version 28.

RESULTS: A total of 40 patients from Haji Hospital (n = 20) and from Labuang Baji Hospital (n = 20) with diagnoses of pulmonary tuberculosis, pneumonia, dyspepsia, typhoid fever, normal delivery, and COPD were included and analyzed. Compliance with ICPs in both hospitals was quite low: 50.02% in Haji Hospital and 44.46% in Labuang Baji Hospital. However, the length of patients’ stays (LOS) generally complied with ICP standards, although some cases exceeded the benchmarks. Hospital costs varied across different disease diagnoses, impacting overall financial outcomes. Patient satisfaction improved across all diagnostic categories.

CONCLUSION: The implementation of ICP at both hospitals showed that all indicators of patient clinical outcomes improved according to the time specified in ICP, resulting in patients’ LOS being shorter than stipulated in ICP and an increase in patient satisfaction. ICP implementation has also led to hospitals earning different profits in almost all diagnoses.

PMID:40739272 | DOI:10.1186/s12962-025-00645-5

J Health Popul Nutr. 2025 Jul 30;44(1):269. doi: 10.1186/s41043-025-01013-y.

ABSTRACT

INTRODUCTION: Observational studies have indicated that individuals with hypertension (HTN) and diabetes mellitus (DM) tend to exhibit elevated plasma atherogenic index of plasma (AIP), defined as log (triglyceride [TG]/high-density lipoprotein cholesterol (HDL-C)). However, the precise relationship between these factors remains unclear. This study aimed to examine the correlations among HTN, DM, and AIP.

METHODS: Data from the National Health and Nutrition Examination Survey (NHANES; 2011-2016), a nationally representative sample, were analyzed to assess the relationship between AIP and the coexistence of HTN and DM in United States (US) adults. AIP served as the exposure variable, adjusted for 28 covariates. Baseline characteristics, correlation analysis, stratified analysis, and non-linear modeling were employed to elucidate these associations. The Extreme Gradient Boosting (XGBoost) machine learning algorithm was utilized to evaluate the predictive value of various variables for the presence of HTN and DM. Receiver operating characteristic (ROC) curve analysis was performed to assess AIP’s diagnostic accuracy for detecting HTN and DM.

RESULTS: Baseline characteristics revealed that individuals with HTN and DM had higher mean AIP values (0.39). Participants with alcohol use, obesity, or metabolic syndrome were more likely to present with both conditions. A significant positive correlation between AIP and the coexistence of HTN and DM was found (model 1: odds ratio [OR] = 5.93, 95% confidence interval [CI] = 3.84-9.16, P < 0.001; model 2: OR = 6.78, 95% CI = 4.14-11.1, P < 0.001; model 3: OR = 3.95, 95% CI = 1.66-9.39, P = 0.005), as confirmed by stratified analysis and smoothing curve analysis. The XGBoost algorithm identified AIP as an important predictor of HTN and DM. ROC curve analysis demonstrated AIP’s relatively high accuracy in predicting these conditions. Smoothing curve analysis further supported the positive associations among AIP, HTN, and DM.

CONCLUSION: This cross-sectional study highlights AIP was significantly associated with HTN combined with DM, underscoring its potential as a diagnostic tool. These findings provide valuable insights for future preventive and therapeutic approaches.

PMID:40739270 | DOI:10.1186/s41043-025-01013-y

Trials. 2025 Jul 30;26(1):263. doi: 10.1186/s13063-025-08910-x.

ABSTRACT

BACKGROUND: The United Kingdom Medical Research Council (MRC) guidance for complex interventions recommends the nesting of process evaluations in randomised controlled trials (RCTs) of complex interventions. To date, there has been limited review of how the MRC guidance has been operationalised in RCTs of complex interventions.

OBJECTIVES: This scoping review aimed to identify how process evaluations nested in RCTs on complex interventions have been conducted and reported since the 2015 publication of MRC guidance.

METHODS: We identified articles in PubMed and Scopus that cited the 2015 main journal article on the MRC guidance and applied an RCT filter to these articles. Studies reporting on RCT nested process evaluations in any field of health or social care were included. Data was extracted about study details, process evaluation study design, including methods used for data collection, data analyses, integration with RCT data and use of theory in process evaluation design.

RESULTS: We identified 160 RCTs and 53 pilot/feasibility RCTs. Most process evaluations included a combination of qualitative and quantitative data collection methods, either triangulated (mixed method studies) or not (multi-method studies). Most studies did not report the use of theory in shaping how the process evaluation was designed. Common methods for data analysis included descriptive statistics and thematic analysis for quantitative and qualitative studies respectively. There was limited triangulation of process evaluation data with RCT outcomes.

CONCLUSIONS: Whilst process evaluations can be helpful in explaining outcomes of RCT interventions and subsequent implementation of these intentions, information gathered from process evaluations is often not fully reported in papers. There are currently no suitable reporting guidelines for process evaluations linked to RCTs; work to develop such guidelines, potentially as a StaRI checklist extension, would be valuable.

PMID:40739244 | DOI:10.1186/s13063-025-08910-x

Diabetol Metab Syndr. 2025 Jul 30;17(1):302. doi: 10.1186/s13098-025-01864-9.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease, seriously threatening the public health. However, the specific role of metabolic score of visceral fat (METS-VF) as a prognostic marker in the MASLD population remains unclear. In this study, we explored the association and nonlinear relationship between METS-VF and all-cause mortality among MASLD population.

METHODS: This study included American adults aged over 20 years with MASLD who participated in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) in the United States. Kaplan-Meier curve was used to explore the relationship between different METS-VF levels and all-cause mortality. Multivariable Cox regression analysis was used to explore the independent linear relationship between METS-VF and all-cause mortality. In addition, Cox regression with restricted cubic spline functions and smooth curve fitting were used to evaluate potential nonlinear associations. An inflection point of METS-VF was determined using a two-piece Cox regression model.

RESULTS: During an average follow-up period of 23.15 years, there were 1,413 all-cause deaths and the cumulative all-cause mortality proportion was 46.6%. Kaplan-Meier curve revealed that high METS-VF significantly increased the mortality risk in the MASLD population. Multivariate Cox regression analysis revealed that METS-VF was independently associated with all-cause mortality (hazard ratio [HR]: 1.121; 95% confidence interval [CI]: 1.103-1.139; P < 0.001). Cox regression with restricted cubic spline functions and smooth curve fitting showed a J-shaped relationship between METS-VF and all-cause mortality, with an inflection point of 6.394. The HR was 1.068 (95% CI: 1.038-1.099, P < 0.001) before the inflection point and 1.143 (95% CI: 1.122-1.166, P < 0.001) after it.

CONCLUSION: This study reveals that higher METS-VF levels are significantly associated with an increased risk of all-cause mortality in individuals with MASLD, characterized by a J-shaped non-linear relationship. This finding provides a new indicator for prognosis assessment in the MASLD population.

PMID:40739243 | DOI:10.1186/s13098-025-01864-9

BMC Cancer. 2025 Jul 30;25(1):1246. doi: 10.1186/s12885-025-14583-1.

ABSTRACT

BACKGROUND: Brain metastasis is a common and serious complication in patients with non-small cell lung cancer (NSCLC), often associated with poor prognosis. While traditional diagnostic approaches such as magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) cytology are commonly used for detection, these methods have notable limitations. Circulating tumor DNA (ctDNA) in CSF has been reported as a superior alternative. This study evaluates the diagnostic test accuracy of CSF ctDNA for CNS metastases detection in patients with NSCLC, in comparison to CSF cytology, while also examining its potential prognostic value.

METHODS: A systematic search was conducted to identify studies that reported CSF ctDNA detection in NSCLC patients with brain or leptomeningeal metastases. Pooled detection rates, sensitivity, specificity, and diagnostic odds ratios were meta-analyzed. Heterogeneity and publication bias were assessed using standard statistical methods. Subgroup and sensitivity analysis were applied to identify and address source of high heterogeneity.

RESULTS: Twenty-six studies were included. The pooled detection rate of CSF ctDNA (86%, 95% CI: 0.79-0.91) was significantly higher than CSF cytology (60%, 95% CI: 36% % 81%). Diagnostic test accuracy analysis for CSF ctDNA showed high pooled sensitivity (91.8%, 95% CI: 74.2%-97.8%), specificity (93.5%, 95% CI: 76.7% – 98.5%) and diagnostic odds ratio (DOR) (93.51%, 95% CI: 13.85-631.44). Additionally, CSF ctDNA detected clinically relevant mutations that correlated with poorer overall survival, highlighting its prognostic potential.

CONCLUSION: CSF ctDNA demonstrates superior diagnostic accuracy for detecting CNS metastases in NSCLC compared to CSF cytology. Its molecular insights may support earlier detection and inform personalized treatment strategies. However, further validation in clinical settings is required.

PMID:40739228 | DOI:10.1186/s12885-025-14583-1

BMC Oral Health. 2025 Jul 30;25(1):1282. doi: 10.1186/s12903-025-06596-w.

ABSTRACT

BACKGROUND: Maxillary tuberosity and buccal plate fractures are common complications observed during routine extractions of upper third molars in daily dental practice. The study aimed to evaluate the association between buccal and palatal cortical bone thickness around upper third molars, the dimensions of the maxillary tuberosity, and the anatomical characteristics of the upper third molars.

METHODS: This retrospective cross-sectional study analyzed 227 cone beam computed tomography (CBCT) scans retrieved from the archives of the University Dental Hospital of Sharjah (UDHS). Measurements included the buccal and palatal cortical bone thickness surrounding the upper third molars. The width, height, and length of the maxillary tuberosity were also evaluated, along with the anatomical features of the third molars. Data were analyzed using SPSS. Descriptive statistics, t-test, ANOVA, ANCOVA, and Pearson’s correlation were applied.

RESULTS: The palatal cortical bone was significantly thicker than the buccal cortical bone (p = 0.011). The mean width, height, and length of the maxillary tuberosity were 8.78 ± 1.897 mm, 8.86 ± 3.262 mm, and 4.86 ± 1.490 mm, respectively. Males exhibited significantly greater mean tuberosity width and length compared to females (p < 0.001). Buccal cortical bone thickness positively correlated with tuberosity height (p < 0.001) and negatively with tuberosity width (p = 0.004). ANCOVA showed significant effects of root number (F = 3.107, p = 0.047) and age group (F = 2.854, p = 0.025) on buccal cortical bone thickness, with no significant interaction between gender and jaw side (p > 0.05). Additionally, a significant difference in tuberosity width (p = 0.002) was also observed across age groups. Furthermore, a positive correlation was found between tuberosity height and the root length of the associated upper third molar (p < 0.001).

CONCLUSIONS: The anatomical dimensions of the maxillary tuberosity and surrounding cortical bone of upper third molars were influenced by age, while sex affected only tuberosity dimensions. Additionally, correlations among upper third molar anatomy, cortical bone thickness, and tuberosity dimensions highlight the importance of thorough anatomical assessment and CBCT analysis to minimize surgical complications during upper third molar extractions.

PMID:40739227 | DOI:10.1186/s12903-025-06596-w

BMC Musculoskelet Disord. 2025 Jul 30;26(1):734. doi: 10.1186/s12891-025-09003-1.

ABSTRACT

BACKGROUND: Preservation of the infrapatellar fat pad (IPFP) during total knee arthroplasty (TKA) is associated with a lower incidence of postoperative anterior knee pain (AKP). However, the comparative efficacy of IPFP preservation remains unclear. The objective of this randomized controlled trial (RCT) was to compare the incidence of AKP between IPFP preservation and partial excision of the IPFP.

METHODS: This prospective RCT included patients with primary varus gonarthrosis < 20° who underwent unilateral computer-assisted TKA between March 2019 and November 2020. Patients were randomly assigned to the partial excision or preservation groups. The intraoperative and postoperative protocols were the same in each group. The incidence and severity of AKP, range of motion (ROM), and modified Western Ontario and McMaster Universities Arthritis Index (WOMAC) score were assessed at 1, 3, 6, and 12 months postoperatively and then annually thereafter. The pre- and postoperative Insall-Salvati ratio (ISR) and mechanical alignment (MA) were also evaluated.

RESULTS: A total of 57 patients were included (27 in the partial excision group and 30 in the preservation group). At 1 month postoperatively, the preservation group had a significantly lower incidence of anterior knee pain (AKP) than the partial excision group (33.3% versus 77.8%, p = 0.001). The visual analogue scale (VAS) pain score was also significantly lower in the preservation group at 1 month (1.2 ± 2.0 vs. 2.4 ± 1.6, p < 0.05). However, these differences were not observed at later follow-up time points (3, 6, or 12 months). Modified WOMAC scores, range of motion (ROM), mechanical alignment (MA), and Insall-Salvati ratio (ISR) did not differ significantly between groups at any time point. Although a statistically significant difference in WOMAC score was observed at 6 months, the magnitude of this difference was below the minimal clinically important difference (MCID), indicating limited clinical relevance.

CONCLUSION: IPFP preservation during TKA reduced the incidence and severity of subacute postoperative AKP.

LEVEL OF EVIDENCE: I. Trial registration Thai Clinical Trials Registry, TCTR20220215011 Registered 08/02/2022 – Retrospectively registered, https://www.thaiclinicaltrials.org/show/TCTR20220215011 .

PMID:40739226 | DOI:10.1186/s12891-025-09003-1

BMC Public Health. 2025 Jul 30;25(1):2591. doi: 10.1186/s12889-025-23977-6.

ABSTRACT

BACKGROUND: Health-related quality of life (HRQoL) is a vital measure of overall well-being and is influenced by chronic conditions and unhealthy lifestyle behaviors. This study aimed to investigate the impact of chronic conditions and unhealthy behaviors on HRQoL among Iranian women aged 18 years and older.

METHODS: A national cross-sectional study was conducted in 2024-2025 among 1,803 women from nine provinces in Iran using a convenience sampling method. Data were collected through face-to-face interviews using a structured questionnaire that included sociodemographic characteristics, lifestyle behaviors, chronic disease status, and the validated Iranian versions of the EQ-5D-5 L (hereafter referred to as EQ-5D) and EQ-VAS instruments to assess HRQoL. Given that the dependent variables (EQ-5D utility values and EQ-VAS scores) were not normally distributed and heteroscedasticity was detected, multivariable regression analyses were performed using a generalized linear model (GLM) with robust standard errors, adjusted age, marital status, level of education, place of birth, province, and self-assessed household economic status.

RESULTS: Approximately 23.8% of participants reported at least one chronic condition. Women with chronic diseases had significantly lower EQ-5D index (mean = 0.62) and EQ-VAS scores (mean = 64.5) compared to those without (EQ-5D = 0.81, EQ-VAS = 76.1). Unhealthy behaviors, including poor physical activity, poor sleep quality, alcohol consumption, and smoking were all significantly associated with lower HRQoL scores (p-value < 0.05 in univariate analysis). Among these, poor sleep quality demonstrated the strongest negative association with both EQ-5D index and EQ-VAS scores. The GLM analyses indicated that chronic conditions and unhealthy behaviors, poor physical activity, poor sleep quality, and alcohol consumption were independently associated with significantly lower HRQoL after controlling for confounding factors.

CONCLUSION: Chronic diseases and unhealthy lifestyle behaviors significantly diminish HRQoL among Iranian women. Public health interventions targeting these modifiable factors, especially improving sleep quality and promoting physical activity, are essential to enhance women’s well-being in Iran and similar settings.

PMID:40739224 | DOI:10.1186/s12889-025-23977-6

BMC Oral Health. 2025 Jul 30;25(1):1276. doi: 10.1186/s12903-025-06633-8.

ABSTRACT

OBJECTIVE: This investigation evaluates Endothelial Cell-Specific Molecule-1 (Endocan), an endothelial-derived protein, for its capacity to discriminate between healthy and pathological peri-implant tissues and its diagnostic potential in peri-implant disease.

MATERIALS AND METHODS: This cross-sectional investigation analyzed 62 peri-implant sites from 62 individuals, including 31 healthy sites, chosen according to clinical and radiographic parameters based on 2017 consensus recommendations. Collection of peri-implant crevicular fluid (PICF) utilized paper point methodology, with Endocan quantification performed through enzyme-linked immunosorbent assay (ELISA) techniques. Statistical analysis included multivariable linear regression models to evaluate associations between disease status and Endocan levels, adjusting for demographic factors.

RESULTS: Endocan levels demonstrated a clear disease progression pattern. Healthy sites showed the lowest levels (643.66 ± 128.49 ng/L), while peri-implantitis sites exhibited significantly elevated concentrations (841.83 ± 62.72 ng/L, p < 0.001). Peri-implant mucositis sites (671.99 ± 133.00 ng/L) were not significantly different from healthy sites (p = 0.757). Modeling demonstrated that peri-implantitis exhibited significant correlation with increased Endocan concentrations (B = 187.74, p < 0.001), while peri-implant mucositis showed no significant association (p = 0.431). Additionally, younger age, female sex, and smoking were independently associated with higher Endocan concentrations.

CONCLUSIONS: Endocan demonstrates specificity as a biomarker for peri-implantitis, showing capacity to differentiate advanced peri-implant pathology from healthy tissues and peri-implant mucositis. These results suggest Endocan’s potential utility for disease staging and monitoring in peri-implant care, providing a foundation for biomarker-based diagnostic approaches in implant dentistry.

PMID:40739222 | DOI:10.1186/s12903-025-06633-8