Nevin Manimala

J Am Acad Orthop Surg Glob Res Rev. 2025 Aug 19;9(8). doi: 10.5435/JAAOSGlobal-D-25-00002. eCollection 2025 Aug 1.

ABSTRACT

BACKGROUND: Clinical research is an integral component of orthopaedic practice with the purpose of advancing the field and improving patient care. The Journal of Bone and Joint Surgery (JBJS) is a well-respected journal with a high impact factor and considerable influence on clinical practice. To our knowledge, there has been no systematic evaluation highlighting the variety of research published in this journal. Therefore, the purpose of this study was to evaluate trends in characteristics of articles published in JBJS from 2012 to 2022, including type of study, level of evidence, author information, and country of publication.

METHODS: Articles published in JBJS between 2012 and 2022 were retrieved from the JBJS Archives. Title, level of evidence, description of the study as delineated in the abstract, first author degree, number of authors, and country of publication were recorded for each published article.

RESULTS: A total of 2668 articles were published in JBJS from 2012 to 2022. The proportion of preclinical studies published per year significantly decreased (P = 0.0025), whereas no statistically significant change was observed in the proportion of clinical studies (P = 0.34). A significant increase was noted in the proportion of database studies published (P = 0.00012). Studies classified as level II decreased over the study period (P = 0.029), whereas level III increased over the study period (P = 0.034). The average number of authors per article was 6 ± 3 authors with a significantly increasing trend over the study period (P = 0.0043). The proportion of first authors who were MD or equivalent decreased (P = 0.025), whereas first authors who were non-MD or non-PhD equivalent increased (P = 0.0068).

CONCLUSION: The publication trends in JBJS over the past decade demonstrate the changing landscape of orthopaedic research as it aims to address the burden of musculoskeletal injury and disease.

PMID:40828978 | DOI:10.5435/JAAOSGlobal-D-25-00002

Gen Dent. 2025 Sep-Oct;73(5):42-47.

ABSTRACT

The aim of this study was to evaluate the shear bond strength and Adhesive Remnant Index (ARI) of ceramic brackets bonded to enamel using a universal adhesive system free of bisphenol A glycidyl methacrylate (Bis-GMA). A total of 100 bovine incisors were divided into 2 groups (n = 50) that received ceramic brackets (Morelli Ceramic or Ice Clear) bonded after acid etching and application of 1 of 5 adhesive systems (n = 10): Adper Single Bond 2, a conventional adhesive system (control group); Scotchbond Universal Plus, a Bis-GMA-free universal adhesive system; and Single Bond Universal, BeautiBond Xtreme, and BeautiOrtho Bond II, all Bis-GMA-containing universal adhesives. Shear bond strength was tested in a universal testing machine (50-kgf load cell; 0.5 mm/min crosshead speed), and the ARI was analyzed under ×20 magnification. Statistical analysis included a generalized linear model with Fisher exact test, Kruskal-Wallis test with post hoc Dunn test, and Mann-Whitney U test; the significance level was set at 5%. No statistically significant differences in shear bond strength were observed among the adhesive systems (P = 0.7821) or their interactions with bracket type (P = 0.5449). A significant difference was found when bracket types were compared (P < 0.0001), with the Morelli Ceramic bracket groups showing the highest bond strengths regardless of the adhesive system used. A significant association between adhesives and the Morelli Ceramic bracket was observed for the ARI score (P = 0.0018), with 100% of specimens in the Scotchbond Universal Plus adhesive group retaining more than half of the resin on the tooth. The Bis-GMA-free universal adhesive system achieved the highest percentage of adhesive retention on the tooth for both bracket types.

PMID:40828557

Gen Dent. 2025 Sep-Oct;73(5):36-40.

ABSTRACT

Nonodontogenic cysts and pseudocysts pose diagnostic challenges due to their similarity to other maxillofacial lesions in clinical and radiographic appearance. However, these lesions are studied less frequently than odontogenic lesions. This retrospective cross-sectional study aimed to evaluate the frequencies and characteristics of nonodontogenic lesions in an Iranian population over a 20-year period. Archived records of 7036 patients referred to the Department of Oral and Maxillofacial Pathology, Shahid Beheshti University Faculty of Dentistry, Tehran, were reviewed. Data on the age and sex of the patients and the type, clinical and radiographic features, and histopathologic diagnoses of the lesions were collected. Statistical analyses included Fisher exact, Kruskal-Wallis, and chi-square tests, and a value of P < 0.05 was considered statistically significant. Nonodontogenic cysts were found in 0.5% of all referred patients, while pseudocysts were identified in 2.6%. After a review of records, 218 patients with a confirmed diagnosis of oral pseudocysts or nonodontogenic cysts were included in a more detailed analysis. Mucocele was the most common lesion (63.8%), followed by simple bone cyst (13.8%) and nasopalatine duct cyst (11.9%). The mean (SD) age of these patients was 30.5 (15.7) years, and 53.7% of all the lesions occurred in men. Statistically significant relationships were observed between cyst type and sex (P = 0.001; Fisher exact test), age (P < 0.001; Kruskal-Wallis test), and location (P < 0.001; chi-square test). Most pseudocysts occurred on the lower lip, while nonodontogenic cysts and intraosseous pseudocysts were predominantly found in the maxilla and mandible, respectively. The results of this study highlight the varied demographics and clinical and radiographic presentations of nonodontogenic cysts and pseudocysts, emphasizing the need for thorough radiographic and histopathologic analyses to guide appropriate treatment strategies.

PMID:40828556

Gen Dent. 2025 Sep-Oct;73(5):28-34.

ABSTRACT

Periodontitis is an inflammatory destructive condition influenced by obesity and type 2 diabetes mellitus (T2DM). Apelin, a bioactive peptide, is linked to periodontitis, obesity, and T2DM. This study aimed to investigate apelin levels in individuals with periodontitis who are affected by obesity and T2DM. This cross-sectional observational study included 84 participants categorized into 3 main groups of 24 patients based on their periodontal status, body mass index (BMI), and glycated hemoglobin (HbA_1c) levels. Group 1 comprised systemically healthy participants, group 2 comprised individuals with obesity (BMI of 30.0 to 39.0 kg/m2), and group 3 comprised individuals with both obesity and T2DM (HbA_1c of 6.5% to 8.5%). Each group was subcategorized based on the presence or absence of chronic periodontitis (CP), resulting in 6 subgroups with 14 participants each. The clinical parameters assessed included the Sulcus Bleeding Index (SBI), probing depth (PD), clinical attachment loss (CAL), BMI, and HbA_1c level. Apelin levels in serum and saliva were quantified using enzyme-linked immunosorbent assay. Data were analyzed using 1-way analysis of variance and independent samples t test. Pearson correlation coefficients were calculated to assess relationships between different parameters. Within groups, individuals with CP had lower serum and salivary levels of apelin than those without CP, and the differences were statistically significant except in the case of salivary levels in patients with obesity (P < 0.05). Individuals with obesity, as well as those with both T2DM and obesity, had elevated levels of serum apelin compared with systemically healthy individuals. A significant negative correlation was observed between serum apelin and periodontal parameters (SBI, PD, and CAL) in specific subgroups. Apelin could be a valuable biomarker for evaluating periodontal disease affected by obesity and T2DM. However, further longitudinal research with a larger patient sample is needed. Trial registration: Clinical Trials Registry – India No. CTRI/2019/02/017522.

PMID:40828555

Int J Geriatr Psychiatry. 2025 Aug;40(8):e70140. doi: 10.1002/gps.70140.

ABSTRACT

OBJECTIVES: In a sample of community-dwelling older adults, we examined the association of Alzheimer’s Disease and Related Dementias (AD/ADRD) blood-based biomarkers (BBMs) and neuropsychiatric symptoms (NPS) and whether informant type (i.e., spouse vs. child vs. other) modified that association.

METHODS: This study included 430 participants with a cognitively unimpaired or mild cognitive impairment consensus diagnosis from the Wake Forest Alzheimer’s Disease Research Center Clinical Core cohort. Informants reported NPS using the Neuropsychiatric Inventory Questionnaire. AD/ADRD BBMs included the Aβ42/40 ratio, p-tau181, p-tau217, NfL, and GFAP. Generalized linear models were used to examine the associations between AD/ADRD BBMs and NPS. Secondary models adjusted for age, sex, education, race, and cognitive status. Tertiary models adjusted for covariates in secondary models, as well as informant type. Interactions between informant type and AD/ADRD BBMs were examined.

RESULTS: Higher p-tau217 was associated with higher NPS in both unadjusted models and models adjusted for demographics and cognitive status. This association was attenuated and no longer statistically significant after additionally adjusting for informant type. Significant interactions of informant type and p-tau181 or p-tau217 on NPS were demonstrated, where p-tau181 or p-tau217 were more strongly associated with NPS reported by children compared to spouses.

CONCLUSIONS: Informant type modified the association between AD/ADRD BBMs and NPS, with stronger associations observed when symptoms were reported by child informants compared to spouse informants. These findings have important implications for earlier detection of individuals with AD/ADRD pathologies.

PMID:40828547 | DOI:10.1002/gps.70140

J Acquir Immune Defic Syndr. 2025 Aug 19. doi: 10.1097/QAI.0000000000003747. Online ahead of print.

ABSTRACT

BACKGROUND: We assessed an adaptation of a mobile HIV prevention smartphone app, HealthMindr-PrEP, to assess its effectiveness to increase pre-exposure prophylaxis (PrEP) uptake among gay and bisexual men who have sex with men (GBMSM).

SETTING: This study was conducted online among GBMSM living in Ending the HIV Epidemic priority jurisdictions, primarily in the southern United States.

METHODS: We conducted a randomized controlled trial in which participants were randomly assigned to receive the intervention app or an app that only allowed participants to track their study progress. The primary outcome was self-reported PrEP uptake. Cox proportional hazards models were used to compare the rate of PrEP uptake across study arms.

RESULTS: Although no results were statistically significant, the rate of PrEP initiation was higher among participants in the intervention arm compared to the control arm, particularly among participants with PrEP indications at baseline. Among those with PrEP indications at baseline, participants in the intervention arm had a 64% higher rate of PrEP initiation compared to the control arm (hazard ratio = 1.64, 95% CI: 0.89, 3.03). Among those without PrEP indications, the same hazard ratio was 1.05 (95% CI: 0.67, 1.66).

CONCLUSION: Our results suggest that HealthMindr-PrEP increases the rate of PrEP uptake compared to a standard of care control condition; however, we had insufficient statistical power for stratified analyses that demonstrated the strongest effect was among those who had PrEP indications at baseline.

PMID:40828543 | DOI:10.1097/QAI.0000000000003747

JAMA Netw Open. 2025 Aug 1;8(8):e2527464. doi: 10.1001/jamanetworkopen.2025.27464.

ABSTRACT

IMPORTANCE: Genetic testing is the criterion standard for diagnosing neurodevelopmental disorders (NDDs), with chromosomal microarray analysis (CMA) used as a first-line test for autism, intellectual disability, or global developmental delay. Despite advancements in genetic testing technologies and integration into health care systems, data on clinical use remain limited.

OBJECTIVE: To evaluate genetic counseling and testing rates in patients with major NDDs and these individuals’ clinical and sociodemographic characteristics.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal, retrospective, population-based cohort study analyzed electronic health records of individuals born between 2000 and 2020 and insured by Clalit Health Services, the largest health maintenance organization in Israel. Follow-up extended through December 6, 2023. Patients diagnosed with autism spectrum disorder, intellectual disability or global developmental delay, epilepsy, or cerebral palsy (major NDDs) were included.

EXPOSURE: Neurodevelopmental disorders.

MAIN OUTCOMES AND MEASURES: The outcome was the rate of genetic counseling, CMA testing, and NDD diagnosis measured using descriptive statistics.

RESULTS: Of 2 406 763 individuals born in Israel between 2000 and 2020, 25 403 (1.06%; mean [SD] age at December 6, 2023, 11.9 [4.3] years; 68.7% male) were diagnosed with a major NDD. The cohort was predominantly of middle socioeconomic status (56.5%), and autism was the most common diagnosis (40.6%). Among 18 709 children indicated for CMA (ie, those with autism, intellectual disability or global developmental delay, or multiple diagnoses), 7233 (38.7%) received genetic counseling, and 4592 (24.5%) underwent testing (63.5% of those counseled). Genetic testing rates were higher in children with multiple co-occurring NDDs (1478 of 4005 [36.9%]) compared with those with autism alone (2189 of 10 311 [21.2%]). Genetic counseling rates were lowest for cerebral palsy and epilepsy as guidelines were less established. Genetic evaluation rates increased with more recent birth cohorts. While evaluation rates were similar across subpopulations for children with a diagnosis, initial autism diagnosis rates were 54% to 83% lower in lower socioeconomic status and minority populations, limiting access to counseling and testing.

CONCLUSIONS AND RELEVANCE: A key finding of this cohort study was that more than one-third of patients who received genetic counseling did not undergo testing. Furthermore, low socioeconomic status and minority populations experienced drastic underdiagnosis of autism. These findings underscore the need for national initiatives to improve awareness and access to counseling and testing for all major NDDs and the recognition of autism in minority groups.

PMID:40828538 | DOI:10.1001/jamanetworkopen.2025.27464

Transl Vis Sci Technol. 2025 Aug 1;14(8):25. doi: 10.1167/tvst.14.8.25.

ABSTRACT

PURPOSE: This study presents an artificial intelligence (AI)-based system for measuring eyeball rotation angles, which is a key symptom in assessing eye disease severity. The system aims to accurately segment the optic disc and macula, and compute the eyeball rotation angle based on these features.

METHODS: The system consists of three modules: optic disc segmentation, macular segmentation, and measurement. The optic disc segmentation module utilizes the Efficient-UNet3+ network to address sample imbalance and irregular edge detection of the optic disc. The macular segmentation module uses the Efficient-UNet based on Dual Attention network (DA-EUNet) to enhance macular recognition and boundary feature detection while suppressing irrelevant background interference. The measurement module calculates the eyeball rotation angle by locating the centers of the optic disc and macula and determining the angle between the line connecting these centers and the horizontal vector.

RESULTS: The proposed method demonstrated high accuracy, with a correlation coefficient of 0.94 compared to expert measurements. Statistical analysis revealed no significant difference between the AI-based measurements and expert assessments (P = 0.26).

CONCLUSIONS: This system achieves high accuracy and reliability in clinical diagnostics. The segmentation techniques used significantly improve feature recognition and segmentation performance, enabling accurate measurements of eyeball rotation.

TRANSLATIONAL RELEVANCE: This AI-based system bridges the gap between basic research in medical image processing and clinical care. It provides an automated and reliable tool for ophthalmologists to assess eyeball rotation, which is crucial for diagnosing eye diseases. Eyeball rotation can occur in many eye diseases or systemic diseases, and measuring the eyeball rotation angle has been a challenging issue in clinical practice. By automating this process, the system reduces the clinicians’ workload and enhances diagnostic consistency.

PMID:40828527 | DOI:10.1167/tvst.14.8.25

Invest Ophthalmol Vis Sci. 2025 Aug 1;66(11):44. doi: 10.1167/iovs.66.11.44.

ABSTRACT

PURPOSE: To investigate the diurnal variations of episcleral venous pressure (EVP) and its relationships with IOP, blood pressure, and heart rate in healthy and systemic hypertension subjects.

METHODS: Twenty healthy adults and eight patients taking systemic antihypertensive medications were enrolled. IOP and EVP of both eyes, systolic and diastolic blood pressure (SBP and DBP), and heart rate (HR), were measured at five time points, every two hours from 8 AM to 4 PM. IOP was measured by pneumatonometry, and EVP was assessed using a computer-controlled episcleral venomanometer with video recording and image processing. Changes in measurements at each time point were compared with baseline (8 AM) by using generalized estimating equation models. Correlations between EVP and other variables were determined using linear regression analysis.

RESULTS: EVP and IOP were highest in the early morning (8 AM) and lowest in the late afternoon (4 PM), with statistically significant changes (P < 0.05) across all time points compared to baseline in normotensive subjects. Changes in EVP and IOP were correlated at all time points. In treated systemic hypertensive subjects, similar trends were observed, with significant IOP and EVP correlations at multiple time points. No clear pattern of correlation was noted between EVP, SBP, DBP, and HR in all subjects.

CONCLUSIONS: IOP and EVP follow a diurnal rhythm with the highest values in the early morning, which gradually decrease throughout the day. The relationship between IOP and EVP suggests that reduction of EVP can be an important target for clinical regulation and stability of IOP.

PMID:40828522 | DOI:10.1167/iovs.66.11.44

Int Urol Nephrol. 2025 Aug 19. doi: 10.1007/s11255-025-04724-7. Online ahead of print.

ABSTRACT

BACKGROUND: Lower urinary tract dysfunction (LUTD) is a potential late effect in childhood cancer survivors, often overlooked in survivorship care. Neurotoxic chemotherapy, pelvic tumors, and radiation exposure may contribute to its development.

OBJECTIVES: To determine the prevalence and severity of LUTD in childhood cancer survivors and identify associated risk factors.

METHODS: A prospective observational study was conducted over six months among 92 childhood cancer survivors aged ≥ 5 years to 10 years. Participants were screened using the LUTD Scoring System (DVSS). A score ≥ 9 in males and ≥ 6 in females was considered diagnostic of LUTD. Clinical and treatment-related variables were extracted from medical records and analyzed for associations. Uroflowmetry and ultrasonography were performed in children with abnormal DVSS to further assess voiding pattern and bladder parameters.

RESULTS: LUTD was identified in 20 of 92 participants (21.7%), with a higher prevalence in females (31.6%) compared to males (14.8%), though this difference was not statistically significant (p = 0.073). Significant associations were observed with pelvic tumors (p = 0.002; Φ = 0.394), pelvic irradiation (p < 0.001; Φ = 0.455), Vinca alkaloid use (p = 0.035; Φ = 0.307), and high cumulative alkylating agent dose (> 8000 mg/m²) (p = 0.017; Φ = 0.267). Uroflowmetry confirmed abnormal voiding patterns in 95% of DVSS-positive patients. Most cases were managed conservatively with bladder training, while a subset required anticholinergics or laxatives.

CONCLUSION: LUTD is prevalent among childhood cancer survivors, particularly those exposed to Vinka alkaloids and pelvic-directed therapies. Routine LUTD screening using DVSS should be integrated into long-term follow-up protocols for early detection and intervention.

PMID:40828499 | DOI:10.1007/s11255-025-04724-7