Tag: nevin manimala

Spine Deform. 2025 Sep 20. doi: 10.1007/s43390-025-01190-0. Online ahead of print.

ABSTRACT

PURPOSE: Sagittal spinopelvic alignment (SPA) is originally calculated by the algebraic expression pelvic incidence-lumbar lordosis (PI-LL), heralded numerous clinically relevant radiographic measures of spine alignment, e.g., T4-L1-pelvic angle. SPA malalignment compromises spine fusion outcomes and quality of life of typically aging persons. This study investigated gait and SPA of patients with cerebral palsy (CP) using multiple sagittal radiographic measures.

METHODS: Twenty-three patients, mean age 35 years with CP at GMFCS I-II were included. Radiographic measures included C2PA, T4PA, L1PA. PI-LL and T4-L1PA mismatch were defined as > 10°/ < – 10° and > 4°/ < – 4°, respectively. Trunk, pelvis, hips, and knees kinematics were obtained. Statistical parameter mapping (SPM) assessed kinematic differences throughout the gait cycle. Multivariable linear regression assessed the relationship between gait and radiographic parameters.

RESULTS: Fourteen and eleven patients (60.9% and 47.8%) presented with PI-LL and T4-L1PA mismatch, respectively. PI-LL mismatched patients demonstrated significantly lower knee flexion during gait. T4-L1PA mismatched patients demonstrated increased anterior pelvic tilt, hip flexion, and decreased knee flexion during gait, which was consistent with SPM analysis. Multivariable linear regression showed T4-L1PA, C2PA, and anterior pelvic tilt were associated with knee flexion.

CONCLUSION: This is the first study to evaluate SPA parameters and gait kinematics in patients with CP. This observational and preliminary data suggested that SPA and knee flexion in gait may be associated. Whether the variations in gait patterns are coping mechanisms or the cause for SPA malalignment requires clarification. The implications of SPA malalignment on the quality of life of this population warrant further investigations.

PMID:40975725 | DOI:10.1007/s43390-025-01190-0

Environ Monit Assess. 2025 Sep 20;197(10):1130. doi: 10.1007/s10661-025-14591-5.

ABSTRACT

Green vegetation plays a crucial role in monitoring air pollution in a sustainable and cost-effective manner. The present study evaluated the tolerance of ten plant species to air pollution in the Raniganj coalfield area by calculating their Air Pollution Tolerance Index (APTI). Four adjoining sites, including polluted and reference areas, were selected for comparison. Calotropis procera, with a higher APTI, was reported as a resistant species in all the study areas and considered an excellent performer. In contrast, Cassia tora had the lowest APTI, marking it as sensitive and a potential bio-indicator. Physiological parameters such as pH, relative water content (RWC), and ascorbic acid were higher in tolerant species, whereas total chlorophyll was stable under pollution stress. The concentration of heavy metals in plant leaves followed the trend Manganese (Mn) > Iron (Fe) > Lead (Pb) > Cadmium (Cd) and was higher in polluted sites than in the reference area. The Metal Accumulation Index (MAI) also varied significantly among species. Plants like Calotropis procera and Ficus religiosa, with high APTI and MAI, showed minimal leaf area reduction, indicating greater resilience. Elevated ascorbic acid levels at polluted sites suggest an adaptive antioxidant response to oxidative stress. The findings of the present study highlight the utility of APTI and MAI as effective tools in identifying plant species suitable for monitoring environmental pollution. The results support the integration of tolerant species in greenbelt design and warrant further exploration of their genetic and molecular responses for long-term environmental sustainability. Future research should emphasize on detailed investigations into defense mechanisms, large-scale field validation, seasonal monitoring and the exploration of plant-based phytoremediation strategies to strengthen their role in urban and industrial landscape planning.

PMID:40975713 | DOI:10.1007/s10661-025-14591-5

J Prosthodont. 2025 Sep 20. doi: 10.1111/jopr.70029. Online ahead of print.

ABSTRACT

PURPOSE: The cement interface is particularly important for successful zirconia-titanium base (Ti-base) restorations, as retention relies primarily on adhesive bonding. The aim of this in vitro study was to assess and compare the influence of a universal resin cement used with either a self-adhesive or adhesive bonding protocol versus adhesive resin cements on the retention of zirconia to Ti-base abutments, with and without autoclaving.

MATERIALS AND METHODS: Zirconia buildups were cemented to titanium-base abutments using RelyX Universal (RXU) as a self-adhesive resin cement, RXU with a primer (RXU/SUP), Panavia V5 (PV5) with primer, or multilink hybrid abutment (MHA) with primer. Half of the specimens were autoclaved. Push-out testing was performed, and data were statistically evaluated using the analysis of variance (ANOVA), Tukey honest significant difference test, and family-wise error rate method.

RESULTS: Of the nonautoclaved groups, RXU/SUP showed the highest initial mean push-out load (1576.45 ± 195.86 N), followed by MHA (1268.10 ± 160.67 N), RXU (959.66 ± 139.24 N), and PV5 (905.84 ± 298.38 N). Autoclaving did not have a significant influence on cement push-out load when compared directly within cement pairs. The push-out load of RXU used as self-adhesive cement was similar to PV5 with primer. Retention of RXU/SUP and MHA groups was significantly higher than that of RXU or PV5.

CONCLUSION: In this in vitro study, RXU performed as well as PV5 groups and required the fewest preparation steps, suggesting it may be a good option for improving workflow efficiency. Results indicated a marginally positive effect of autoclaving between pairs, however, it was not significant.

PMID:40975710 | DOI:10.1111/jopr.70029

HPB (Oxford). 2025 Sep 5:S1365-182X(25)01594-1. doi: 10.1016/j.hpb.2025.09.001. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: Robotic platforms in Hepato-Pancreato-Biliary (HPB) surgery improved surgical precision and recovery. However, their adoption remains inconsistent. This study aims to assess the current status of robotic surgery in HPB procedures.

METHODS: The Innovation Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA) developed a web-based survey. The survey collected data from 82 European and African centers on the availability, usage, and surgical volumes of robotic platforms in liver and pancreatic resections. Descriptive statistics were used to analyze responses.

RESULTS: The survey found that 94% (77/82) of centers use robotic platforms for HPB surgery, but only 6% (5/82) rely solely on robotic systems. The Da Vinci Surgical System was the most commonly used platform, present in 88% (72/82) of centers. Regarding surgical volumes, 62% (51/82) of centers perform at least 20 robot-assisted liver resections annually, whereas only 2% (2/82) exceed 80 procedures. In pancreatic surgery, 28% (23/82) of centers do not utilize robotic platforms. Additionally, 37% (30/82) of centers perform fewer than 10 robot-assisted HPB resections per year. Conversely, 38% (31/82) report using robotic platforms 2-3 days per week.

DISCUSSION: Robotic platforms are increasingly incorporated into HPB surgery. However, their widespread adoption is limited by economic, logistical, and utilization constraints.

PMID:40975703 | DOI:10.1016/j.hpb.2025.09.001

Med Dosim. 2025 Sep 19:S0958-3947(25)00050-0. doi: 10.1016/j.meddos.2025.08.002. Online ahead of print.

ABSTRACT

This study aimed to compare the performance of RapidPlan models developed by different planners and to evaluate the impact of inter-planner variability on treatment plan quality. Three planners with different levels of clinical experience developed RapidPlan models (Models A, B, and C) using the same set of 30 prostate cancer cases. Each planner manually created treatment plans for these cases, referring to PlanIQ for dosimetric guidance. PlanIQ provides estimates of achievable dose sparing for organs-at-risk (OAR) based on computed tomography images and anatomical contours, and was used to guide the planning process. Each model was then used to generate treatment plans (Plans A, B, and C). The models were evaluated using 12 independent cases not included in model training, and plan quality was assessed using dose-volume parameters for the planning target volume excluding the rectum (PTV-Rectum), rectum, and bladder. Plan A yielded better dose uniformity for the PTV-Rectum, as indicated by lower D2% and higher D98%. For the rectum, the mean volume receiving 58 Gy (V58 Gy) was lowest in Plan C, followed by Plans B and A, indicating that Model C provided the most effective dose sparing. Plan A yielded superior dose uniformity for the PTV-Rectum, whereas Plan C more effectively spared OAR. Although no statistically significant differences were observed, the results suggest that planner-related variability can influence model performance. These findings underscore the importance of quality control in model construction and support the feasibility of shared or standardized RapidPlan models, particularly in resource-limited settings.

PMID:40975700 | DOI:10.1016/j.meddos.2025.08.002

Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Aug 30:S2212-4403(25)01193-9. doi: 10.1016/j.oooo.2025.08.015. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the prevalence of Epstein-Barr virus (EBV) positive lymphomas in a cohort of patients with head and neck lymphomas and to correlate these lymphomas with HIV status, CD4⁺ cell count, clinical stage, and overall survival.

STUDY DESIGN: This retrospective descriptive study sourced data from pathology reports and clinical records. Data collected included lymphoma type, HIV status, and medical information related to immunosuppression, CD4⁺ T-cell counts, HIV viral load, Ann Arbor clinical stage, and follow-up data.

RESULTS: We reviewed 228 lymphomas, comprising 9 Hodgkin lymphomas and 219 non-Hodgkin lymphomas (HIV-positive: 133; HIV-negative: 23, and unknown HIV status: 72). Diffuse large B-cell lymphoma and plasmablastic lymphoma (PBL) were common and associated with HIV immune suppression, male sex, and middle age. Seventy-four lymphomas were Epstein-Barr encoded RNA in situ hybridization (EBER-ISH) positive. PBL was the most common EBV-driven lymphoma (median CD4⁺ count = 147 cells/mm³), with the highest Ann Arbor staging.

CONCLUSION: These findings suggest that EBV infection is among the primary factors contributing to PBL oncogenesis in HIV-positive patients. Patients with PBL presented with CD4⁺ T-cell counts of <400 cells/mm³. Patients with HIV infection had a lower overall survival rate compared to HIV-negative patients, irrespective of lymphoma type.

PMID:40975699 | DOI:10.1016/j.oooo.2025.08.015

Farm Hosp. 2025 Sep 19:S1130-6343(25)00041-8. doi: 10.1016/j.farma.2025.03.016. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of the study was to analyse possible changes in antibiotic policy with ceftazidime-avibactam during the SARS-CoV-2 pandemic in an Intensive Care Unit (ICU) to determine patient mortality 28 days after initiation of antimicrobial therapy and to describe the microorganisms that most frequently colonise critically ill patients.

MATERIAL AND METHOD: Observational, single-centre, cohort study that included patients on treatment with ceftazidime-avibactam in ICU between March 2020 and September 2021. Demographic (age, sex), microbiological (colonisation, microorganisms isolated in blood cultures), pharmacotherapeutic (duration of treatment with ceftazidime-avibactam, antimicrobials used in synergy with ceftazidime-avibactam) and clinical (mortality, length of hospital stay and comorbidities) variables were collected. As associated comorbidities, we identified how many of the patients included in the study had diabetes mellitus (DM), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD) or obesity.

RESULTS: Eighty-nine patients were included, 85.39% of whom were male. Forty-nine patients were infected with Sars-CoV-2. Median ICU stay was 46 days (RIQ = 58-27) in SARS-CoV-2 infected and 34 days (RIQ = 51-24) in non-infected patients. Patients were on ceftazidime-avibactam treatment for a median of 8 days (RIQ = 13-4), being 7 days (RIQ = 11-2) in COVID-19 positive patients and 11 days (RIQ = 14-6) in COVID-19 negative patients (p > 0.05). Empirical treatment with ceftazidime-avibactam was started empirically in 41.57% (n = 37) of the patients. The percentage of empiric initiations in SARS-CoV-2 infected patients was 43% and in non-infected patients 40%, with no statistically significant difference between empiric initiation according to SARS-CoV-2 diagnostic status (p > 0.05). A total of 43.8% (n = 39) of the patients were colonised by a multidrug-resistant (MDR) bacterium. Regarding on the microorganisms that colonised patients had, the most frequent was Klebsiella pneumoniae, present in 66.6% of patients (n = 26 patients). Overall mortality was 41.6%, with no statistically significant differences between SARS-CoV-2 infected and non-infected patients (42.9% and 40%, respectively; p > 0.05).

CONCLUSION: The SARS-CoV-2 pandemic did not lead to a change in the criteria for the use of ceftazidime-avibactam in the critically ill patient.

PMID:40975682 | DOI:10.1016/j.farma.2025.03.016

Transplant Proc. 2025 Sep 20:S0041-1345(25)00427-0. doi: 10.1016/j.transproceed.2025.08.025. Online ahead of print.

ABSTRACT

BACKGROUND: Recently, marginal donor hearts have been applied to patients with end-stage heart failure due to rising waiting list mortality and increasing demand for donors. However, the principles of risk prevention and the usage of marginal donor hearts have yet to be clearly defined.

METHODS: A retrospective analysis was performed to investigate the outcomes of patients undergoing heart transplantation at our center between October 2019 and March 2024. Forty-four patients were enrolled and divided into the marginal donor heart group (n = 30) and the conventional donor heart group (n = 14) according to the classification criteria. The clinical data between the 2 groups were compared and analyzed.

RESULTS: There were no statistically significant differences in the postoperative length of hospitalization, ICU stay, left ventricular ejection fraction, or serum biochemical indicators between the 2 groups. Five patients died during the 3-month follow-up period. Notably, 1- and 3- month postoperative follow-up showed no significant differences in left ventricular ejection fraction, serum biochemical indicators, and mortality between the 2 groups CONCLUSION: The application of marginal donor hearts can partially alleviate the shortage of donor heart resources. It did not significantly affect patients’ short-term survival or recovery.

PMID:40975674 | DOI:10.1016/j.transproceed.2025.08.025

Foot Ankle Surg. 2025 Sep 18:S1268-7731(25)00222-X. doi: 10.1016/j.fas.2025.09.009. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the relationship between chronic ankle instability (CAI) and both the anatomical characteristics of the anterior talofibular ligament (ATFL) and the bony morphometry of its attachment sites on the fibula and talus using MRI.

METHODS: A total of 94 patients were included in this retrospective study (44 with CAI, 50 controls). Morphometric parameters including ATFL length, width, thickness, and the ATFL/PTFL angle were measured, along with sagittal and coronal widths of the fibula and talus at ATFL attachment levels.

RESULTS: The ATFL was significantly longer, thinner, and narrower in the CAI group compared to controls (p < 0.001). The ATFL/PTFL angle was also significantly greater in the CAI group (p = 0.007). However, no statistically significant differences were observed in the sagittal or coronal widths of the talus and fibula. ROC analysis revealed that ATFL length had the highest diagnostic performance (AUC = 0.881). Logistic regression identified increased ATFL/PTFL angle and decreased ATFL width and thickness as independent predictors of instability.

CONCLUSION: While the ligamentous characteristics of the ATFL, particularly its length and angulation, are strongly associated with CAI, the morphometric features of its bony attachment sites do not appear to contribute significantly. The ATFL/PTFL angle may be considered a reliable, indirect MRI marker in the assessment of CAI and should be considered in routine evaluations.

PMID:40975665 | DOI:10.1016/j.fas.2025.09.009

Curr Probl Pediatr Adolesc Health Care. 2025 Sep 19:101838. doi: 10.1016/j.cppeds.2025.101838. Online ahead of print.

ABSTRACT

OBJECTIVE: Upstream oil and gas development (OGD) can release carcinogenic and radioactive agents into air and water. This review summarizes evidence on the relationship between residential proximity to upstream OGD and cancer risk among children, adolescents, and young adults (CAYA).

METHODS: We systematically searched PubMed and Embase through April 25, 2025, for original, peer-reviewed epidemiologic investigations of residential proximity to upstream OGD and cancer in CAYA (≤25 years). We excluded studies of downstream activity, those lacking CAYA-specific results, and non-English publications. Two reviewers independently screened records, extracted data, and assessed risk of bias with a World Health Organization tool.

RESULTS: From 3274 screened articles, 10 met inclusion criteria. Four case-control studies, all United States-based (Pennsylvania n = 3, Colorado n = 1), used individual-level proximity metrics during defined temporal windows and controlled for confounders. Six ecological studies (Ecuador n = 4, Croatia n = 1, Pennsylvania n = 1) used area-based density or binary exposure metrics with limited confounder adjustment. All studies assessed hematopoietic malignancies. All case-control studies observed positive associations between OGD proximity and cancer with three reporting elevated leukemia risk. Two studies from different states reported highly similar leukemia risk in the closest OGD buffer zones (Colorado: 3 km OR 2.07, 95 % CI 1.08-3.74; Pennsylvania: 2 km OR 1.98, 95 % CI 1.06-3.69). Ecologic study findings were mixed, including elevated risks for hematologic and central nervous system cancers. Limitations include few studies, imprecise exposure metrics, and potential residual confounding.

DISCUSSION: Despite limited evidence, the majority of studies reported positive, statistically significant associations between OGD and childhood cancer, most consistently for leukemia, supporting efforts to reduce OGD proximity to children.

PMID:40975664 | DOI:10.1016/j.cppeds.2025.101838