Tag: nevin manimala

Cardiooncology. 2025 Apr 28;11(1):40. doi: 10.1186/s40959-025-00331-8.

ABSTRACT

BACKGROUND: Cardio-inflammatory immune related adverse events (irAEs) while receiving immune checkpoint inhibitor (ICI) therapy are particularly consequential due to their associations with poorer treatment outcomes. Evaluation of predictive factors of these serious irAEs with a time dependent approach allows better understanding of patients most at risk.

OBJECTIVE: To identify different elements of patient data that are significant predictors of early and late-onset or delayed cardio-inflammatory irAEs through various predictive modeling strategies.

METHODS: A cohort of patients receiving ICI therapy from January 1, 2010 to May 1, 2022 was identified from TriNetX meeting inclusion/exclusion criteria. Patient data collected included occurrence of early and later cardio-inflammatory irAEs, patient survival time, patient demographic information, ICI therapies, comorbidities, and medication histories. Predictive and statistical modeling approaches identified unique risk factors for early and later developing cardio-inflammatory irAEs.

RESULTS: A cohort of 66,068 patients on ICI therapy were identified in the TriNetX platform; 193 (0.30%) experienced early cardio-inflammatory irAEs and 175 (0.26%) experienced later cardio-inflammatory irAEs. Significant predictors for early irAEs included: anti-PD-1 therapy at index, combination ICI therapy at index, and history of peripheral vascular disease. Significant predictors for later irAEs included: a history of myocarditis and/or pericarditis, cerebrovascular disease, and history of non-steroidal anti-inflammatory medication use.

CONCLUSIONS: Cardio-inflammatory irAEs can be divided into clinically meaningful categories of early and late based on time since initiation of ICI therapy. Considering distinct risk factors for early-onset and late-onset events may allow for more effective patient monitoring and risk assessment.

PMID:40296103 | DOI:10.1186/s40959-025-00331-8

BMC Med Educ. 2025 Apr 28;25(1):626. doi: 10.1186/s12909-025-07193-9.

ABSTRACT

BACKGROUND: Students’ self-assessment and rubrics are pedagogical tools designed to enhance learning and evaluation processes. Achieving convergence between learners and teachers is paramount during the learning of complex treatments such as endodontic procedures, although it can be challenging due to uncontrollable factors that may affect task performance and perception. This study aimed to evaluate the influence of various factors (anatomical difficulty, type of instrumentation system, and training level) on the assessments of root canal treatments (RCT) by teachers and students using a rubric, and to determine the degree of agreement between them.

METHODS: 144 RCT were performed on extracted human molars by 36 dental students using two mechanized systems and subsequently evaluated using a rubric by both the students and four teachers. Rubric yielded a total score for the sum of 4 items analyzed individually: radiographic evaluation, access cavity, instrumentation, and obturation. The influence of the three following factors: anatomical difficulty (categories: minimal, moderate and high), instrumentation system (categories: Protaper Next and Reciproc Blue), and training level (categories: initial and advanced) on teachers’ and students’ RCT total scores and for each item were analyzed by three-way ANOVA. Agreements between teachers and students were measured by intraclass correlation coefficients and quadratic weighted Kappa. Statistical analyses were conducted at a pre-set alpha of 0.05 using Stata 16.

RESULTS: No significant influence of anatomical difficulty, instrumentation system, or training level was observed on RCT total scores given by teachers and students (p > 0.05). However, training level influenced the assessments by teachers in instrumentation as those by students in radiographic evaluation. Agreement was moderate for RCT total scores and substantial for teeth with minimal or high difficulty, after using Protaper Next, and at the initial training level. Agreement was substantial in obturation, and moderate in radiographic evaluation, access cavity, and instrumentation. Some categories in instrumentation and obturation items showed substantial agreement, while fair agreement was observed only in access cavity.

CONCLUSIONS: Educational factors in Endodontics such as anatomical difficulty, mechanized instrumentation system, and level of training did not influence the total scores of preclinical RCT by teachers or students. Agreement for RCT total scores ranged from moderate to substantial. The strongest agreement was observed in obturation, while access cavity yielded the lowest. The rubric as an assessment tool in Endodontics teaching is recommended.

PMID:40296102 | DOI:10.1186/s12909-025-07193-9

Prostate. 2025 Apr 28. doi: 10.1002/pros.24907. Online ahead of print.

ABSTRACT

BACKGROUND: Congenital urological malformations encompass a wide range of anomalies affecting the urinary tract and reproductive organs. MRI has emerged as a diagnostic tool in identifying these conditions. Prostatic utricle is an enlarged diverticulum in the posterior urethra, which results from incomplete degradation of the Müllerian ducts or decreased androgenic stimulation of the urogenital sinus. Prostatic utricle is an uncommon congenital anomalies, with 1% incidence in autopsy findings and clinical prevalence of 5% in urologic patients.

METHODS: This retrospective study analyzed 5819 prostate MRI interpretations from 4990 unique patients. The primary objective was to identify congenital abnormalities, focusing on the presence of a utricle and other related anomalies. Prostates suspected to have utricles were reevaluated by genitourinary specialized radiologist and utricles size were measured.

RESULTS: The study identified 127 patients positive for a utricle with an average age of 66 years at examination among the unique cohort. The average prostate size for patients with a utricle was 78.3 cc and the average utricle size was 0.4 cm³. Statistical analysis did not demonstrate any statistical trend between prostate size, age or PSA to utricle size. Additional congenital anomalies detected included one patient with a seminal vesicle cyst, one patient with right seminal vesicle agenesis and bilateral vas deferens agenesis, and two patients with ureterocele.

CONCLUSION: The prevalence of prostate utricle within a cohort of 4990 middle-aged to elderly men is 2.54%.

PMID:40296095 | DOI:10.1002/pros.24907

Head Face Med. 2025 Apr 28;21(1):32. doi: 10.1186/s13005-025-00511-y.

ABSTRACT

OBJECTIVES: To determine the influence of a consumable auxiliary device, the O-I buckle, on the accuracy of intraoral scanning among complete arches.

METHODS: A standard mandibular model with six implants was used as the master model and was scanned by a precise dental laboratory scanner to establish a reference. Three impression techniques were compared: the conventional splinted open-tray impression (CI group), the digital intraoral scanning technique (IOS group), and IOS with the auxiliary device (OI group). For OI group, six prefabricated O-I buckles were attached for each intraoral scan body (ISB) and the definite models were scanned 10 times. The STL datasets were imported into a 3D inspection software to obtain the trueness and precision values for three scanning ranges (BCDE, BCDEF, and ABCDEF). The trueness was the absolute value of the root mean square (RMS) between the reference and test models, while precision referred to the value of the test group subtracted from each other. The data were statistically analyzed using two-way ANOVA and post hoc multiple comparison tests.

RESULTS: The impression method (p <.001) and scanning range (p <.001) significantly influenced the trueness and precision of implant impressions for complete edentulous arches. The IOS with O-I buckle showed higher trueness compared to the IOS group for all implant configurations with most being significantly different (p =.758, = 0.04, and = < 0.001 for BCDE, BCDEF, and ABCDEF, respectively) and significantly higher precision was seen in group ABCDEF (p <.001). For four and five implants (group BCDE and BCDEF), there was no significant difference comparing IOS with O-I buckle and CI (p >.05). As the range expanded, the trueness and precision of IOS and OI decreased (p <.05), whereas the accuracy of CI remained stable.

CONCLUSIONS: The auxiliary O-I buckle fixed to the ISBs significantly improved the multiple-implant intraoral scanning accuracy for digital impressions in complete arches; With CI as a reference, the accuracy of IOS with OI buckles were comparable for four and five implants.

CLINICAL RELEVANCE: The digitization accuracy of intraoral scanning for complete edentulous arches can be improved through IOS with OI buckles. This may lead to improved passive fit of the restoration, improving patient outcomes in a convenient and cheap way.

PMID:40296092 | DOI:10.1186/s13005-025-00511-y

BMC Surg. 2025 Apr 28;25(1):186. doi: 10.1186/s12893-025-02930-9.

ABSTRACT

BACKGROUND: Postoperative urinary retention (POUR) was reported as a common complication in patients undergoing primary total knee arthroplasty (pTKA), but descriptions of its prevalence and negative outcomes vary widely and remain inadequately studied.

METHODS: A retrospective cohort study was conducted using the National Inpatient Sample database from 2005 to 2014. The annual incidence, baseline characteristics, and inpatient outcomes of POUR after pTKA were recorded. Logistic regression analysis was performed to estimate potential predictors of POUR. Statistical significance was defined as P < 0.01.

RESULTS: A total of 1,228,621 patients undergoing pTKA were identified. The incidence of POUR after pTKA is increasing annually from 2005 (1.51%, 95%CI 1.44-1.59%) to 2014 (2.29%, 95%CI 2.21-2.37%), and the cumulative incidence of POUR was 1.91% (95%CI 1.89-1.93%). POUR was significantly associated with higher Charlson Comorbidity Index and Elixhauser Comorbidity Index scores, and higher medical costs. In patients experiencing pTKA, the Top 5 most significant risk factors for developing POUR were male gender (odds ratio [OR] = 3.40; 95% confidence interval [CI] 3.30-3.51; P < 0.0001), fluid and electrolyte disorders (OR = 2.02; 95% CI 1.94-2.10; P < 0.0001), age over 60 (OR = 1.97; 95% CI 1.89-2.05; P < 0.0001), paralysis (OR = 1.78; 95% CI 1.46-2.17; P < 0.0001), and psychoses (OR = 1.57; 95% CI 1.43-1.72; P < 0.0001). Although POUR did not result in higher inpatient mortality (0.1% vs. 0.07%, P = 0.1242), it may be associated with the occurrence of other complications such as acute myocardial infarction (0.42% vs. 0.20%, P < 0.0001), pulmonary embolism and infarction (0.80% vs. 0.42%, P < 0.0001), acute renal failure (6.06% vs. 1.49%, P < 0.0001), deep venous thrombosis (0.71% vs. 0.45%, P < 0.0001), acute posthemorrhagic anemia (28.89% vs. 19.45%, P < 0.0001), and infection (0.29% vs. 0.15%, P < 0.0001).

CONCLUSIONS: Although POUR has no effect on inpatient mortality, our large-scale national study provides new insights that it increases postoperative complications and impairs clinical outcomes. Given the increasing incidence of POUR, early identification of high-risk patients, particularly those with identified comorbidities, should be prioritized. Preventive strategies, such as optimized perioperative fluid management, may help mitigate the risk of POUR. Future research should focus on developing preventive strategies to mitigate its impact.

PMID:40296087 | DOI:10.1186/s12893-025-02930-9

Adv Rheumatol. 2025 Apr 28;65(1):21. doi: 10.1186/s42358-025-00452-9.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of intra-articular injections (IAIs) with triamcinolone hexacetonide (TH) combined with a progressive resistance exercise program (PREP) in improving pain, function, muscle strength, and quality of life in elderly patients with knee osteoarthritis (OA).

METHODS: Fifty-nine elderly individuals with knee OA were randomized into three groups: IAI with TH (IAI-TH) + PREP, IAI with saline solution (IAI-SS) + PREP, and IAI with placebo + PREP. The IAIs were administered once, one week before starting PREP, which was performed twice weekly for 12 weeks. Outcomes assessed at baseline and at 2, 6, and 12 weeks post-IAI included pain (Numerical Pain Scale – NPS), swelling, function (Western Ontario and McMaster Universities Osteoarthritis Index – WOMAC), quality of life (Short Form-36 – SF-36), performance tests (Six-Minute Walk Test – 6MWT, Timed Up and Go Test – TUGT, Short Physical Performance Battery – SPPB), and muscle strength (one-repetition maximum test – 1RM). Due to the COVID-19 pandemic, only 15 participants per group completed the study protocol.

RESULTS: All groups showed significant intragroup improvements over time in pain, function, muscle strength, and quality of life. However, no statistically significant differences were found between the groups for any of the assessed outcomes. The bodily pain domain of the SF-36 and analgesic consumption were the only measures showing differences over time.

CONCLUSION: The combination of IAI-TH and a 12-week PREP (twice weekly) was not superior to IAI-SS or placebo combined with the same PREP in improving pain, function, or quality of life in elderly patients with knee OA. These findings highlight the role of exercise as a key therapeutic strategy, regardless of prior IAI. Future studies with larger sample sizes and long-term follow-ups are needed to better assess the role of intra-articular corticosteroid injections in OA rehabilitation.

CLINICAL TRIAL NUMBER: ensaiosclinicos.gov.br (RBR-556md5g). Registered 27 October 2022.

PMID:40296068 | DOI:10.1186/s42358-025-00452-9

BMC Psychiatry. 2025 Apr 28;25(1):426. doi: 10.1186/s12888-025-06869-2.

ABSTRACT

INTRODUCTION: Prisoners face severe restrictions on freedom and social connections, negatively impacting their mental health and increasing suicidal thoughts and attempts. Suicide is a significant public health concern, with rates among inmates much higher than in the general population. Research indicates that suicidal ideation is common among convicts. Despite the alarming prevalence of suicidal ideation and attempts among inmates, many countries lack comprehensive data on prison suicides, highlighting the need for targeted preventive strategies. This systematic review and meta-analysis aims to synthesize findings of different studies and pool them to provide a comprehensive figure of suicidal ideation and attempts among prisoners and to inform policymakers on improving health services for vulnerable inmates.

OBJECTIVE: This study comprehensively assessed and pooled the prevalence of suicidal ideation and attempts and the effect size of determinants among prisoners in Ethiopia.

METHODS: Systematic searches for observational studies were conducted in various databases, including PubMed (MEDLINE), CINAHL (EBSCO), Embase, Web of Science, HINARI, Science Direct, Google Scholar, Mednar, and the Cochrane Library. Observational studies involving inmates from 2015 to 2024 were included, except those who fulfill exclusion criteria. Four research groups independently selected studies, extracted data, and assessed quality. Nine studies involving 4435 prisoners were included. A meta-analysis using random-effects models was performed.

RESULTS: A total of nine studies involving 4435 study participants were included in the review. This study of studies revealed that the pooled prevalence of suicidal ideation and attempted suicide among prisoners in Ethiopia was 23.28% (95% confidence intervals (CI): 12.26%, 34.29%) and 10.20% (95% CI: 8.63%, 11.78%), respectively. Depression, poor social support, suicidal history, and previous mental illness were significantly associated. Statistically significant heterogeneity across included studies was found both for suicidal ideation (I² = 98.74%, p ≤ 0.001) and suicidal attempts (I² = 73.05%, p ≤ 0.001). Egger’s test revealed publication bias in studies on suicidal ideation (p = 0.001) but not in studies on suicidal attempts (p = 0.271).

CONCLUSION: This study revealed a high prevalence of suicidal ideation and attempts among prisoners. These public health problems are significantly determined by depression, poor social support, mental illness, and family history of suicide. The review advocates for integrating mental health services in prisons, including routine screenings, while emphasizing the need to combat the marginalization of prisoners for meaningful change.

TRIAL REGISTRATION: The protocol for this study was submitted and registered in PROSPERO on 03 May 2024, and the first version of this protocol was published on 14 May 2024 with the PROSPERO ID of CRD42024542958.

PMID:40296065 | DOI:10.1186/s12888-025-06869-2

BMC Pediatr. 2025 Apr 28;25(1):334. doi: 10.1186/s12887-025-05664-y.

ABSTRACT

BACKGROUND: The aim of our research was to explore the distribution characteristics of the most common food and inhalant allergens in children from Foshan city in Southwest China to provide evidence for the development of prevention and treatment strategies for allergic diseases in children.

METHODS: A total of 635 children who attended the Sixth Affiliated Hospital, South China University of Technology, were included in our retrospective study from February 2013 to October 2019. The sensitivity of immunoglobulin E (IgE) for 20 allergens (10 inhalant allergens and 10 food allergens) was determined. Statistical analysis was performed to analyze differences in the percentage of allergens among individuals according to sex, age and season.

RESULTS: Of the 635 patients, 200 tested positive for allergies. Dust mites were the most common inhalant allergens, followed by dog hair. The highest percentage of positive house dust mite sensitization was in the summer. Among the food allergens, individuals most frequently tested positive for wheat and milk allergies. The percentage of individuals with milk and egg allergies decreased with increasing age.

CONCLUSION: The most common allergens found in children from Foshan were dust mites, dog hair, wheat, tree nuts (hazelnut and pistachio), milk and peanuts. The results obtained could be helpful in determining the etiology of allergic diseases.

PMID:40296060 | DOI:10.1186/s12887-025-05664-y

BMC Public Health. 2025 Apr 28;25(1):1566. doi: 10.1186/s12889-025-22768-3.

ABSTRACT

BACKGROUND: Updated data on hormone-related cancers (HRCs) are crucial for their prevention, management, and treatment, aligning with the UN’s Sustainable Development Goals. This study focuses on HRCs: breast, thyroid, uterine, ovarian, prostate, and testicular cancers. Despite their significance, comparative studies on these cancers are limited.

METHODS: Data for incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) related to HRCs were obtained from the Global Burden of Disease Study 2021. Statistical analyses were performed using R and Joinpoint Software. Age-standardized rates (ASR), percentage changes (1990-2021), annual percent change (APC) and average annual percent change (AAPC) are used to examine trends and risk factors associated with HRCs across various years, genders, and age groups, both in China and globally.

FINDINGS: In 2021, China reported 659450 incidence cases of six HRCs, including 527009 cases (95% UI: 398030, 684814) in females and 132442 cases (89701, 181113) in males, reflecting a 29.97% increase since 1990. Deaths attributed to HRCs totaled 176526, with 130281 cases (99207, 166654) among females and 46245 cases (33049, 62510) among males, marking an 11.07% increase during the same period. The age-standardized incidence rates (ASIR) for HRCs in China were 10.70 (38.19, 65.86) per 100,000 for females and 13.87(9.50, 18.71) for males, in contrast to global rates of 17.07(62.11, 72.57) for females and 39.21(35.75, 41.69) for males. Age-standardized death rates (ASDR) were 3.54(9.22, 15.50) for females and 5.86(4.16, 7.83) for males, compared to higher global ASDRs of 6.17(19.49, 22.98) and 13.73(12.06, 14.78),respectively. From 1990 to 2021, China and the global population saw significant increases in ASIR for most cancers, except global ovarian cancer (AAPC = -0.229). Female HRCs mortality, YLLs, and DALYs declined significantly, particularly for uterine cancer. Conversely, Chinese males experienced increased mortality, YLLs, and DALYs for breast and thyroid cancers. Testicular cancer prevalence increased among Chinese males (AAPC = 7.329). Specifically, female breast cancer mortality in China decreased from 2011 to 2014 (APC = -2.82). Uterine cancer mortality dropped sharply from 2011 to 2015 (APC = -7.91). Thyroid cancer mortality declined from 2000 to 2007 (APC = -3.54), while ovarian cancer mortality decreased from 2000 to 2004 (APC = -3.33). Male breast cancer incidence peaked around 2010, and testicular cancer incidence rose significantly from 2011 to 2015 (APC = 7.77). All above changes were statistically significant (P < 0.05). Regarding age distribution characteristics, female HRCs consistently peak in the 60-74 age group globally and in China, whereas male HRCs show greater variability. In this age bracket, female breast cancer incidence reaches 348.90 (270.60, 440.16) in China versus 483.55 (449.97, 516.08) globally, while uterine cancer rates are 71.74 (52.18, 99.03) in China compared to 151.71 (138.55, 163.03) worldwide. Similarly, ovarian cancer peaks at 39.29 (28.29, 51.02) in China and 69.95 (63.59, 75.55) globally. Prostate cancer incidence also peaks in this group, with rates of 121.87 (84.48, 168.23) in China contrasting sharply with 534.72 (491.27, 568.09) globally. Conversely, testicular cancer shows a distinct pattern, peaking in the younger age group of 25-44 years, with incidences of 5.95 (4.44, 7.85) in China and 19.21 (18.04, 20.56) globally. The 25-44 age group also remains significant for thyroid cancer, with incidences of 23.31 (17.01, 32.52) in China and 31.57 (27.61, 36.30) globally. In terms of risk factors, smoking contributed to an ASR of 0.22 (0.16, 0.27) deaths globally, while alcohol accounted for 0.39 (0.27, 0.54) deaths. In China, low physical activity resulted in an ASR of 0.18 (0.03, 0.33) deaths, where high BMI notably increased risks for female HRCs. Environmental factors significantly impacted global ovarian cancer, contributing 0.12 (0.06, 0.19) deaths, while smoking influenced prostate cancer mortality, with an ASR of 0.36 (0.16, 0.60) deaths.

INTERPRETATION: Our study reveals that rising incidence rates and age-specific patterns of female HRCs in China and globally are largely associated with shifts in lifestyle and dietary habits. To address this issue, it is essential to implement tailored prevention strategies for different cancer types and age groups and enhance management of risk factors, especially considering the growing burden of diseases affecting the elderly due to population aging.

PMID:40296059 | DOI:10.1186/s12889-025-22768-3

Arch Oral Biol. 2025 Apr 19;175:106273. doi: 10.1016/j.archoralbio.2025.106273. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effects of sclerostin on the proliferation and migration of human cementoblasts and periodontal ligament cells.

DESIGN: Sclerostin expression in human cementoblasts and periodontal ligament cells was assessed using immunochemical staining. Human cementoblasts and periodontal ligament cells were cultured and treated with 100 ng/mL of recombinant human sclerostin. Cell proliferation was evaluated using a 5-bromo-2-deoxyuridine enzyme-linked immunosorbent assay and quantified with a live-cell imaging and analysis platform (IncuCyte® S3 system). Furthermore, sclerostin’s impact on apoptosis in human cementoblasts and periodontal ligament cells was evaluated using IncuCyte® Caspase-3/7 green dye. Additionally, cell migration was analyzed through quantitative wound healing assessment using the IncuCyte® S3 system. Polymerase chain reaction, enzyme-linked immunosorbent assay, and Western blotting were then performed to confirm the effect of sclerostin on CEMP-1. The data obtained were statistically analyzed using the Mann-Whitney U test.

RESULTS: Intracellular sclerostin localization in human cementoblasts and periodontal ligament cells were confirmed form the immunochemical staining. The sclerostin-treated group showed suppressed proliferation and migration of human cementoblasts and periodontal ligament cells compared with the non-treated group. Furthermore, the sclerostin-treated group showed significantly elevated caspase-3/7 activity compared with the non-treated group. However, the addition of sclerostin did not result in any significant changes in CEMP-1.

CONCLUSION: Sclerostin is crucial in regulating the proliferation and migration of cementoblasts and periodontal ligament cells. This highlights its importance in regenerating the cementum and periodontal ligament.

PMID:40294473 | DOI:10.1016/j.archoralbio.2025.106273