Tag: nevin manimala

Eur Arch Paediatr Dent. 2025 Dec 8. doi: 10.1007/s40368-025-01147-x. Online ahead of print.

ABSTRACT

PURPOSE: To assess the prevalence and experience of dental caries among 6-year-old children in Ajman, United Arab Emirates (UAE), and examine associations with sociodemographic, behavioural, and service-related factors.

METHODS: A cross-sectional survey was conducted among 285 Grade One children in government schools. Parent questionnaires captured background, diet, oral hygiene, fluoride exposure, and dental visits. Clinical dental examinations were conducted using the International Caries Detection and Assessment System (ICDAS II), with d(4-6)mft as the main criterion, and incipient lesions (d(1-2)) were also systematically recorded, providing novel insight into the early stages of caries lesions amongst local children.

RESULTS: The findings revealed a high prevalence of dental caries, with children experiencing both advanced and early-stage lesions. The prevalence of dental caries was 85.6%, with a mean d(4-6)mft score of 5.8 ± 4.4, whilst incipient caries (d(1-2)t) affected 47.6% of the children. Caries experience was higher amongst children who frequently consumed sugar-sweetened beverages (ARR [Adjusted Rate Ration] = 2.4, 95% CI 0.9-7.5), whilst regular brushing with fluoride toothpaste was associated with lower caries experience (ARR = 0.5, 95% CI 0.3-0.9). In contrast, symptom-driven dental visits were statistically significantly associated with greater caries experience (ARR = 2.0, 95% CI 1.0-4.1).

CONCLUSIONS: The present study identified a high prevalence of dental caries amongst 6-year-old children in Ajman and represents the first report in the UAE to include both incipient and cavitated lesions based on ICDAS-II. These findings highlight the need to strengthen national oral health strategies through school-based caries preventive programmes and integration into child health policies. They support implementing school-based fluoride and dietary interventions to reduce caries experience and advance child oral health in the UAE.

PMID:41359223 | DOI:10.1007/s40368-025-01147-x

Dermatol Ther (Heidelb). 2025 Dec 8. doi: 10.1007/s13555-025-01595-9. Online ahead of print.

ABSTRACT

INTRODUCTION: While bimekizumab has demonstrated rapid, superior clinical efficacy versus adalimumab and ustekinumab, with sustained responses through 4 years, its comparative and long-term impact on patient-reported outcomes (PROs) remains underexplored. Here, we report PROs with bimekizumab versus adalimumab/ustekinumab/placebo in phase 3 controlled trials, and over 4 years with bimekizumab.

METHODS: Data were analyzed from BE SURE, BE VIVID, BE READY (52/56 weeks), and their open-label extension (OLE), BE BRIGHT (144 weeks; 4 years’ total treatment). Patients were randomized to bimekizumab/adalimumab/ustekinumab/placebo during comparator-controlled periods; all received bimekizumab during BE BRIGHT. Proportions of patients reporting Psoriasis Symptoms and Impacts Measure (P‑SIM) = 0 and Dermatology Life Quality Index (DLQI) = 0 (both at item-level) were assessed during comparator‑controlled periods using non-responder imputation (NRI). Over 4 years, PROs were analyzed using modified NRI in patients who received continuous bimekizumab from baseline into the OLE.

RESULTS: BE SURE included 478 patients (bimekizumab, 319; adalimumab, 159); BE VIVID included 567 (bimekizumab, 321; ustekinumab, 163; placebo, 83); BE READY included 435 (bimekizumab, 349; placebo, 86). In total, 771 patients received continuous bimekizumab into the OLE. A larger proportion of bimekizumab-treated patients achieved P-SIM = 0 across key items versus adalimumab (week 24; itching, 30.7% vs. 18.9%; skin pain, 43.9% vs. 30.2%; scaling, 39.2% vs. 19.5%), ustekinumab (week 16; itching, 31.2% vs. 17.8%; skin pain, 51.7% vs. 27.6%; scaling, 43.6% vs. 17.2%), and placebo. Similar trends were seen for other P-SIM items and in proportions of bimekizumab-treated patients reporting DLQI = 0 across items versus comparators. The patient-reported benefits of bimekizumab were demonstrated throughout the OLE, with 65.5-94.8% of patients reporting DLQI = 0 across items at 4 years.

CONCLUSIONS: Bimekizumab provided greater improvements in PROs versus comparators, with durable effects over 4 years. These findings reinforce bimekizumab’s role in effective psoriasis management, linking clinical efficacy with sustained patient-reported benefits.

TRIAL REGISTRATION: NCT03412747, NCT03370133, NCT03410992, NCT03598790. A Graphical Abstract is available for this article.

PMID:41359217 | DOI:10.1007/s13555-025-01595-9

J Prev (2022). 2025 Dec 8. doi: 10.1007/s10935-025-00888-1. Online ahead of print.

ABSTRACT

Youth violence, including gender-based violence, is a major public health issue in the UK, yet evidence on effective interventions in the UK remains limited. Becoming a Man (BAM) is a two-year school-based positive youth development programme for adolescent boys, developed in Chicago, US, where two RCTs found reduced violent crime arrests and improved academic engagement. This study evaluated BAM’s potential in the UK using a theory-driven design (no comparison group). 97 boys aged 12-14 years (66% Black/Black British) in three London schools enrolled in BAM. Data sources included: implementation records (recruitment, attendance, adherence, quality, youth socio-demographics); school data (attendance, exclusions, attainment); 36 qualitative interviews (11 scholars, 14 parents, 3 school staff, 3 BAM counsellors (2 interviews each), 1 each from delivery organisation and intervention developer); and a counsellor focus group. Interviews focused on implementation, outcomes and BAM contribution to outcomes. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using framework analysis. Case studies of 11 scholars explored what worked, for whom, under what circumstances and why. Implementation outcomes were mixed. Attendance targets were met but those for group size, reach and curriculum progression were not. Case study scholars who engaged deeply with BAM’s values demonstrated improved self-control and decision-making, although external influences also affected their development. Concerns about negative labelling were mitigated through balanced recruitment. Limited adverse effects on academic attainment were reported. BAM has potential in the UK but requires further adaptation, implementation support and evaluation (including impact on gender norms).

PMID:41359212 | DOI:10.1007/s10935-025-00888-1

Infection. 2025 Dec 8. doi: 10.1007/s15010-025-02685-8. Online ahead of print.

ABSTRACT

PURPOSE: Sepsis is a leading cause of morbidity and mortality, yet its documentation and coding in administrative health data remain unreliable. Accurate coding is essential for epidemiological surveillance, quality assurance, and reimbursement. This study aims to identify patient characteristics associated with under-diagnosis and under-coding of sepsis in German inpatient administrative health data (IAHD).

METHODS: This secondary analysis of the multicenter OPTIMISE study included 10,334 hospital cases from ten German hospitals (2015-2017). Sepsis cases were identified via structured chart review and compared to ICD-coded diagnoses. Logistic regression and classification tree analyses were used to determine predictors of under-diagnosis and under-coding, including ICU admission, organ dysfunction, and infection source.

RESULTS: Among 1,310 cases fulfilling severe sepsis-1 criteria, only 30.7% were correctly coded. The strongest predictor for coding accuracy was explicit mention of sepsis in the medical chart (OR 19.58). ICU treatment, organ dysfunction severity, and mechanical ventilation were also associated with higher coding rates, while pneumonia as the infection source was linked to a lower probability of sepsis being named and coded.

CONCLUSION: Sepsis coding in administrative data is frequently inaccurate. Explicit naming of sepsis and severity markers strongly influence correct coding. As Germany introduces mandatory sepsis quality assurance in 2026, targeted interventions – including enhanced clinician documentation and electronic coding support – are essential to improve coding reliability and patient care.

PMID:41359203 | DOI:10.1007/s15010-025-02685-8

Carbon Balance Manag. 2025 Dec 8. doi: 10.1186/s13021-025-00370-9. Online ahead of print.

ABSTRACT

Consolidated airborne laser scanning (ALS) programs, satellite imagery and spaceborne structural measurements have enabled major advances in canopy height mapping that translate towards the forest carbon biomass arena. However, we must carefully evaluate the cost of using fine-grained canopy height products to predict biomass under calibration models scoped at the scale of inventory plots. In this study, we estimated biomass using field plots and ALS metrics before predicting biomass over a jurisdiction of ~ 15,500 km² in Spain using 10 m, 25 m, 44 m, and 100 m as prediction scales. We altered the scale of ALS-based biomass predictors in 10 sub-jurisdictions intensively surveyed by the Spanish National Forest Inventory (NFI) before estimating mean and total biomass using three options: (i) traditional NFI design-based (DB) estimation, (ii) a model-based (MB) approach using scale-varying canopy height metrics from ALS and NFI plots, and (iii) an small-area estimation (SAE) implemntation designed for sub-jurisdictional domains. Higher uncertainties – relative standard errors (SE) – were found for DB, particularly at sub-jurisdictional and stratum levels. We observed a consistent increase in uncertainty for MB estimation from the finest 10 m scale up to 100 m. In MB estimation, the maximum relative bias reached 11% for 10-m predictions compared to the baseline estimate at the NFI sampling native resolution. The bias associated with the prediction scale ranged from + 5% (25 m) to -8% (100 m). The mean biomass estimates for SAE generally ranged between DB and MB but at lower uncertainty to the former, especially as the NFI sampling becomes scarcer and not enough for solid inference of biomass mean. The SEA statistics helped to disentangle biomass comparisons between ALS-based inference and the traditional NFI estimation that do not incorporate remote sensing data.

PMID:41359202 | DOI:10.1186/s13021-025-00370-9

Support Care Cancer. 2025 Dec 8;34(1):15. doi: 10.1007/s00520-025-10226-0.

ABSTRACT

BACKGROUND: Pancreatic cancer is often diagnosed at advanced stages with limited treatment options. Although palliative care (PC) improves symptom control and end-of-life outcomes, referrals are frequently delayed. We evaluated changes in symptom intensity and analyzed survival and place of death among patients referred to PC.

METHODS: We conducted a retrospective study of adults diagnosed with pancreatic cancer between 2011 and 2024 at a tertiary care hospital. Patients were grouped by referral to PC. Data were extracted from electronic records. Symptom intensity was assessed using the Edmonton Symptom Assessment System (ESAS) at the first and second PC visits. Survival was analyzed with Kaplan-Meier curves, and alluvial plots illustrated changes in symptom burden.

RESULTS: Among 489 patients (median age 67), 69.5% were referred to PC. Only 8.8% had resectable tumors, and 49.7% had metastases, more common in the PC group (54.7% vs. 14.8%; p < 0.001). Pain and fatigue were the most intense symptoms at admission. Anxiety, depression, and nausea demonstrated a significant improvement in intensity at the second PC assessment. In locally advanced unresectable cancer, PC referral was associated with longer survival (188 vs. 58 days; p = 0.022). Patients receiving PC more often died at home (80.2% vs. 25.0%; p < 0.001).

CONCLUSION: Our findings demonstrate a reduction in symptom intensity-particularly pain and fatigue-after PC admission. Patients referred to PC were more likely to have advanced, unresectable disease. These results underscore the need to integrate PC earlier in the treatment course to provide more comprehensive, individualized, and compassionate care.

PMID:41359199 | DOI:10.1007/s00520-025-10226-0

Environ Monit Assess. 2025 Dec 8;198(1):24. doi: 10.1007/s10661-025-14880-z.

ABSTRACT

The Vaal River is a vital water source for domestic, industrial, and agricultural use in South Africa’s economic heartland, but its water quality is increasingly threatened by nutrient pollution, resulting in nuisance algal blooms and invasive aquatic plant growth. This study applies an Algal Problem Index (API) to assess biological water quality and identify risks associated with algae and cyanobacteria in the Vaal River’s upper reaches. Water samples were collected over a 12-month hydrological year from 16 sites, including sites in the main stream, major tributaries, and reservoirs. Cyanobacteria and algae were identified, and analyses of physico-chemical parameters and chlorophyll-a concentrations were conducted. Multivariate statistical analysis was used to evaluate relationships between environmental conditions and algal-related problems. Results revealed 16 taxa, including Microcystis aeruginosa and Dolichospermum circinale, responsible for bad tastes, foul odours, and potential toxin production. Tributaries such as the Riet Spruit and Klip River were major sources of nutrient loading, although low light conditions limited algal growth in certain areas. Elevated API scores increased downstream, reflecting degrading water quality from the Vaal Dam to the Vaal River barrage. This study demonstrated the innovative and practical application of the API as a visual tool integrating multiple biological indicators into a single, easily interpretable measure of water quality. By summarising complex algal-related risks, it can provide water managers with a rapid, practical way to assess ecological conditions, and it can be applied in other catchments facing similar challenges.

PMID:41359193 | DOI:10.1007/s10661-025-14880-z

Tech Coloproctol. 2025 Dec 8;30(1):6. doi: 10.1007/s10151-025-03236-x.

ABSTRACT

INTRODUCTION: Limited data exists in literature regarding concomitant ventral rectopexy (VRP) and sacrocolpo/hysteropexy (SCP/SHP), with existing studies being predominantly retrospective. The aim of this meta-analysis is to assess the anatomical and functional outcomes of combined VRP and SCP/SHP for the treatment of multicompartmental pelvic organ prolapse (POP).

METHODS: We performed systematic research and meta-analysis from PubMed/MEDLINE and EMBASE, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, until 15 January 2025. Women submitted to VRP with SCP/SHP were included. Improvement of anorectal symptoms were evaluated. Postoperative anatomical relapse was reported. Re-operation rates were evaluated.

RESULTS: Six articles were included. Constipation/obstructed defecation syndrome (ODS) [odds ratio (OR) 0.26, 95% CI 0.10-0.68; p = 0.006 (I² test 81%, p = 0.56)] and of anal/fecal incontinence (AI/FI) rates [OR 0.09, 95% CI 0.03-0.30; p < 0.0001 (I² test 70%, p = 0.04)] significantly improved after combined VRP and SCP/SHP. The proportion metanalysis of four included studies reported a subjective POP recurrence rate of 7% (95% CI 1-13%; I² test 82.9%, p < 0.001). The proportion metanalysis of five included studies for objective POP recurrence was 5% (95% CI 1-9%; I² test 56.9%, p = 0.041). No serious adverse events were reported.

CONCLUSIONS: VRP combined with SCP/SHP has been shown to be safe and effective for women with multicompartment POP, providing optimal anatomical and functional outcomes. Larger, long-term, prospective-controlled studies are needed to confirm these results.

PMID:41359190 | DOI:10.1007/s10151-025-03236-x

Diabetologia. 2025 Dec 8. doi: 10.1007/s00125-025-06613-1. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: The aetiology of type 1 diabetes remains elusive. Family history of type 1 diabetes increases the disease risk but the role of other autoimmune diseases or type 2 diabetes in the family are unclear. Here, we aimed to analyse the effect of family history of diabetes and autoimmune diseases on development of islet autoimmunity and progression to type 1 diabetes.

METHODS: The Environmental Determinants of Diabetes in the Young (TEDDY) study is a prospective observational cohort study of children recruited as newborns in 2004-2010 at clinical centres in Finland, Germany, Sweden and the USA. A total of 8676 children with high-risk HLA-DR-DQ genotype for type 1 diabetes fulfilled the eligibility criteria for regular follow-up. Questionnaire-based family history of all types of diabetes and autoimmune diseases among first- and second-degree relatives (FDRs and SDRs; data available for 8558 and 7479 children, respectively) was collected. The main outcomes were development of islet autoimmunity and progression from autoimmunity to type 1 diabetes. Data until 31 January 2016 were analysed.

RESULTS: Persistent islet autoantibodies were found in 669 children and type 1 diabetes in 233 children (45% and 46% female sex, respectively). The median follow-up time after seroconversion was 6.5 years (IQR 3.3-8.5). Having an FDR with type 1 diabetes increased the child’s risk of islet autoimmunity (HR 2.2 [95% CI 1.8, 2.8]; p<0.001), particularly if the father or sibling had type 1 diabetes. Islet autoimmunity was also associated with family history of type 1 diabetes in an SDR when participants having an FDR with type 1 diabetes were excluded from the analysis (HR 1.4 [95% CI 1.1, 1.8]; p=0.017). Notably, progression from autoantibody positivity to type 1 diabetes was significantly delayed in children having type 2 diabetes in an SDR (HR 0.61 [95% CI 0.44, 0.86]; p=0.004). Islet autoimmunity or progression to type 1 diabetes were not associated with other types of diabetes or autoimmune diseases in the family.

CONCLUSIONS/INTERPRETATION: Family history of diabetes is differentially associated with development of islet autoimmunity and progression to type 1 diabetes. The contribution made by familial, genetic and environmental factors to the two phases of the disease pathogenesis deserves distinct analyses.

DATA AVAILABILITY: Data reported here can be obtained by request at the NIDDK Central Repository website, Resources for Research (R4R), https://repository.niddk.nih.gov/ .

PMID:41359174 | DOI:10.1007/s00125-025-06613-1

Eur Radiol. 2025 Dec 8. doi: 10.1007/s00330-025-12194-9. Online ahead of print.

ABSTRACT

OBJECTIVE: Diagnostic reference levels (DRLs) are essential for optimizing radiation dose in CT examinations. However, current DRLs may not reflect the performance of CT scanners or the background of individual facilities, potentially leading to misleading dose indicators. Furthermore, the factors that influence DRLs remain unclear. This study aims to investigate how facility characteristics and CT scanner performance affect DRLs.

MATERIALS AND METHODS: A dose survey was conducted in 2023 targeting 982 medical facilities in Tokyo. Data were collected from 100 facilities and 176 CT scanners, focusing on adult patients (50-70 kg) undergoing common CT protocols. CTDIvol and DLP were analyzed, and the 75th percentile was defined as the Tokyo-DRL. Factors potentially influencing DRLs, including the presence of radiologists, certified CT technologists, hospital size, CT scanner specifications, and image reconstruction methods, were systematically evaluated.

RESULTS: The Tokyo-DRLs were lower than Japan’s 2020 DRLs across all protocols, likely reflecting advancements in CT technology and staff expertise. Radiation doses were lower in facilities with radiologists and certified CT technologists, more hospital beds, wider scan beam widths, and use of iterative reconstruction or deep learning-based reconstruction. For dual-energy CT, DRLs were established only for the pulmonary artery with contrast due to limited data. Multivariate analysis revealed key dose-influencing factors such as tube current modulation and scan sequence in the head, and beam width in trunk scanning.

CONCLUSION: Facility characteristics and scanner performance significantly impact radiation dose. Periodic, detailed surveys are necessary to update DRLs in line with evolving technologies and clinical practice.

KEY POINTS: Question How do facility characteristics and CT scanner performance influence diagnostic reference levels in clinical CT examinations? Findings Radiation doses in CT examinations varied significantly depending on facility size, staff expertise, scanner specifications, and image reconstruction methods. Clinical relevance Identification of facility and scanner characteristics enables more effective radiation dose optimization, enhancing patient safety without compromising diagnostic quality in CT imaging.

PMID:41359161 | DOI:10.1007/s00330-025-12194-9