Tag: nevin manimala

BMC Oral Health. 2025 Apr 13;25(1):557. doi: 10.1186/s12903-025-05964-w.

ABSTRACT

BACKGROUND: Titanium is commonly used for dental implants due to its high biocompatibility and durability. However, concerns about metal ion release and aesthetic limitations in certain tissue biotypes have driven the search for alternative materials. Polyetherketoneketone (PEKK), a high-performance polymer, has emerged as a promising option due to its biomimetic properties. Surface modifications, such as treatment with sulfuric acid (H2SO4), may further enhance its osteogenic potential.

AIM: The study aimed to evaluate the osteogenic efficacy of H2SO4-modified PEKK implants in comparison to titanium implants.

METHODOLOGY: Three groups were assessed: Titanium, unmodified PEKK and H2SO4-modified PEKK(SPEKK). Surface characteristics were analyzed using scanning electron microscopy (SEM). Wettability was checked through contact angle evaluation. Cell viability was evaluated through MTT assays. Implants were placed in rat mandibles, and bone formation was analyzed after 6 weeks using nano-CT and histological assessments. Toxicity was as Statistical comparisons were performed using one-way ANOVA and Tukey’s post-hoc test.

RESULTS: Acid-modified PEKK implants exhibited the highest bone formation (280.09 ± 12.03) significantly outperforming Titanium (265.12 ± 11.08) and unmodified PEKK (266.52 ± 7.28) (p < 0.05).

CONCLUSIONS: H2SO4-modified PEKK (SPEKK) implants demonstrated superior osteogenic properties compared to titanium, suggesting that these modified polymers could be viable alternatives for aesthetic implants.

PMID:40223045 | DOI:10.1186/s12903-025-05964-w

J Holist Nurs. 2025 Apr 13:8980101251330394. doi: 10.1177/08980101251330394. Online ahead of print.

ABSTRACT

Purpose: The purpose of this study is to evaluate if integrating a holistic mindfulness modality into group therapy can decrease violence with-injury on an inpatient psychiatric unit. Design: The research used a mixed experimental design. Method: Allied Therapy Services (ATS) staff was trained in the mindfulness modality Brief Intentional Grounding and implemented it within group therapy twice daily in two different acute psychiatric units. Six months of post-intervention data on workplace violence with-injury incidents was compared to 6-month pre-intervention statistics on workplace violence with-injury. Qualitative data included patient and staff surveys on benefits of the intervention. Findings: The study revealed the use of Brief Intentional Grounding correlated with a significant reduction in workplace violence with-injury in two adult acute inpatient psychiatric units over a 6-month period when compared to the previous six months. The qualitative survey-data showed significant improvement in patients’ emotional regulation, ability to manage stress, interpersonal connectivity, and gratitude after practicing Brief Intentional Grounding. Furthermore, staff reported practicing Brief Intentional Grounding was beneficial and improved their well-being. Conclusions: Integrating Brief Intentional Grounding into group therapy on an acute adult inpatient psychiatric unit improved patients’ ability to regulate their emotions and led to reductions in violence with-injury, providing a safer work environment for nursing staff.

PMID:40221990 | DOI:10.1177/08980101251330394

J Parkinsons Dis. 2025 Apr 13:1877718X251323914. doi: 10.1177/1877718X251323914. Online ahead of print.

ABSTRACT

BackgroundParkinson’s disease (PD) has marked phenotypic variability. Increased lipids have been suggested as being neuroprotective whilst hyperglycemia may increase α-synuclein aggregation.ObjectiveWe have tested whether high total cholesterol and high-density lipoprotein cholesterol (HDL-C) and low levels of fructosamine are associated with better PD phenotypes and predict less rapid progressionMethodsNon-fasting serum HDL-C, total cholesterol, and fructosamine were measured at baseline in 866 patients with early PD (median duration, 0.96; IQR, 0.43-1.98 years) from the Oxford Discovery cohort. These biomarkers were compared against our data-derived PD subtypes using multinomial logistic regression. We used multilevel models to predict longitudinal motor and non-motor outcomes (e.g., cognition, mood).ResultsHDL-C and total cholesterol differed across baseline PD phenotype clusters, with reduced levels associated with the most severe motor and non-motor phenotypes (psychological well-being, cognitive impairment, REM sleep behavior disorder, and daytime sleepiness). Higher HDL-C and total cholesterol, although the latter was attenuated after adjustment for statin use, were associated with better baseline activities of daily living (e.g., UPDRS-II score with 1 SD increase in HDL-C -0.74, 95%CI -1.22 to -0.26, p = 0.002) and non-motor features. Neither predicted the rate of motor or non-motor progression. Fructosamine levels were not associated with phenotypic variability or rate of disease progression.ConclusionsHypercholesterolemia was associated with a better motor/non-motor disease subtype and daily living impairment at presentation, but did not predict longitudinal change. Future research needs to determine if these associations are causally related or secondary to disease onset by examining prodromal subjects.

PMID:40221968 | DOI:10.1177/1877718X251323914

Stat Methods Med Res. 2025 Apr 13:9622802241313283. doi: 10.1177/09622802241313283. Online ahead of print.

ABSTRACT

Balancing influential covariates is crucial for valid treatment comparisons in clinical studies. While covariate-adaptive randomization is commonly used to achieve balance, its performance can be inadequate when the number of baseline covariates is large. It is, therefore, essential to identify the influential factors associated with the outcome and ensure balance among these critical covariates. In this article, we propose a novel adaptive randomization approach that integrates the patients’ responses and covariates information to select sequentially significant covariates and maintain their balance. We establish theoretically the consistency of our covariate selection method and demonstrate that the improved covariate balancing, as evidenced by a faster convergence rate of the imbalance measure, leads to higher efficiency in estimating treatment effects. Furthermore, we provide extensive numerical and empirical studies to illustrate the benefits of our proposed method across various settings.

PMID:40221962 | DOI:10.1177/09622802241313283

Eur Radiol. 2025 Apr 13. doi: 10.1007/s00330-025-11567-4. Online ahead of print.

ABSTRACT

PURPOSE: This multicenter trial was conducted to evaluate MRI for the longitudinal management of incidental pulmonary nodules in heavy smokers.

MATERIALS AND METHODS: 239 participants (63.9 ± 8.4 years, 43-82 years) at risk of or with COPD GOLDI-IV from 16 centers prospectively underwent two rounds of same-day low-dose computed tomography (LDCT1&2) and MRI1&2 at an interval of three years in the nationwide COSYCONET trial. All exams were independently assessed for incidental pulmonary nodules in a standardized fashion by two blinded readers, incl. axis measurements and Lung-RADS categorization, with consensual LDCT results serving as the standard of reference. A change in diameter ≥ 2 mm was rated as progress. 11 patients underwent surgery for suspicious nodules after the first round.

RESULTS: Two hundred twenty-four of two hundred forty nodules (93.3%) persisted from LDCT1 to LDCT2, with a sensitivity of MRI2 of 82.8% and 81.5% for readers 1 and 2, respectively. Agreement in Lung-RADS categories between LDCT2 and MRI2 was substantial in per-nodule (κ = 0.62-0.70) and excellent in a per-patient (κ = 0.86-0.88) approach for both readers, respectively. Concordance between LDCT2 and MRI2 for growth was excellent to almost perfect (κ = 0.88-1.0). The accuracy of LDCT1 and MRI1 for lung cancer was 87.5%. Lung-RADS ≥ 3 category on MRI1 had higher accuracy for predicting progress (23.1% and 21.4%, respectively) than LDCT1 (15.8%).

CONCLUSION: Compared to LDCT, MRI shows similar capabilities for the longitudinal evaluation of incidental nodules in heavy smokers. Decision-making for nodule management guided by Lung-RADS seems feasible based on longitudinal MRI.

KEY POINTS: Question Can MRI serve as an alternative to low-dose CT (LDCT) for the longitudinal management of pulmonary nodules in heavy smokers, addressing concerns over radiation exposure? Findings MRI demonstrated substantial agreement with LDCT in detecting nodule growth, accurately categorizing Lung-RADS, and comparable accuracy in identifying malignancy over a three-year follow-up. Clinical relevance Longitudinal MRI demonstrates high consistency with LDCT in assessing the growth of incidental pulmonary nodules and categorizing per-patient Lung-RADS, offering a reliable, radiation-free alternative for monitoring and early malignancy detection in high-risk populations.

PMID:40221941 | DOI:10.1007/s00330-025-11567-4

Eur Radiol. 2025 Apr 13. doi: 10.1007/s00330-025-11574-5. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to assess diagnostic performance of high-resolution dynamic contrast-enhanced (DCE) MRI with deep learning-based compressed sensing and super-resolution (DLCS-SR) reconstruction for identifying microadenomas.

MATERIALS AND METHODS: This prospective study included 126 participants with suspected pituitary microadenomas who underwent DCE MRI between June 2023 and January 2024. Four image groups were derived from single-scan DCE MRI, which included 1.5-mm slice thickness images using DLCS-SR (1.5-mm DLCS-SR images), 1.5-mm slice thickness images with deep learning-based compressed sensing reconstruction (1.5-mm DLCS images), 1.5-mm routine images, and 3-mm slice thickness images using DLCS-SR (3-mm DLCS-SR images). Diagnostic criteria were established by incorporating laboratory findings, clinical symptoms, medical histories, previous imaging, and certain pathologic reports. Two readers assessed the diagnostic performance in identifying pituitary abnormalities and microadenomas. Diagnostic agreements were assessed using κ statistics, and intergroup comparisons for microadenoma detection were performed using the DeLong and McNemar tests.

RESULTS: The 1.5-mm DLCS-SR images (κ = 0.746-0.848) exhibited superior diagnostic agreement, outperforming 1.5-mm DLCS (κ = 0.585-0.687), 1.5-mm routine (κ = 0.449-0.487), and 3-mm DLCS-SR images (κ = 0.347-0.369) (p < 0.001 for all). Additionally, the performance of 1.5-mm DLCS-SR images in identifying microadenomas [area under the receiver operating characteristic curve (AUC), 0.89-0.94] surpassed that of 1.5-mm DLCS (AUC, 0.83-0.87; p = 0.042 and 0.011, respectively), 1.5-mm routine (AUC, 0.76-0.78; p < 0.001), and 3-mm DLCS-SR images (AUC, 0.72-0.74; p < 0.001).

CONCLUSION: The findings revealed superior diagnostic performance of 1.5-mm DLCS-SR images in identifying pituitary abnormalities and microadenomas, indicating the clinical-potential of high-resolution DCE MRI.

KEY POINTS: Question What strategies can overcome the resolution limitations of conventional dynamic contrast-enhanced (DCE) MRI, and which contribute to a high false-negative rate in diagnosing pituitary microadenomas? Findings Deep learning-based compressed sensing and super-resolution reconstruction applied to DCE MRI achieved high resolution while improving image quality and diagnostic efficacy. Clinical relevance DCE MRI with a 1.5-mm slice thickness and high in-plane resolution, utilizing deep learning-based compressed sensing and super-resolution reconstruction, significantly enhances diagnostic accuracy for pituitary abnormalities and microadenomas, enabling timely and effective patient management.

PMID:40221940 | DOI:10.1007/s00330-025-11574-5

Eur Radiol. 2025 Apr 13. doi: 10.1007/s00330-025-11566-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Radiation safety concerns have spurred the development of real-time dosimetry systems. This study investigated the occupational dose exposure of interventional radiologists during lower extremity and abdominal procedures.

MATERIALS AND METHODS: Real-time dosimetry was performed during 102 consecutive interventions (51 lower extremity, 51 abdominal). Radiation protection measures included protective glasses (lead equivalent 0.5 mm), thyroid shielding (0.5 mm), vests (0.35 mm), aprons (0.25 mm), as well as movable acrylic and table shields (both 0.5 mm) during all procedures. Dosimeters were attached to the interventionalist’s glasses on the side of the x-ray tube, to the back of the supporting hand, and under the vest. Using standardized values over time to account for exposure time differences between interventions, dose-area products and the dose equivalent H_P(10) were recorded in all three positions.

RESULTS: Lower extremity angiographies were associated with a substantially lower median dose-area product (5.3 vs. 51.4 Gy × cm²) and exposure time (462 vs. 762 s) than abdominal interventions (both p < 0.001). For lower extremity procedures, H_P(10) per minute recorded by the hand, cranium/eye lens, and body trunk dosimeters was 2.45, 0.01, and < 0.01 µSv/min, respectively. Markedly higher dose equivalents were documented for the hand (7.54 µSv/min), cranium/eye lens (0.26 µSv/min), and body trunk (0.04 µSv/min) during abdominal interventions (all p < 0.001).

CONCLUSION: Real-time dosimetry confirmed sufficient radiation protection with the application of dedicated safety measures, even in dose-intensive abdominal procedures. Interventionalists’ supporting hands are subjected to the highest radiation exposure, followed by the cranium/eye lens and the body trunk.

KEY POINTS: Question Active dosimetry facilitates real-time assessment of radiation exposure in different measurement sites, but a multi-dosimeter setup has not been explored for interventional radiology so far. Findings Occupational radiation exposure is considerably higher in abdominal than in lower extremity procedures. Interventionalists’ supporting hands receive the highest dose equivalents regardless of procedure type. Clinical relevance Dose monitoring in real time is key to understanding the radiation burden of different anatomical features during image-guided interventions. Especially in dose-intensive abdominal procedures, protective measures are essential to minimize the occupational radiation exposure of the interventionalist.

PMID:40221939 | DOI:10.1007/s00330-025-11566-5

Microbiol Immunol. 2025 Apr 13. doi: 10.1111/1348-0421.13220. Online ahead of print.

ABSTRACT

Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers, and immunotherapy targeting programmed cell death 1 (PD-1) has become a treatment option for recurrent OSCC after surgery and radiation therapy. However, few studies have identified definitive biomarkers for predicting patient response to anti-PD1 therapy in OSCC. In the present study, biopsy specimens were obtained from 23 patients with recurrent OSCC who were subsequently treated with anti-PD1 therapy. Immunohistochemical examinations of CD3, CD8, FOXP3, CD103, CD163, programmed cell death ligand 1 (PD-L1), HLA-A/B/C, HLA-DR, and β2 microglobulin were performed, and their correlation with clinical response was statistically analyzed. We found that an increased density of CD8-positive lymphocytes and increased PD-L1 expression predicted a favorable response to anti-PD1 therapy in recurrent OSCC. In contrast, clinical factors such as age and sex, and immune-related factors such as HLA-Classes I and II, were not associated with the response to anti-PD1 therapy. Taken together, our results suggest that immunohistochemical analysis of CD8 and PD-L1 may be useful for predicting the efficacy of anti-PD1 therapy in recurrent OSCC.

PMID:40221937 | DOI:10.1111/1348-0421.13220

J Hosp Med. 2025 Apr 13. doi: 10.1002/jhm.70054. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric Hospital Medicine (PHM) has a rapidly changing landscape following subspecialty certification in 2016. As the field continues to evolve, so does the role of fellowship training.

OBJECTIVES: The goal of this study was to characterize postgraduate expectations of current PHM fellows to contribute to the understanding of PHM workforce dynamics.

METHODS: Using a constructivist approach, we employed a cross-sectional survey method with both multiple-choice and free-text questions to study PHM fellows’ perspectives regarding posttraining employment and motivations for pursuing fellowship. We used multiple listservs to recruit current PHM fellows for participation. We analyzed survey data using descriptive statistics and free-text responses using conventional inductive content analysis.

RESULTS: A total of 119 PHM fellows (response rate 61%) completed the survey. Most participants anticipated higher starting salaries, more protected time and leadership opportunities, and more efficient career advancement because of PHM fellowship training. Additionally, participants noted several modifiable factors influencing their postgraduate employment considerations which included workplace culture and lifestyle considerations. Participants reported various motivations for pursuing PHM fellowship training, including future job security and career flexibility.

CONCLUSIONS: Despite different reasons for pursuing additional training, the majority of PHM fellows in our study believe that fellowship training should result in increased compensation, resources, and career opportunities than if they had not completed fellowship training. These findings have implications for counseling trainees interested in PHM and for the PHM workforce.

PMID:40221932 | DOI:10.1002/jhm.70054

Knee Surg Sports Traumatol Arthrosc. 2025 Apr 13. doi: 10.1002/ksa.12675. Online ahead of print.

ABSTRACT

PURPOSE: Wearable technologies, like the Apple Watch, offer new possibilities for collecting objective data on physical activity post-operatively following total knee arthroplasty (TKA). This study aims to describe changes in daily physical activity levels using objective metrics over different time points following TKA.

METHODS: This study analyzed data from a prospective cohort of 152 patients undergoing a unilateral TKA. Patients wore an Apple Watch and used a digital care management application for data collection. Step count, steadiness, standing duration, gait speed and performance on a 6-min walk test were collected from Apple HealthKit at multiple time points: pre-operative, 6 weeks post-operatively, 6 months post-operatively and 12 months post-operatively. Statistical analyses were performed using R software, including descriptive statistics and paired t tests to compare outcomes at different time points post-operatively.

RESULTS: Participants demonstrated significant improvements in daily physical activity levels over the course of 12 months post-operative. At 6 months post-operative, participants showed the highest average daily step count (mean ± SD: 5293 ± 236 steps; p < 0.001), with improvements persisting at 12 months post-operative (5180 ± 260 steps; p < 0.001) compared to preoperative values. Gait speed increased from 0.88 ± 0.01 m/s preoperatively to 1.01 ± 0.01 m/s (p = 0.006) at 12 months post-operative. Standing hours increased from 9.99 ± 0.30 to 11.47 ± 0.31 h at 6 months post-operative and persisted. Steadiness and the estimated 6-minute walk test showed recovery trends, though variability remained at 12 months post-operative, suggesting the need for additional longitudinal assessment CONCLUSION: This study provides one of the first longitudinal analyses of post-operative functional recovery using Apple HealthKit, offering continuous real-world gait and activity tracking beyond traditional patient-reported measures. These findings highlight the value of wearable technology in monitoring post-operative activity and offering insights into TKA recovery patterns. The study suggests a critical recovery window at 6 months post-operative and emphasizes the need for ongoing support to maintain improvements. The integration of wearable technology in post-operative monitoring offers a promising approach to tracking patient progress and optimizing functional outcomes following TKA.

LEVEL OF EVIDENCE: Level II.

PMID:40221914 | DOI:10.1002/ksa.12675