Tag: nevin manimala

Spine Deform. 2025 Jan 27. doi: 10.1007/s43390-025-01048-5. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the sites where the tether breaks in vertebral body tethering (VBT) cases.

METHODS: Intraoperative evaluation of broken tethers in patients who had anterior revision.

INCLUSION CRITERIA: anterior revision of VBT cases with explantation of the full implant and photo documentation. Eight patients met the inclusion criteria. The primary variable of interest was the location of tether breakage in relation to the vertebral curve and the tether-screw interface. Another variable of interest was to evaluate the difference in breakage rates between anterior and posterior tethers in double tether cases.

RESULTS: Sixty tethers bridging the intervertebral disc within this cohort of eight patients were found. Seven implants were removed from thoracolumbar curves and one implant from a thoracic curve. We identified 32 tether breakages. Double tethers were used in six patients. In these six cases, 15 breakages were found in the posterior tether and 13 in the anterior tether. Four cases (50%) exhibited breakages at the apex, eight cases (100%) at the lowest instrumented vertebra (LIV), and five cases (63%) at the uppermost-instrumented vertebra (UIV). Five tether breakages (in three cases with double tether) were observed at the screw sites, while the remaining 27 exhibited cord breakages near the intervertebral discs. In double tether systems, statistical analysis did not reveal any significant difference in breakage rates between anterior and posterior tethers.

CONCLUSIONS: In VBT cases, the tether breaks mostly at the level of the intervertebral disc, adjacent to the lowest instrumented vertebra.

LEVEL OF EVIDENCE: Level IV (Case series with no comparison group).

PMID:39871083 | DOI:10.1007/s43390-025-01048-5

Oral Radiol. 2025 Jan 27. doi: 10.1007/s11282-025-00802-9. Online ahead of print.

ABSTRACT

OBJECTIVES: This study evaluates the potential of pulp volume/total tooth-volume measurements of canine teeth in relation to chronologic age in patients with cleft lip and palate (CLP). The significance of this study lies in its exploration of the usability of these measurements for age determination in CLP patients, providing a novel perspective to the existing literature.

METHODS: Cone beam computed tomography images of 33 patients (16 females, 17 males) with unilateral CLP aged 14-45 years and 33 age- and sex-matched healthy individuals (16 females, 17 males) were retrospectively evaluated. Using ITK-SNAP software, pulp and whole tooth volumes of canine teeth on the non-defect side of CLP patients and the corresponding side of healthy individuals were measured. Their relationship with chronologic age was evaluated, and comparisons were made between the CLP and control groups.

RESULTS: No statistically significant difference was observed between the whole tooth volume, pulp volume, and pulp volume/total tooth-volume ratios of the control and CLP groups. A paired t test comparing chronologic age and calculated mean age of both groups found no significant difference.

CONCLUSIONS: The results show that the pulp and total tooth-volume ratios of canine teeth in the non-defect areas of individuals with unilateral CLP correlate with chronologic age and can be used reliably for age determination. This indicates that individuals with CLP can be evaluated similarly to healthy individuals, allowing accurate age estimation based on dental measurements.

PMID:39871068 | DOI:10.1007/s11282-025-00802-9

Ann Biomed Eng. 2025 Jan 27. doi: 10.1007/s10439-025-03684-4. Online ahead of print.

ABSTRACT

Titanium (Ti)-based materials are favored for hard tissue applications, yet their bioinertness limits their success. This study hypothesizes that functionalizing Ti materials with chitosan nano/microspheres and calcitriol (VD) will enhance their bioactivity by improving cellular activities and mineralization. To test this, chitosan particles were applied uniformly onto Ti surfaces using electrophoretic deposition (EPD) at 20 V for 3 minutes. VD was then loaded onto the coated surfaces, and the release profile of VD was monitored. Human fetal osteoblastic cells (hFOB) were cultured on the VD-loaded Ti surfaces. Cellular activities such as proliferation, Alkaline phosphatase (ALP) activity, osteogenic gene expression (runt-related transcription factor 2 (Runx2), collagen type 1 (Col I), osteocalcin ( OCn), osteopontin (OP)), and mineralization were assessed. Von Kossa staining was performed to analyze mineralization, and the expression of cell adhesion proteins (N-cadherin (NC), integrin alpha V (IaV), integrin beta 3, (Ib3)) was measured. The results showed that approximately 50% of the VD released over 50 hours. The chitosan coating increased surface roughness three-fold, and this, combined with VD release, resulted in reduced cell proliferation but increased ALP activity, suggesting enhanced differentiation. VD-functionalized Ti surfaces showed statistically significant differences in osteogenic gene expressions, particularly on rougher surfaces. Additionally, the expression of cell adhesion proteins (NC, IaV, Ib3) was upregulated on VD-containing coated surfaces. Von Kossa analysis revealed that surface roughness significantly enhanced mineralization, particularly on VD-free surfaces by day 7, while mineralization on VD-containing bare surfaces started on day 14. These findings demonstrate that VD-loaded chitosan coatings significantly enhance the biocompatibility and bioactivity of Ti-based materials, highlighting their potential for applications in bone regeneration.

PMID:39871063 | DOI:10.1007/s10439-025-03684-4

J Vet Intern Med. 2025 Mar-Apr;39(2):e70002. doi: 10.1111/jvim.70002.

ABSTRACT

BACKGROUND: Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a biomarker for the early diagnosis of AKI.

OBJECTIVES: To evaluate uNGAL in dogs with non-associative immune mediated hemolytic anemia (IMHA) and to evaluate whether uNGAL correlates with disease severity markers, negative prognostic indicators and outcome.

ANIMALS: Twenty-two dogs with non-associative IMHA and 14 healthy dogs.

METHODS: Prospective case-control study. uNGAL was measured by a commercially available ELISA-kit and corrected to urine creatinine (uNGAL to creatinine ratio [UNCR]). uNGAL and UNCR of IMHA cases were compared to that of healthy dogs and the correlation with other clinicopathological markers was evaluated. uNGAL and UNCR were also compared between dogs with a CHAOS or ASA score < 3 and ≥ 3.

RESULTS: uNGAL and UNCR were significantly higher in dogs with IMHA when compared to healthy controls (uNGAL median 114.58 and 0.43 ng/mL, respectively, p < 0.001; UNCR median 174.87 and 0.13 ng/mg, respectively, p < 0.001). uNGAL and UNCR were moderately positively correlated with urea (p = 0.005, r = 0.58, 0.20-0.81 95% CI and p = 0.001, r = 0.64, 0.29-0.84 95% CI, respectively) and total bilirubin (p = 0.003, r = 0.60, 0.22-0.82 95% CI and p = 0.002, r = 0.62, 0.25-0.83 95% CI, respectively). These were also significantly higher in dogs with hemoglobinuria compared to those without (uNGAL: median 269 and 30.99 ng/mL, respectively, p < 0.001; UNCR: median 585.3 and 352 37.47 ng/mg, respectively, p < 0.001). There was no statistically significant difference in uNGAL or UNCR when assessing survival to discharge (p = 0.24 and p = 0.16, respectively, 95% CI).

CONCLUSIONS: This study suggests that renal injury might be underappreciated in dogs with IMHA.

PMID:39871050 | DOI:10.1111/jvim.70002

Int Urol Nephrol. 2025 Jan 27. doi: 10.1007/s11255-025-04389-2. Online ahead of print.

ABSTRACT

PURPOSE: To identify prognostic factors for overall survival (OS) and develop a prognostic score in patients receiving docetaxel in metastatic castration-resistant prostate cancer (mCRPC).

METHODS: Retrospective analysis was conducted on mCRPC patients treated with docetaxel at a German tertiary center between March 2010 and November 2023. Prognostic clinical and laboratory factors were analyzed using uni- and multivariable logistic regression. Next, the result of the modified Glasgow Prognostic Score (mGPS), neutrophil-to-lymphocyte ratio (NLR) (cut-off ≥3), the presence of high-volume bone metastases (as defined by CHAARTED criteria), hemoglobin (Hb) (cut off < 13.2 g/dl), Gleason score ≥8, and presence of visceral metastases were combined into the Metastasized Prostate Cancer Survival Score (MeProCSS). Patients were then stratified into three prognostic groups. Their OS was assessed by Kaplan-Meier analysis.

RESULTS: Median OS for the overall cohort (n = 153) and the first-line cohort (n = 83) was 18 and 21.5 months, respectively. In multivariable analysis, high-volume bone metastases and Hb levels below the norm were significant predictors of shorter OS in the total cohort. The MeProCSS demonstrated an area under curve (AUC) of 0.837 in the overall cohort and 0.946 in first-line cohort. Kaplan-Meier analysis revealed a significant association between lower MeProCSS and longer OS in both the overall (p<0.001) and first-line (p = 0.035) cohort.

CONCLUSION: MeProCSS, consisting of routinely collected parameters prior to the start of chemotherapy, seems to effectively stratify patients with mCRPC into risk groups based on their metastatic burden, nutritional and inflammatory status. This model may guide treatment decisions and reveal a potentially often underestimated or overlooked urgency for additional measures as supportive palliative care in mCRPC patients. Further large and prospective studies are necessary for validation of MeProCSS-also in other systemic PC therapy regimens.

PMID:39871032 | DOI:10.1007/s11255-025-04389-2

Cardiovasc Eng Technol. 2025 Jan 27. doi: 10.1007/s13239-025-00771-4. Online ahead of print.

ABSTRACT

PURPOSE: The initiation of intracranial aneurysms has long been studied, mainly by the evaluation of the wall shear stress field. However, the debate about the emergence of hemodynamic stimuli still persists. This paper builds on our previous hypothesis that secondary flows play an important role in the formation cascade by examining the relationship between flow physics and vessel geometry.

METHODS: A composite evaluation framework was developed to analyze the simulated flow field in perpendicular cross-sections along the arterial centerline. The velocity field was decomposed into secondary flow components around the centerline in these cross-sections, allowing the direct comparison of the flow features with the geometrical parameters of the centerline. Qualitative and statistical analysis was performed to identify links between morphology, flow, and the formation site of the aneurysms.

RESULTS: The normalized mean curvature and curvature peak were significantly higher in the aneurysmal bends than in other arterial bends. Similarly, a significant difference was found for the normalized mean velocity ( p = 0.0274 ), the circumferential ( p = 0.0029 ), and radial ( p = 0.0057 ) velocity components between the arterial bends harboring the aneurysm than in other arterial bends. In contrast, the difference of means for the normalized axial velocity is insignificant ( p = 0.1471 ).

CONCLUSION: Thirty cases with aneurysms located on the ICA were analyzed in the virtually reconstructed pre-aneurysmal state by an in-silico study. We found that sidewall aneurysm formation on the ICA is more probable in these arterial bends with the highest case-specific curvature, which are accompanied by the highest case-specific secondary flows (circumferential and radial velocity components) than in other bends.

PMID:39871029 | DOI:10.1007/s13239-025-00771-4

J Occup Rehabil. 2025 Jan 28. doi: 10.1007/s10926-025-10270-x. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to develop an online vocational rehabilitation (VR) readiness screening (VRRS) tool for young adults diagnosed with cancer. VR readiness was defined as being physically and cognitively ready to enter or return to work or school.

METHODS: We developed an initial VRRS tool informed by previous studies, a scoping review to determine such a tool had not already been developed, and consultation with subject matter experts. We iteratively refined the tool on the basis of four rounds of interviews with young adults with cancer. The refined VRRS was then administered online to patients before they attended scheduled clinic appointments. We evaluated the VRRS completion rate; the ability of the online VRRS tool to assess patients’ readiness for VR; and the concordance between clinical interview and that of the online VRRS tool, which was determined by using Cohen’s κ or a fitting alternative; κ ≥ .61 suggested clinical utility.

RESULTS: The proportion of study participants completing the VRRS was 72.3% (136/188, 95% CI [65.4%, 78.6%]) and 69.2% (81/117, 95% CI [60.0%, 77.4%]) of participants who completed a clinical interview also completed the online VRRS tool. All clinical interview determinations and 93.8% (76/81) of online VRRS tool indicated participants’ VR readiness. The VRRS-clinical interview agreement rate was 93.8% (95% CI [86.2%, 98.0%]). The prevalence index, bias index, and prevalence- and bias-adjusted κ statistic with 95% CIs were 0.938 [- 0.991, – 0.886], 0.062 [0.009, 0.114], and 0.877 [0.724, 0.959], respectively.

CONCLUSION: The VRRS tool is thus both feasible and effective in this sample of young adults with cancer.

PMID:39871010 | DOI:10.1007/s10926-025-10270-x

Brain Inform. 2025 Jan 27;12(1):3. doi: 10.1186/s40708-024-00249-4.

ABSTRACT

Cognitive resilience (CR) describes the phenomenon of individuals evading cognitive decline despite prominent Alzheimer’s disease neuropathology. Operationalization and measurement of this latent construct is non-trivial as it cannot be directly observed. The residual approach has been widely applied to estimate CR, where the degree of resilience is estimated through a linear model’s residuals. We demonstrate that this approach makes specific, uncontrollable assumptions and likely leads to biased and erroneous resilience estimates. This is especially true when information about CR is contained in the data the linear model was fitted to, either through inclusion of CR-associated variables or due to correlation. We propose an alternative strategy which overcomes the standard approach’s limitations using machine learning principles. Our proposed approach makes fewer assumptions about the data and CR and achieves better estimation accuracy on simulated ground-truth data.

PMID:39871006 | DOI:10.1186/s40708-024-00249-4

Clin Rheumatol. 2025 Jan 27. doi: 10.1007/s10067-025-07341-y. Online ahead of print.

ABSTRACT

To synthesize available evidence on predictive factors associated with systemic lupus erythematosus (SLE) flares during pregnancy, we systematically searched MEDLINE, Embase, and the Cochrane Library through January 2024 for observational studies on risk and protective factors of SLE flares during pregnancy. Odds ratios (OR) and mean differences (MD), as well as their 95% confidence intervals (CI) were used to quantify effect sizes. We employed fixed-effect or random-effect models based on heterogeneity assessments (I² statistics). Sensitivity analyses were performed using the leave-one-out method, and publication bias was assessed through Egger’s test. Thirty-two studies were included in the meta-analysis. Significant baseline SLE characteristics associated with higher risks for flares during pregnancy were identified: thrombocytopenia (with OR [95%CI], 2.29 [1.14-4.58]), hypocomplementemia (1.70 [1.28-2.27]), anti-dsDNA positivity (1.43 [1.16-1.77]), and a history of lupus nephritis (2.34 [1.70-3.21]). Protective factors included achieving remission before pregnancy (0.32 [0.20-0.49]) and antimalarial use at baseline (0.71 [0.55-0.92]) and during pregnancy (0.44 [0.33-0.58]). Additional risk factors included baseline glucocorticoid usage (1.51 [1.17-1.94]), glucocorticoid administration during pregnancy (3.39 [1.90-6.06]), use of other immunosuppressive drugs at baseline (1.46 [1.00-2.12]), and hypertension (2.16 [1.45-3.23]). Furthermore, individuals in the flare group were younger, had higher baseline disease activity, and lower C3/C4 levels compared to the non-flare group. This study highlighted the critical role of managing SLE disease activity prior to pregnancy to minimize flare risks, and identified significant risk and protective factors associated with flares. These evidences facilitate better clinical management strategies for pregnant women with SLE. Key Points • Synthesizes existing evidence on the risk and protective factors associated with SLE flares during pregnancy. • Highlights the critical importance of effectively managing disease activity prior to conception. • Provides insights to enhance risk stratification and management strategies for pregnancies in patients with SLE.

PMID:39870967 | DOI:10.1007/s10067-025-07341-y

Int J Behav Med. 2025 Jan 27. doi: 10.1007/s12529-025-10348-z. Online ahead of print.

ABSTRACT

BACKGROUND: Irritable bowel syndrome (IBS) has been effectively treated with acupuncture, but the significance of quality of life, depression, and anxiety in the assessment of IBS patients has received little consideration. This study examined the impact of acupuncture on depression, anxiety, and quality of life in IBS patients.

METHOD: PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), EMBASE, China Science and Technology Journal Database (VIP), Chinese Biological Medical (CBM, SinoMed) Database, and the Wan Fang Database were among the electronic databases from which relevant randomized controlled trials (RCTs) were systematically retrieved between their inception and July 2023. The outcomes included adverse events, total response rate, anxiety, and symptoms of depression, as well as quality of life. In this study, the heterogeneity, publication bias, standardized mean difference (SMD), and risk ratios (RR) with 95% confidence intervals (CI) were estimated.

RESULTS: In this study, 29 RCTs including 3114 participants for analysis (treatment group, 1730; control group, 1384) were included. Compared to other therapies, acupuncture significantly improved the quality of life (SMD = 0.61, 95% CI = [0.26, 0.96], P < 0.001) and alleviated anxiety (SMD = – 0.72, 95% CI = [- 1.76, 0.32], P = 0.18) and depression (SMD = – 0.74, 95% CI = [- 1.18, – 0.3], P < 0.001) in IBS patients. A statistically significant improvement was recorded in their quality of life, and they also displayed fewer symptoms of depression. The total response rate (RR = 1.18, 95% CI = [1.12, 1.25], P < 0.001) indicated that acupuncture significantly affected IBS treatment in comparison to other methods. Subgroup analysis of primary outcome indicators revealed that acupuncture demonstrated better results regardless of the duration of intervention and was more effective than Western medicine or sham acupuncture. In addition to the total response rate (I² = 0%), the other three outcome indicators showed significant heterogeneity (I² > 50%). No publication bias was noted in RR (P < 0.05); however, a significant publication bias was observed in quality of life (P > 0.05).

CONCLUSION: Acupuncture can enhance the quality of life and relieve anxiety and depression in patients with IBS with apparent safety; however, a large number of high-quality RCTs are still needed.

PMID:39870963 | DOI:10.1007/s12529-025-10348-z