Tag: pubmed

Front Oral Health. 2025 Apr 25;6:1569940. doi: 10.3389/froh.2025.1569940. eCollection 2025.

ABSTRACT

Oral health is intricately related to systemic health, with new worldwide research demonstrating vitamin D’s critical role in sustaining dental and periodontal health. Vitamin D regulates calcium and phosphate metabolism, which is required for the formation and maintenance of healthy teeth and bones. According to research, vitamin D deficiency may contribute to the etiology of periodontal disease by decreasing the host immune response, making it more susceptible to infections like gingivitis and periodontitis. Oral health in India is a tapestry of traditional practices, socioeconomic factors, lifestyle factors, and access to modern healthcare, all of which are intricately linked with the concept of habitus, which refers to deeply embedded habits, dispositions, and practices shaped by an individual’s social space. Deep-rooted social and cultural influences have a substantial impact on oral hygiene practices, food patterns, and health-seeking behaviours. Oral diseases are considered as a worldwide health issue. Though standard Western medicine has had effectiveness in preventing and treating periodontal diseases and other oral disorders, the hunt for alternative solutions continues, and natural phytochemicals extracted from plants used in traditional medicine are regarded as viable alternatives to synthetic chemicals. India’s traditional medical knowledge and practice, take a comprehensive approach to oral health, emphasizing the balance of physiological components and the use of natural treatments to maintain oral hygiene and treat oral disorders. However, the structural integrity of teeth and optimal oral health can be accomplished by combining Indian traditional medical practices with vitamin D supplementation, which has synergistic attributes for gum health, anti-inflammatory effects, and dental caries prevention. Nevertheless, the unique association of oral health, vitamin D deficiency and the habitus from Indian perspective is extremely underrepresented in academia. To the best of our knowledge, in the aforementioned context, the present narrative review is probably the maiden attempt to discern the crosstalk of oral health and Vitamin D from the perspectives of Indian habitus.

PMID:40351788 | PMC:PMC12062093 | DOI:10.3389/froh.2025.1569940

J Med Signals Sens. 2025 Apr 19;15:11. doi: 10.4103/jmss.jmss_29_24. eCollection 2025.

ABSTRACT

BACKGROUND: The global increase in diabetes prevalence necessitates advanced diagnostic methods. Machine learning has shown promise in disease diagnosis, including diabetes.

MATERIALS AND METHODS: We used a dataset collected from the Medical City Hospital laboratory and the Specialized Center for Endocrinology and Diabetes at Al-Kindy Teaching Hospital in Iraq. This dataset includes 1000 physical examination samples from both male and female patients. The samples are categorized into three classes: diabetic (Y), nondiabetic (N), and predicted diabetic (P). The dataset contains twelve attributes and includes outlier data. Outliers in medical studies can result from unusual disease attributes. Therefore, consulting with a specialist physician to identify and handle these outliers using statistical methods is necessary. The main contribution of this study is the proposal of two hybrid models for diabetes diagnosis in two scenarios: (1) Scenario 1 (presence of outlier data): Hybrid Model 1 combines the K-medoids clustering algorithm with a Gaussian naive Bayes (GNB) classifier based on kernel density estimation (KDE) to handle outliers and (2) Scenario 2 (after removing outlier data): Hybrid Model 2 combines the K-means clustering algorithm with a GNB classifier based on KDE with suitable bandwidth. We performed principal component analysis to minimize dimensionality and evaluated the models using fivefold cross-validation.

RESULTS: All experiments were conducted in identical settings. Our proposed hybrid models demonstrated superior performance in two scenarios, handling and rejecting outliers, compared to other machine-learning models in this study, including support vector machines (with radial-based, polynomial, linear, and sigmoid kernel functions), decision trees (J48), and GNB classifiers for diabetes prediction. The average accuracy for Scenario 1 with Hybrid Model 1 was 0.9743, and for Scenario 2 with Hybrid Model 2, it was 0.9867. We also evaluated precision, sensitivity, and F1-score as performance metrics.

CONCLUSION: This study presents two hybrid models for diabetes diagnosis, demonstrating high accuracy in distinguishing between diabetic and nondiabetic patients and effectively handling outliers. The findings highlight the potential of machine-learning techniques for improving the early diagnosis and treatment of diabetes.

PMID:40351779 | PMC:PMC12063970 | DOI:10.4103/jmss.jmss_29_24

Adv Med Educ Pract. 2025 May 5;16:729-748. doi: 10.2147/AMEP.S491271. eCollection 2025.

ABSTRACT

PURPOSE: Metabolic dysfunction-associated steatotic liver disease (MASLD) and its inflammatory subtype, metabolic dysfunction-associated steatohepatitis (MASH), are associated with cardiometabolic risk factors, including obesity and type 2 diabetes. The prevalence of both conditions is rising rapidly and is underdiagnosed (<5%). We aimed to gather qualitative and quantitative insights from program leaders in US medical education training on their experience with MASH-related training and education.

PARTICIPANTS AND METHODS: A cross-sectional study consisting of a quantitative survey and qualitative discussions with individuals in primary care (internal medicine and family medicine) and specialty programs (hepatology, gastroenterology, and endocrinology) were held from February 21 to August 28, 2023. Descriptive statistics were used for data analysis.

RESULTS: A total of 190 leaders participated in the online survey and 11 leaders joined the focus groups. Almost all respondents reported that MASLD (96%) and MASH (92%) were included in their program’s curricula. However, many believed that little time was devoted to discussing MASH in their program. Most respondents agreed that MASH is extremely underdiagnosed. Program leaders agreed that the interconnectedness of MASH with other cardiometabolic conditions necessitates instruction time on MASH beyond that of its dedicated curriculum time. All participants believed that emergence of regulatory-approved drugs for MASH will drive a decision to increase the time allotted for MASH in the curriculum.

CONCLUSION: Although program leaders agreed that MASH has an important place in medical education curricula, the relative paucity of treatment options reduces its coverage in training, thereby limiting healthcare practitioners’ understanding of MASH.

PMID:40351776 | PMC:PMC12063625 | DOI:10.2147/AMEP.S491271

Front Vet Sci. 2025 Apr 25;12:1486786. doi: 10.3389/fvets.2025.1486786. eCollection 2025.

ABSTRACT

Transitional cell carcinoma (TCC) is the most prevalent cancer of the urinary tract in dogs. The prognosis is often poor, and the optimal standard treatment has not been established. The objectives of this study were to (1) describe the clinical outcomes of dogs with TCC, and (2) determine the potential effects of tumor locations and treatment modalities on the survival times of patients. Electronic records of client-owned dogs with TCC treated with different modalities in a large veterinary hospital in Hong Kong (2005-2024) were evaluated. Of 84 confirmed cases included in the study, 49 (58.3%) died or were euthanized due to TCC. Tumors were located in the bladder neck or trigone region (41), apex (26), prostate (10), and urethra (7). Metastases were detected in 10 patients (12%) at diagnosis, including 4 peripheral lymph nodes, 4 lungs, and 2 in the lumbar spine. Of 84 cases, 4 (4.8%) did not receive any treatments, 14 (16.7%) underwent surgery, 25 (29.7%) received metronomic chemotherapy with chlorambucil with/without methotrexate, 27 (32.1%) received COX-2 inhibitors alone, and 14 (16.7%) received conventional chemotherapy, of which, 5 were later switched to metronomic chemotherapy. The overall median survival time was 233 days. There was no statistically significant difference in patients’ survival between tumor locations (p > 0.05), aside from tumors involving the prostate that had the shortest MST (88 days). Metronomic chemotherapy led to a significantly longer survival time (median of 303 days) than the other treatment groups (p < 0.05), with the lowest incidence of adverse events. Metronomic chemotherapy using chlorambucil was well-tolerated and can be considered as a single modality treatment or as adjunctive therapy to conventional chemotherapy in dogs with TCC.

PMID:40351774 | PMC:PMC12063355 | DOI:10.3389/fvets.2025.1486786

Front Vet Sci. 2025 Apr 25;12:1527167. doi: 10.3389/fvets.2025.1527167. eCollection 2025.

ABSTRACT

BACKGROUND: Although metastasis-associated protein 1 (MTA1) is known to play a role in cancer invasion and metastasis of various cancers, the clinical significance of its expression in canine urothelial carcinoma (UC) has not been explored. We sought to evaluate the expression of MTA1, cyclooxygenase 2 (COX2) and E-cadherin (E-cad) in association with clinicopathological parameters in clinical samples of canine UC.

METHODS: We retrospectively analyzed UC tissues from 28 canine patients using immunohistochemistry for Ki67, CD31, MTA1, COX2, and E-cad staining. Statistical significance for marker staining intensities was evaluated by ANOVA or Student’s t-test. The correlation between molecular markers in canine UC samples detected by IHC and clinicopathological features was calculated by the Wilcoxon (Mann-Whitney) and Kruskal-Wallis tests. Western blot analysis was performed for detection of EMT markers in canine cell lines.

RESULTS: We show that MTA1 and COX2 are overexpressed in canine UC samples compared to normal canine bladder samples, whereas E-cad levels are higher in normal bladder. The results demonstrated that MTA1 expression correlated with aggressive clinicopathological features such as high tumor-grade, muscular/vascular invasion, and metastasis. The expression of MTA1 differed in tumors depending on their localization, with the highest being in the urethra adjoining the prostate. Unexpectedly, higher E-cad levels were detected in metastatic tumor cells compared to primary tumor cells.

CONCLUSION: These findings suggest that MTA1 may represent a key upstream effector tightly associated with COX2 and E-cad-mediated events in canine UC. Accordingly, MTA1 may be considered a feasible interceptive and therapeutic target for canine UC treatment.

PMID:40351767 | PMC:PMC12062746 | DOI:10.3389/fvets.2025.1527167

Patient Prefer Adherence. 2025 May 5;19:1305-1316. doi: 10.2147/PPA.S524090. eCollection 2025.

ABSTRACT

PURPOSE: Insomnia and perceived stress are among the most prevalent health concerns in primary care, yet their complex relationship remains underexplored. This study examines the association between perceived stress and insomnia severity, while considering the potential moderating or mediating effects of lifestyle factors and medication use.

METHODS: A cross-sectional study was conducted with 300 consecutive primary care patients who completed validated questionnaires assessing insomnia severity (Insomnia Severity Index, ISI) and perceived stress (Perceived Stress Scale, PSS). Logistic regression models were employed to identify predictors of clinical insomnia and explore key relationships.

RESULTS: A moderate but statistically significant correlation (r = 0.460, p < 0.001) was observed between perceived stress and insomnia severity. In logistic regression analysis, higher perceived stress scores (OR = 1.134, p < 0.001) and hypnotic medication use (OR = 3.220, p < 0.001) were significant predictors of clinical insomnia. Interestingly, alcohol consumption was unexpectedly associated with insomnia (OR = 0.551, p = 0.048), warranting further exploration. No significant associations were found for caffeine intake, tobacco use, or demographic variables. The model explained 33% of the variance in insomnia (Nagelkerke R² = 0.328).

CONCLUSION: These findings highlight the significant role of perceived stress in insomnia severity and underscore the complex interplay between pharmacological interventions and sleep disturbances. While hypnotic medications are commonly used, their long-term impact and potential dependence require careful consideration. Integrating stress-reduction strategies into primary care may improve insomnia management while reducing reliance on pharmacological treatments. Future research should employ longitudinal designs to clarify causality and further explore additional factors influencing sleep disturbances.

PMID:40351739 | PMC:PMC12063695 | DOI:10.2147/PPA.S524090

J Patient Exp. 2025 May 9;12:23743735251342125. doi: 10.1177/23743735251342125. eCollection 2025.

ABSTRACT

The COVID-19 pandemic influenced dental care behaviors, with increased concern over virus transmission. This study provides insights into Thai patient behaviors and attitudes about dental care during the Omicron wave. A cross-sectional survey was conducted via Google Forms in June 2022, collecting sociodemographic data, attitudes, and behaviors related to dental care during the pandemic. Nine hundred and seventy-eight responses were analyzed using descriptive statistics, the Mann-Whitney U-test, and multiple linear regression. Nearly half of the respondents expressed high to extreme concerns about delayed dental care affecting oral health (49.3%) and the risk of contracting COVID-19 in dental settings (45.7%). Individuals who avoided dental visits increased from 8.1% before the pandemic to 36.3% during the pandemic. However, 59.4% of respondents reported confidence in avoiding COVID-19 when dental workers strictly followed preventive measures. The study highlights concern over delayed dental care and COVID-19 risks, leading to increased avoidance of visits. However, strict preventive measures by dental workers boosted confidence, emphasizing the need for effective infection control to ensure continued access to dental care.

PMID:40351734 | PMC:PMC12065987 | DOI:10.1177/23743735251342125

Semin Arthritis Rheum. 2025 May 4;73:152743. doi: 10.1016/j.semarthrit.2025.152743. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to evaluate standardized incidence ratios (SIRs) of overall malignancies, hematologic malignancies and solid tumors in patients with Sjögren’s disease (SjD) compared to the general population. Furthermore, it sought to identify independent predictors of malignancy and quantify the impact of cancer on mortality.

METHODS: This prospective, multicenter study included 314 patients clinically diagnosed with SjD and fulfilling 2002 American-European Consensus Group criteria, with a median follow-up of 9.5 years. Clinical, demographic, and serological data were collected, along with malignancy incidence and mortality outcomes. SIRs were calculated using GLOBOCAN data. Multivariate Cox regression identified malignancy predictors. The relative risk (RR) of death and the etiologic fraction in exposed individuals (EFE) assessed cancer-related mortality.

RESULTS: A total of 22 malignancies (7.01%) were identified, including 11 hematologic malignancies (50%) and 11 solid tumors (50%). The overall cancer risk was increased (SIR: 1.68, 95% CI: 1.68-1.69), with a substantially higher risk for hematologic malignancies (SIR: 3.55, 95% CI: 3.54-3.56) and a moderate increase for solid tumors (SIR: 1.54, 95% CI: 1.53-1.55). All hematologic malignancies were non-Hodgkin lymphomas (NHL). Independent predictors of malignancy included older age, smoking, lymphadenopathy, splenomegaly, and cryoglobulinemia. Cancer was responsible for 23.8% of deaths (RR: 2.21, EFE: 55%).

CONCLUSIONS: Patients with SjD have an elevated malignancy risk, mainly driven by NHL, while solid tumor risk remains modest. Malignancy was a significant contributor to mortality. These findings underscore the need for better risk stratification and targeted surveillance in high-risk SjD patients for early detection and intervention.

PMID:40349421 | DOI:10.1016/j.semarthrit.2025.152743

Brain Dev. 2025 May 10;47(4):104367. doi: 10.1016/j.braindev.2025.104367. Online ahead of print.

ABSTRACT

BACKGROUND: Fragile X syndrome (FXS) commonly cause developmental delay, intellectual disability, and autism spectrum disorder. Although genetic testing has been available and included in Japan’s national health insurance since 2016, the number of cases diagnosed with FXS remains low. This study aimed to explore the levels of awareness and understanding of FXS among pediatricians managing developmental delay/ intellectual disability in Japan, particularly between pediatrician with and without clinical genetics certification (or clinical experience with FXS).

METHODS: A survey involving 1217 certified pediatric neurologists from the Japanese Society of Pediatric Neurology and 367 members of the Japanese Society of Pediatric Genetics was conducted. Additional participants were recruited from an online mailing list of 1469 pediatric neurologists. The survey comprised questions on demographics, knowledge about FXS, and genetic testing practices. The responses were analyzed using Chi-square and Fisher’s exact tests, and a p-value <0.05 was considered statistically significant.

RESULTS: Out of 386 respondents, 326 had experience ordering some kind of genetic testing, including 78 certified clinical geneticists. Knowledge gaps were significant between clinical geneticists and non-genetic specialists. While 20 % of non-genetic specialists were unaware of insurance-covered FXS genetic testing, this percentage was lower among those with clinical experience in FXS cases. Many respondents, irrespective of certification, struggled to determine the indications for requesting FXS genetic testing. Furthermore, non-genetic specialists reported more difficulty providing genetic counseling owing to the psychological burden on mothers.

CONCLUSION: This study highlights the necessity for expanding education and training on FXS among pediatricians in Japan. Addressing these knowledge gaps may enhance FXS diagnostic rates and improve the management of affected individuals and families. Future efforts should focus on strengthening the collaboration between clinical geneticists and general pediatricians and establishing reliable genetic counseling support systems.

PMID:40349415 | DOI:10.1016/j.braindev.2025.104367

Eur J Radiol. 2025 May 3;188:112160. doi: 10.1016/j.ejrad.2025.112160. Online ahead of print.

ABSTRACT

OBJECTIVES: Optimize deep learning-based vertebrae segmentation in longitudinal CT scans of multiple myeloma patients using structural uncertainty analysis.

MATERIALS & METHODS: Retrospective CT scans from 474 multiple myeloma patients were divided into train (179 patients, 349 scans, 2005-2011) and test cohort (295 patients, 671 scans, 2012-2020). An enhanced segmentation pipeline was developed on the train cohort. It integrated vertebrae segmentation using an open-source deep learning method (Payer’s) with a post-hoc structural uncertainty analysis. This analysis identified inconsistencies, automatically correcting them or flagging uncertain regions for human review. Segmentation quality was assessed through vertebral shape analysis using topology. Metrics included ‘identification rate’, ‘longitudinal vertebral match rate’, ‘success rate’ and ‘series success rate’ and evaluated across age/sex subgroups. Statistical analysis included McNemar and Wilcoxon signed-rank tests, with p < 0.05 indicating significant improvement.

RESULTS: Payer’s method achieved an identification rate of 95.8% and success rate of 86.7%. The proposed pipeline automatically improved these metrics to 98.8% and 96.0%, respectively (p < 0.001). Additionally, 3.6% of scans were marked for human inspection, increasing the success rate from 96.0% to 98.8% (p < 0.001). The vertebral match rate increased from 97.0% to 99.7% (p < 0.001), and the series success rate from 80.0% to 95.4% (p < 0.001). Subgroup analysis showed more consistent performance across age and sex groups.

CONCLUSION: The proposed pipeline significantly outperforms Payer’s method, enhancing segmentation accuracy and reducing longitudinal matching errors while minimizing evaluation workload. Its uncertainty analysis ensures robust performance, making it a valuable tool for longitudinal studies in multiple myeloma.

PMID:40349413 | DOI:10.1016/j.ejrad.2025.112160